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Evaluation of dentoskeletal and periodontal effects of diferential rapid maxillary expansion in pacients with bilateral complete cleft lip and palate


The maxillary dental arch of patients with bilateral complete cleft lip and palate is generally constricted showing a transversal deficiency of increasing magnitude from molar to canine regions. Conventional orthopedic maxillary expanders promote equal transverse increments in the anterior and posterior regions (Haas type and Hyrax expanders), or cause expansion exclusively in the anterior region of the dental arch (fan-shaped expanders). Purpose: The objective of this study consists in testing and evaluating the effects of an orthopedic maxillary expander which produces differential amount of expansion in the anterior and posterior regions of the dental arch, in patients with cleft lip and palate. Methodology: The study sample will be composed by 30 patients with bilateral complete cleft lip and palate and maxillary dental arch constriction. Rapid maxillary expansion will be performed in the mixed dentition, using the differential expansion appliance. Cone Beam Computed Tomography scans (i-Cat, Hartsfield, PA, USA) and conventional dental casts will be performed before expansion and 6 months after the expansion, when the appliance is removed. In the CBCT images, the maxillary transverse dimensions, the buccal and lingual bone plate thickness and buccal bone plate crest levels will be measured using Nemoscan software (Nemotec, Madri, Spain). After digitalization of the maxillary dental casts using the 3Shape R700 3D scanner (3Shape A/S, Copenhagen, Denmark), maxillary dental arch transverse dimensions, buccolingual inclination of posterior teeth, dental arch perimeter and palate volume will be measured. Dependent "t" tests will be used for evaluating the changes between phases (p<0.05). (AU)

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DISPOSITIVO EXPANSOR MAXILAR COM ABERTURA DIFERENCIAL PI1101050-9 - Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) ; Universidade de São Paulo (USP) . Daniela Gamba Garib Carreira; Lourival de Castro Garcia; Vagner Pereira - March 2011, 25