Comparison of Transversal Effects of Different Expansion Protocols: Alt-RAMEC versus RME
Abstract
Abstract
Objectives
The aim of this study is evaluate the transversal effects of the Alt-RAMEC(Alternate Rapid Maxillary Expansion and Constriction) protocol on both craniofacial and dentoalveolar structures and to compare the transversal effects of the RME(Rapid Maxillary Expansion) protocol.
Materials and Methods
In our archive, selected patients were divided into two groups. Group 1 included 22 patients(12boys,10girls, mean age 11.61±2.11years) who had been treated with 5 weeks of Alt-RAMEC. Group 2 comprised 21 patients(11boys,10girls, mean age 11.66±1.23years) who had been treated with 1 week of RME. Transversal measurements were also performed on the study models pre-(T0) and post-treatment(T1) with digital caliper. Internasal, interzygomatic, interjugular and intergonial width measurements were made on posteroanterior radiographs. The initial measurements and the mean changes within the groups were analysed using a student’s t test.
Results
According to the results of the study, there was no statistically significant difference between the groups in terms of chronological age, gender distribution and initial values. The expansion protocols showed a statistically significant increase in the widths of intercanine, interpremolar, intermolar and alveolar base widths in the maxilla(p<0.05). No statistically significant changes were observed in both groups(p>0.05) in mandible. The changes in maxillary intercanine, interpremolar widths between the two groups were statistically significant(p<0.05). In the posteroanterior measurements, only statistically significant difference was found between the groups in internasal width(p<0.05).
Conclusions
Alt-RAMEC and RME protocols are effective treatment protocols for correction of transverse deficiency in growing patients. 5-weeks Alt-RAMEC protocol significantly increased intercanine and interpremolar widths compared to 1-week RME.
Clinical Relevance
Since there are no studies in the literature comparing the effects of two different expansion protocols in the transverse direction, this is both the first. Most importantly, clinicians will see which of these two protocols is more singular in the treatment of transversal problems.
Keywords: RME, Alt-RAMEC, tranversal measurements
References
Haas AJ. The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod. 1965;35:200-17.
Haas AJ. Rapid palatal expansion: a recommended prerequisite to Class III treatment. Trans Eur Orthod Soc. 1973;311-8.
Tollaro I, Baccetti T, Franchi L, Tanasescu CD. Role of posterior transverse interarch discrepancy in Class II, Division 1 malocclusion during the mixed dentition phase. Am J Orthod Dentofacial Orthop. 1996;110(4):417-22.
Baccetti T, Franchi L, McNamara JA Jr, Tollaro I. Early dentofacial features of Class II malocclusion: a longitudinal study from the deciduous through the mixed dentition. Am J Orthod Dentofacial Orthop. 1997;111(5):502-9.
Lineberger MW, McNamara JA, Baccetti T, Herberger T, Franchi L. Effects of rapid maxillary expansion in hyperdivergent patients. Am J Orthod Dentofacial Orthop. 2012;142(1):60-9.
Kanomi R, Deguchi T, Kakuno E, Takano-Yamamoto T, Roberts WE. CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance. Angle Orthod. 2013;83(5):851-7.
Diouf JS, Ngom PI, Sonko O, Diop-Bâ K, Badiane A, Diagne F. Influence of tonsillar grade on the dental arch measurements. Am J Orthod Dentofacial Orthop. 2015;147(2):214-20.
Liou EJ, Tsai WC. A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate Craniofac J. 2005;42:121-7.
Graber LW, Vanarsdall RL, Vig KW. Orthodontics: current principles and techniques. 5th Ed. St Louis: Elsevier Health Sciences; 2012.
Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics. 5th Ed. St Louis: Elsevier Health Sciences; 2014.
Ngan P. Deguchi T. Roberts E.W. Orthodontic treatment of Class III malocclusion. Bentham Science Publisher Ltd, Sharjah, UAE, 2014.
Haas AJ. Long-term post-treatment evaluation of rapid palatal ex¬pansion. Angle Orthod. 1980;50:189-217.
Buyukcavus MH. Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) protocol: A Comprehensive Literature Review. Turk J Orthod. 2019,32(1):47-52.
Isci D, Turk T, Elekdag-Turk S. Activation-deactivation rapid palatal expansion and reverse headgear in Class III cases. Eur J Orthod. 2010;32:706–15.
Liou EJ. Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis. Prog Orthod. 2005;6:154–171.
da Luz Vieira G, de Menezes LM, de Lima EM, Rizzatto S. Dentoskeletal effects of maxillary protraction in cleft patients with repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate Craniofac J. 2009;46(4):391-8.
Do-de Latour TB, Ngan P, Martin CA, Razmus T, Gunel, E. Effect of alternate maxillary expansion and contraction on protraction of the maxilla: A pilot study. Hong Kong Dent J. 2009;6:72-82.
Masucci C, Franchi L, Giuntini V, Defraia E. Short-term effects of a modified Alt- RAMEC protocol for early treatment of Class III malocclusion: a controlled study. Orthod Craniofac Res. 2014;17:259-69.
Liu W, Zhou Y, Wang X, Liu D, Zhou S. Effect of maxillary protraction with alternating rapid palatal expansion and constriction vs expansion alone in maxillary retrusive patients: a single-center, randomized controlled trial. Am J Orthod Dentofacial Orthop. 2015;148(4):641-51.
Pithon MM, Santos NL, Santos CR, Baião FS, Pinheiro MC, Matos M, et al. Is alternate rapid maxillary expansion and constriction an effective protocol in the treatment of Class III malocclusion? A systematic review. Dental Press J Orthod. 2016;21:34–42.
Yilmaz BS, Kucukkeles N. Skeletal, soft tissue, and airway changes following the alternate maxillary expansions and constrictions protocol. Angle Orthod. 2014;85(1): 117-126.
Houston WJ. The analysis of errors in orthodontic measurements. Am J Orthod. 1983;83(5):382-90.
Lemos Rinaldi MR, Azeredo F, Martinelli de Lima E, Deon Rizzatto SM, Sameshima G, Macedo de Menezes L. Cone-beam computed tomography evaluation of bone plate and root length after maxillary expansion using tooth-borne and tooth-tissueborne banded expanders. Am J Orthod Dentofacial Orthop. 2018;154(4):504-516.
Celikoglu M, Buyukcavus MH. Changes in pharyngeal airway dimensions and hyoid bone position after maxillary protraction with different alternate rapid maxillary expansion and construction protocols: A prospective clinical study. Angle Orthod. 2017;87(4):519-525.
Fischer B, Masucci C, Ruellas A, Cevidanes L, Giuntini V, Nieri M, et al. Threedimensional evaluation of the maxillary effects of two orthopaedic protocols for the treatment of Class III malocclusion: A prospective study. Orthod Craniofac Res. 2018;21(4):248-257.
Baratieri Cda L, Alves M Jr, Mattos CT, Lau GW, Nojima LI, de Souza MM. Transverse effects on the nasomaxillary complex one year after rapid maxillary expansion as the only intervention: a controlled study. Dental Press J Orthod. 2014;19(5):79-87.
Papadopoulos MA. Meta-analyses and orthodontic evidence-based clinical practice in the 21st century. Open Dent J. 2010;4:92-123.
The Creative Commons Attribution License cc-by-nc-nd formalizes these and other terms and conditions of publishing articles.
Copyright on any open access article in a SEJODR journal published by Dentitio d.o.o. is retained by the author(s).
Authors grant Dentitio d.o.o. a license to publish the article and identify itself as the original publisher.
Authors also grant any third party the right to use the article freely as long as its integrity is maintained and its original authors, citation details and publisher are identified.
The Creative Commons Attribution License cc-by-nc-nd formalizes these and other terms and conditions of publishing articles.