Cleft palate in children and adolescent: a study of arch expansion.

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Date
2004
Authors
Abu Rub, Najeeb Mohammad (Dr.)
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Abstract
The use of palatal expansion appliances has been claimed to produce a light, continuous force, which is capable of expanding the maxilla and correcting dental arch width of cleft palate patients who have deficient maxilla. The aim of this study is to evaluate the palatal changes and the effects of expansion practice with different arch expansion appliances in patients with cleft palate with or without cleft lip (CP/L) that were treated at the Kelantan Combined Cleft lip & palate and Craniofacial Deformity Clinic (KCCCDC) at different stages of the long-term management and also to compare these changes among upper removable appliance with mid-line screw (URA), quadhelix (QH) and upper fixed appliance (UF A). This is a retrospective record review study involving forty-nine oral clefts patients who underwent palatal expansion at KCCCDC, comprising of 12 patients had used Pre-Surgical Orthopedic Plate (PSOP), 11 patients used URA, 11 patients used QH, 3 patients used Rapid Maxillary Expansion (RME), and 12 patients used (UFA). All these had orthodontic study models taken prior to expansion and at the end of the retention period following expansion. These pre and post treatment study models were analyzed for changes in intertuberosities width, inter-canines width, palatal length, palatal depth, inter-canine arch length, posterior arch length; using fowler-sliding caliper measuring instrument (Fowler Ultra- Gold, USA). By analyzing pre and posttreatment dental casts using SPSS statistical analysis version 11.0, differences in palatal changes in all expansion groups were eĀ·valuated Abstract for statistical significance of the effect of expansion appliances using Two-related sample analysis and Wilcoxon signed ranks test. The correlation between age and palatal changes also tested for all expansion groups using Spearman rank correlation. And comparing the palatal changes and the effect of expansion produced between URA, QH, & UFA were evaluated for statistical significance using Kruskal Wallis test . Results of this study suggest that all expansion appliances are clinically capable of expanding the maxilla. There is a significant increase in maxillary inter-tuberosity width following treatment with maxillary expansion appliances. Age does not have influence in explaining the total amount of expansion in all the appliances except that in RME group, the inter-tuberosity width increase as age increase. And quite opposite; palatal depth in UFA group decreases as the age increase. There is no significant difference in palatal change between URA, QH and UF A expansion appliances, except in inter-tuberosity width; there is significant difference between the groups and more increase in the URA group tlien QH and UFA. In conclusion, this study shows that PSOP, URA, QH, RME and UFA are suitable for arch expansion in all ages of children and adolescent, except that RME produce more lateral expansion in adolescent and UFA produce more shallow palate in children.
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Arch expansion. , Adolescent
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