Immediate effects of rapid maxillary expansion on the naso-maxillary facial soft tissue using 3D stereophotogrammetry

Abstract Background Rapid maxillary expansion (RME) is used to expand the narrow maxilla. Dental and skeletal affects have previously been reported but few studies have reported on the overlying soft tissue changes. This study reports on the immediate effects of RME on the naso-maxillary facial soft...

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Bibliographic Details
Published in:	The surgeon (Edinburgh) Vol. 14; no. 2; pp. 63 - 68
Main Authors:	Altorkat, Y, Khambay, B.S, McDonald, J.P, Cross, D.L, Brocklebank, L.M, Ju, X
Format:	Journal Article
Language:	English
Published:	Scotland Elsevier Ltd 01-04-2016
Subjects:	3D imaging Child Cone-Beam Computed Tomography Facial Female Follow-Up Studies Humans Imaging, Three-Dimensional Male Maxilla Nasal Bone Palatal Expansion Technique Palate Photogrammetry - methods Rapid maxillary expansion Rapid palatal expansion Retrospective Studies Soft tissue Stereophotogrammetry Surgery Rapid maxillary expansion Soft tissue Rapid palatal expansion 3D imaging Facial Stereophotogrammetry
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Summary:	Abstract Background Rapid maxillary expansion (RME) is used to expand the narrow maxilla. Dental and skeletal affects have previously been reported but few studies have reported on the overlying soft tissue changes. This study reports on the immediate effects of RME on the naso-maxillary facial soft tissue using 3D stereophotogrammetry. Methods Fourteen patients requiring upper arch expansion using RME as part of their full comprehensive orthodontic plan were recruited. Cone beam CT scans and stereophotogrammetry images were taken for each patient; pre-RME activation (T0 ) and immediately post-RME expansion (T1 ). Based on twenty-three landmarks, 13 linear and 3 angular measurements were made from each of the stereophotogrammetry images. A linear measurement at ANS was taken from each CBCT image. Using a Wilcoxon signed rank test, the pre-RME and post-RME measurements were compared. Results The mean separation of the anterior nasal spine was 3.8 mm ± 1.2 mm. The largest median increase was in nasal base width (1.6 mm), which was statistically significant ( p = 0.001). Changes in the nasal dorsum height, nasal tip protrusion, philtrum width, and upper lip length were not statistically significant ( p < 0.05). No significant differences were observed in the nostril linear measurements, expect for columella width ( p = 0.009). Naso-labial angle decreased but was not statistically significant ( p = 0.276). The only statically significant angular change was an increase in the nasal tip displacement angle ( p = 0.001). Conclusion Rapid maxillary expansion produces subtle changes in the naso-maxillary soft tissue complex. There is an increase in nasal base width, retraction and flattening of the nasal tip. These changes are small, less than 2 mm and variable between patients.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	1479-666X 2405-5840
DOI:	10.1016/j.surge.2014.04.005