Expansion In Children Research Articles

Three Dimensional Skeletal, Dentoalveolar and Airway Space Changes after Slow Maxillary Expansion in Children

The aim of this study was to investigate the effects of slow maxillary expansion (SME) on the dentoalveolar, skeletal, upper airway, and maxillary sinus using cone-beam computed tomography (CBCT). Twenty-three orthodontic patients (mean age 8.93 ± 1.61 years) who were treated with maxillary expansion using banded hyrax in the Department of Pediatric Dentistry at Jeonbuk National University Dental Hospital were included. According to the expansion speed applied, they were divided into two groups: SME (12 subjects, mean age 8.92 ± 1.45 years) and rapid maxillary expansion (RME, 11 subjects, mean age 8.94 ± 1.84 years). CBCT were obtained before (T0) and after (T1) the treatment and were analyzed with InVivo5 software (Anatomage, San Jose, CA, USA). Descriptive statistics showed no significant differences between the two groups in age, sex, or skeletal maturity. There were significant increases in maxillary width at the dentoalveolar and skeletal levels for both groups. Upper airway volume revealed a significant increase of 38.59% in the SME group and 28.72% in the RME group. However, there was no significant difference between SME group and RME group in all measurements. This study suggested the efficacy of SME in growing patients. SME was effective in increasing not only dentoalveolar and skeletal measurements but also airway volume. Therefore, pediatric dentists should select an appropriate expansion method considering the physiological aspects of periodontal tissues and discomfort in growing children.

Morphological Changes of the Epipharynx as a Result of Rapid Maxillary Expansion in Children

Rapid maxillary expansion（RME）is a technique used to treat dental malalignment. Consensus has yet to be reached changes in the epipharyngeal region associated with RME. The objective of this study was to ascertain the morphological changes that occur in the epipharyngeal region as a result of RME. In the present study, a comparative investigation of the pharyngeal tonsils and the epipharyngeal airway on lateral cephalograms scanned before and after RME was therefore performed. Fourteen patients who underwent orthodontic treatment for dental malalignment by RME were included. The mean length of pharyngeal tonsil（A）was 114.65 pixels before RME and 108.64 pixels after RME. The mean value of epipharyngeal space（N）was 210.72 pixels before RME and 233.95 pixels after RME. The mean A/N ratio was 0.547 before RME and 0.466 after RME. The mean pharyngeal tonsil（Pt）area was 16181.14 pixels before RME and 16407.71 pixels after RME. The mean airway（Air）area was 12488.96 pixels before RME and 16040.64 pixels after RME. The mean Pt / Ep（Ep = Pt + Air）area was 0.570 before RME and 0.502 after RME. In this study showed that the A/N and Pt/Ep ratios decreased significantly after RME. The N and Air area values also increased significantly, but there were no significant changes in the A and Pt area values. It was concluded that the decrease in the A/N and Pt/Ep ratios were due to the changes in the N and Air area values.

Discussion of "Does the Mutation Type Affect the Response to Cranial Vault Expansion in Children With Apert Syndrome?"

Raposo-Amaral, Cassio Eduardo MD, PhD*,†; Raposo-Amaral, Cesar Augusto MD*; Ghizoni, Enrico MD, PhD*,† Author Information

Does the Mutation Type Affect the Response to Cranial Vault Expansion in Children With Apert Syndrome?

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Advantages of Interceptive Orthodontic Treatment; Rapid Maxillary Expansion in Children with Malocclusion Resulting from Mouth Breathing Habits

Background: One of the causes of malocclusion in developing children is the practice of mouth breathing. Morphological disturbances may occur during the growth phase in children with chronic mouth breathing. This resulting in the unfavorable development of dentofacial and craniofacial complexes. Mouth breathing in children as a condition has come to the attention of health care professionals. Malocclusion incidence will be decreased and eventually eliminated with the early identification and treatment of these poor oral habits. Purpose: The study determines the benefits of interceptive orthodontics Rapid Maxillary Expansion treatment in children with malocclusion caused by the habit of mouth breathing. Methods: Data were gathered by searching and analyzing literature from electronic databases PubMed, Wiley, and Science Direct in the 2012 and 2022 publication period. Interceptive orthodontics; rapid maxillary expansion; mouth breathing; malocclusion and children keywords were used to conduct the systematic search of the data. Results: One of the most frequent malocclusions is caused by the practice of mouth breathing which narrows the maxillary arch. Some of the characteristic features are decreased distance between nasal cavity’s lateral walls, bilateral or unilateral posterior crossbite, crowding of the anterior teeth, and deep palate.

Changes in the Mandible Following Rapid Maxillary Expansion in Children with Class II Malocclusion: A Systematic Review.

Objective: The aim of this systematic review was to determine whether rapid maxillary expansion (RME) allows favorable changes in the mandible during the treatment of class II malocclusion before the growth spurt. Methods: A search of Pubmed/Medline, the Science Direct, and the Google Scholar database was performed. The keywords used were: orthodontics, rapid maxillary expansion, class II, and growing patients. Relevant articles were assessed for quality according to Cochrane guidelines, and then changes in SNA, SNB, ANB, NL-NSL (or SN-SNP.SNA), and ML-NSL (or SN-Go-Gn) relationships were analyzed. Results: The selection process brought forth five articles, including 162 patients (91 females, 71 males) for detailed analysis. The quality of the evidence (GRADE) for comparisons and outcomes was assessed as moderate for SNB and ANB and as low or very low for other variables. Conclusions: The results of this systematic review showed that there is a small body of moderate-quality evidence for statistically and clinically favorable changes in SNB and ANB angles and a small body of low-quality evidence for changes in vertical parameters after RME.

Condylar Changes after Maxillary Expansion in Children with Cleft Lip and Palate-A Three-Dimensional Retrospective Study.

Background: The presence of posterior crossbite can trigger aesthetic and functional changes as mandibular asymmetry in individuals, contributing to asymmetrical muscle function. Mandibular asymmetry and respective condyle adaptation may be an etiological factor in temporomandibular disorder. This study aims to evaluate the effects of maxillary expansion on the position and angulation of the condyles as well as the intercondylar distance in children with cleft lip and palate. Methods: Twenty-five individuals with cleft lip and palate who underwent maxillary expansion were selected. Condylar changes were evaluated by cone beam computed tomography using the Pullinger and Hollender formula. To determine the statistically significant differences between the variables, the Student t-test and the Benjamini–Hochberg correction method for multiple comparisons were used. Results: No statistically significant differences between angulation and condylar position before and after maxillary expansion were found. The intercondylar distance tended to increase in growing individuals with cleft lip and palate after maxillary expansion. Conclusions: Intercondylar distance shows a tendency to increase after expansion regardless of the cleft phenotype. No differences were found in angulation and condylar position with the changes in occlusion resulting from maxillary expansion.

Effect of Lymphatic Pump on Inflammatory Markers and Chest Expansion in Children with Community-Acquired Pneumonia

Background: Community-acquired pneumonia (CAP) is the most common serious bacterial infectious disease in childhood. It is a leading cause of morbidity and mortality in children younger than the age of 5 years. Pneumonia is an invasion of the lower respiratory tract,that may result in an inflammation, injury or death of the surrounding epithelium and alveoli by a migration of inflammatory cells to the site of infection. Objective: The purpose of this study was to detect the effect of Lymphatic pump as a physical therapy modality on controlling the inflammatory process and improving chest expansion in children complaining of CAP Patients and methods: Thirty inpatient children with diagnosis of CAP ranging in age from 6 to 12 years were selected from El-Abbasia Chest Diseases Hospital. They were randomly assigned into two groups of equal number (control and study groups). Patients in both groups were treated by conventional chest physical therapy program while patients in the study group received an additional intermittent pneumatic compression, sessions were conducted three times per week till discharge. Inflammatory markers and chest expansion were measured before and after the suggested treatment period. Results: show a statistically significant improvement of c-reactive protein (CRP) and chest expansion while insignificant difference of WBCs count, absolute neutrophils, and lactate dehydrogenase (LDH) was recorded. Conclusion: It could be concluded that intermittent Pneumatic compression is an effective physical therapy modality in treating children with community acquired pneumonia.

Oropharyngeal Airway Changes after Rapid Maxillary Expansion in Children with Bilateral left Lip and Palate

Purpose: To assess the effect of rapid palatal expansion (RPE) on the oropharynx in individuals (age range from 9 to 14) with complete bilateral cleft lip and palate (BCLP). Methods: Forty CBCT scans of 20 twenty complete BCLP individuals who had undergone rapid maxillary expansion maxillary before alveolar cleft grafting. Sample was divided into 2 groups according to the type of expander used. Scans were examined before expansion, and 3 months after expansion. Oropharyngeal 3D`volume was measured at both times for each study group. Results: All post scans showed statistically significant increase in volume when compared to the pre scans using ANOVA variance test. However, no difference was detected between both groups. Conclusion: RME increases the volume of the oropharyngeal airway regardless of the type of fixed expander.

Nasal Chamber Changes Following Rapid Maxillary Expansion in Children with Bilateral Cleft Lip and Palate

Purpose: The aim was to study the skeletal effect of rapid palatal expansion (RPE) on the anterior and posterior nasal width in a sample of Egyptian children (age range 9.4-14.3 years, mean 11.16 years) with bilateral cleft lip and palate (BCLP). Methods: Twenty Egyptian children with complete BCLP exhibiting maxillary transverse deficiency were divided randomly into; Group 1 received a fixed fan expander and Group 2 a hyrax expander. Cone-beam computed tomography (CBCT) images were taken before T1 and 3 months after expansion T2, just before the alveolar cleft grafting (ACG) surgical procedure. Linear and angular measurements were assessed to measure the degree of change on the anterior and posterior nasal chamber widths, dentition, and dental arch. Results: Repeated measure ANOVA with a between variable analysis was used to examine the effect of the two expanders on the dental arch and anterior nasal width as well as posterior nasal width. Statistically significant increase in dentoalveolar measurements were found in each group, nasal widths showed no statistically significant differences before and after expansion. Conclusion: increase in nasal width were found to be statistically insignificant following RME.

Change in Nasal Airflow, Associated with the Treatment of Rapid Maxillary Expansion in Children with Maxillary Compression

Maxillary compression malocclusion in horizontal or transverse plane, is in early age, of multifactorial origin, due to the lack of development of the maxilla. It is one of the most common malformations in orthodontics

Rapid maxillary expansion in children with nocturnal enuresis: A randomized placebo-controlled trial.

To investigate whether rapid maxillary expansion (RME) is a useful treatment method for nocturnal enuresis (NE) and whether the treatment effect is due to placebo. The study also aimed to identify prognostic variables in patients responding to treatment. Thirty-eight children with therapy-resistant NE were recruited and randomized into two groups: the intervention group or placebo group. Both groups were treated with RME, but the placebo group received treatment with a sham appliance for 2 weeks before having the actual treatment. A medical history focused on micturition habits, previous treatment, heredity, and sleep disorders was taken. Daytime voided volumes and nocturnal urine production during wet nights were recorded before the intervention. Of the 38 patients recruited, two dropped out as one patient was unable to take dental impressions and one refused to have the appliance fitted. There was a statistically significant reduction of wet nights after the RME treatment (P < .001). No significant reduction was found after the placebo treatment (P < .40). Eleven patients (35%) had their enuresis frequency reduced by >50%. Large voiding volume and a wide maxilla at baseline had a strong association with positive treatment outcome. RME has a modest effect on children with therapy-resistant NE. The treatment outcome does not seem to be due to a placebo effect of the appliance. A wide maxillary width and large voiding volume at baseline seem to be positive predictors regarding response to treatment.

Endoscopic Posterior Cricoid Expansion in Children

Objective: To review our experience with endoscopic posterior cricoid split and costal cartilage graft placement in the management of pediatric bilateral vocal fold immobility (BVFI), posterior glottic stenosis (PGS), and subglottic stenosis (SGS). Method: Multi-institutional retrospective case series of all patients treated with endoscopic posterior cricoid split and costal cartilage graft placement (EPCSCG) by any of the authors. Outcomes measured include: indications, complications, outcome. Results: Twenty-six patients underwent EPCSCG. Age range at time of surgery was 1 month to 15 years. Overall, there was an excellent success rate with 25/26 either never requiring tracheostomy or achieving decannulation and 24/26 having adequate symptom control. The mean follow-up was 23.15 months. Sixteen patients had resolution of their symptoms. Fourteen patients had SGS in isolation or in combination with cricoarytenoid fixation, glottic stenosis or vocal fold immobility. Thirteen achieved decannulation and/or had resolution of preoperative symptoms. Three patients had isolated PGS or cricoarytenoid fixation with 2 achieving decannulation without additional procedures and the third decannulated after revision endoscopic division of a congenital anterior glottic web. Nine patients had isolated BVFI. Two of the 9 had failed prior laryngeal surgeries and 4 did not have tracheostomies at the time of their EPCSCG. Of these 9 patients, 7 had resolution of their airway symptoms without additional procedures. Conclusion: Based on this experience, EPCSCG is worth consideration for the management of select pediatric patients with BVFI, PGS, and SGS.

Long-Term Results in Scalp Tissue Expansion in Children

Tissue expansion is frequently used in scalp repair in children. The short-term complications are well known and described in the literature. Impacts at a distance such as potential deformation of the skull or widening of the scar are not so often presented. The aim of this study is to analyze the results at a distance and the actual impact after scalp tissue expansion in young children. We clinically reviewed 15 children operated on between May 2002 and April 2008 for scalp tissue expansion.Results Mean follow-up was 3 years and 5 months, and mean age of the patients at the first surgery was 20 months. In 11 cases, we observed a widening of the scar. Only two patients presented with a slight flattening of the skull. All parents were satisfied with the results. Children do not remind or keep no unpleasant memory of the surgical protocol. Only rare studies focused on very young children. Most of surgeons fear about the consequences of scalp tissue expansion on cranial bone and thus on cerebral growth in children under the age of 2. But it appears that cranial changes in young children are transient with a return to normal within 6 months after removing the implant. Another common problem is the scar enlargement. According to our results and the review of the literature, it seems essential to perform the suture in two layers associated to local reconstruction on the scar to provide the best cosmetic outcomes. Tissue expansion remains a good technique to repair large lesions of the scalp in children. The deformation of the skull spontaneously resolves and does not have any consequence on brain growth. The widening of the scar is a common problem in children but can be reduced by suture in two layers associated with local reconstruction. Moreover, young children do not keep any unpleasant memory of this period and are not susceptible to social pressure.

Expansion of Children&apos;s Vocabulary by Using Library Weblog Systems

Expansion of Children&apos;s Vocabulary by Using Library Weblog Systems

P89: Tissue Expansion in Children: Nine-Year Experience and Complications in Pediatric Burn Unit

P89: Tissue Expansion in Children: Nine-Year Experience and Complications in Pediatric Burn Unit

Initial Results Regarding Force Exertion during Rapid Maxillary Expansion in Children

We developed a method to measure the forces occurring during rapid maxillary expansion and carried out the University of Ulm rapid maxillary expansion method, similar to that of Chatellier and Chateau, in ten patients. The forces occurring on the maxilla increased up to 120 N. There was considerable variation in force level from patient to patient. After "rupture" of the midpalatal suture, the forces decreased. The remaining forces seemed to be the result from stress on soft tissue and bone.

Rapid maxillary expansion in children with obstructive sleep apnea syndrome.

To evaluate the effect of rapid maxillary expansion on children with nasal breathing and obstructive sleep apnea syndrome. Recruitment of children with maxillary contraction, without of adenoid hypertrophy, with a body mass index < 24 kg/m2, with obstructive sleep apnea syndrome demonstrated by polysomnography, and whose parents signed informed consent. Otolaryngologic and orthognathic-odontologic evaluation with clinical evaluation, anterior rhinometry and nasal fibroscopy, panoramic radiographs, anteroposterior and laterolateral telecephalometry were performed at entry and follow-up. Rapid maxillary expansion (ie, active phase of treatment) was performed for 10 to 20 days; maintenance of device (for consolidation) and orthodontic treatment on teeth lasted 6 to 12 months. 31 children (19 boys), mean age 8.7 years, participated in the study. The mean apnea-hypopnea index was 12.2 events per hour. At the 4-month follow-up, the anterior rhinometry was normal, and all children had an apnea-hypopnea index < 1 event per hour. The mean cross-sectional expansion of the maxilla was 4.32 +/- 0.7 mm. There was a mean increase of the pyriform opening of 1.3 +/- 0.3 mm. Rapid maxillary expansion may be a useful approach in dealing with abnormal breathing during sleep.