The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate
PDF

Keywords

Maxillary expansion
Cleft Lip and Palate

Categories

How to Cite

1.
Dahoue RT, Halimi A, Dohou MAG, Elhaddaoui R, Zaoui F. The Effectiveness of Maxillary Expansion in Wearers of Cleft Lip and Palate. Integr J Med Sci [Internet]. 2021 Mar. 1 [cited 2024 May 21];8. Available from: https://mbmj.org/index.php/ijms/article/view/432

Abstract

Introduction: Cleft Lip and Palate (CLAP) is one of the most frequent craniofacial anomalies. The management of patients with CLAP requires several repair procedures for the soft palate, the primary and secondary bony palate, the alveolar ridge, the lips and the nose. These patients often present with a maxillary transverse deficit responsible for maxillary endognathy which must be corrected for a harmonious development of the maxillomandibular complex. The objective of our work was to evaluate the efficacy of slow, rapid and surgical maxillary expansion in patients with sequelae of CLAP following a systematic review protocol.
Materials and methods: Four databases were searched: PubMed / MEDLINE, ScienceDirect, Cochrane Library and EBSCOhost, using the keywords present in the MeSH according to the equation [Maxillary expansion] AND [Cleft lip and palate]. The selection of articles included all studies published since January 2010 and for which the full text is available, such as meta-analyzes, randomized and non-randomized controlled clinical trials, case-control studies and prospective and retrospective studies.
Results: Among 1107 references only 8 studies met our inclusion criteria. Following analysis of these, we concluded that there is no significant difference between rapid maxillary expansion and slow maxillary expansion in patients with unilateral CLAP, the expansion observed on the side of the cleft is larger than that seen on the healthy side. Surgically assisted expansion is much more reserved for subjects at the end of growth, having unilateral or bilateral CLAP and presenting anterior or posterior lateral crossbones. The results of our systematic review also showed that maxillary expansion in patients with CLAP results in substantial dentoalveolar compensation.
Conclusion: The efficacy of maxillary expansion in patients with sequelae of CLAP is real and alone in some cases allows the restoration of a normal transverse dimension; sometimes in combination with maxillary protraction to correct the anteroposterior deficit.

https://doi.org/10.15342/ijms.2021.432
PDF

References

Figueiredo DS, Bartolomeo FU, Romualdo CR, Palomo JM, Horta MC, Andrade I Jr, et al. Dentoskeletal effects of 3 maxillary expanders in patients with clefts lip and palate: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop. 2014 Jul;146(1):73-81. https://doi.org/10.1016/j.ajodo.2014.04.013

Façanha AJO, Lara TS, Garib DG, da Silva Filho OG. Transverse effect of Haas and Hyrax appliances on upper dental arch in patients with unilateral complete cleft lip and palate: a comparative study. Dental Press J Orthod. Mar-Apr 2014;19 (2):39-45. https://doi.org/10.1590/2176-9451.19.2.039-045.oar

Carpentier S, Van Gastel J, Schoenaers J, Carels C, Van der Poorten V, Coucke W, et al. Evaluation of Transverse Maxillary Expansion After a Segmental Posterior Subapical Maxillary Osteotomy in Cleft Lip and Palate Patients With Severe Collapse of the Collapse of the Lateral Maxillary Segments. Cleft Palate Craniofac J. 2014 Nov;51(6):651-7. https://doi.org/10.1597/113-232

De Medeiros Alves AC, Garib DG, Janson G, de Almeida AM, Calil LR. Analysis of dentoalveolar effects of slow and rapid maxillary expansion in patients with bilateral complete cleft lip and palate: a randomized clinical trial. Clin Oral Investig. 2016 Sep;20(7):1837-47. https://doi.org/10.1007/s00784-015-1675-1

Garib D, Lauris RC, Calil LR, Alves AC, Janson G, De Almeida AM. Dentoskeletal outcome of a rapid maxillary expander with differential opening in patients with bilateral cleft lip and palate: A prospective clinical trial. Am J Orthod Dentofacial Orthop. 2016 Oct;150(4):564-574. https://doi.org/10.1016/j.ajodo.2016.05.006

Ayub PV, Janson G, Gribel FB, LaraTulio S, Gamba GB. Analysis of maxillary dental arch after rapid maxillary expansion in patients with unilateral cleft lip and palate. Am J Orthod Dentofacial Orthop. 2016 May;149(5):705-15. https://doi.org/10.1016/j.ajodo.2015.11.022

De ALMEIDA AM, Ozawa TO, Alves ACM, Janson G, Lauris JRP, Loshida MSY, et al. Slow versus rapid maxillary expansion in patients with bilateral cleft lip and palate: a CBCT randomized clinical trial. Clin Oral Investig. 2017. Jun;21(5):1789-1799. https://doi.org/10.1007/s00784-016-1943-8

Pugliese F, Palomo JM, Calil LR, de Medeiros Alves A, Lauris JRP, Garib D. Dental arch size and shape after maxillary expansion in bilateral complete cleft lip and palate: A comparison of three expander designs. Angle Orthod. 2020 Mar;90(2):233-238. https://doi.org/10.2319/020219-74.1

Vasant MR, Menon S, Kannan S. Maxillary Expansion in Cleft Lip and Palate using Quad’ Helix and Rapid Palatal Expansion Screw. Med J Armed Forces India. 2009 Apr;65(2):150-3. https://doi.org/10.1016/s0377-1237(09)80130-5

Lee H, Nguyen A, Hong C, Hoang P, Pham J, Ting K. Biomechanical effects of maxillary expansion on a patient with cleft palate: A finite element analysis. Am J Orthod Dentofacial Orthop. 2016 Aug;150(2):313-23. https://doi.org/10.1016/j.ajodo.2015.12.029

Gregorio L, de Medeiros A, de Almeida AM, Nevada R, Janson G. Garib Daniela: Cephalometric evaluation of rapid and slow maxillary expansion in patient with bilateral cleft lip and palate. Angle Orthod. 2019 Jul;89(4):583-589. https://doi.org/10.2319/081018-589.1

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Copyright (c) 2021 Dahoue RT et al.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...