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A long-term evaluation of the mandibular Schwarz appliance and the acrylic splint expander in early mixed dentition patients.

Abstract

INTRODUCTION

The aim of this prospective longitudinal clinical study was to evaluate the short-term and long-term changes in dental-arch dimensions in patients treated with either an acrylic splint rapid maxillary expander alone (RME-only) or a rapid maxillary expander combined with a mandibular removable Schwarz plate (RME-Sz) in the early mixed dentition, followed later by fixed appliances in the permanent dentition.

METHODS

The dental casts of 27 RME-only patients were compared with those of 23 RME-Sz patients and 16 untreated controls (CTRL) with constricted maxillary arches at 4 times: pretreatment (T1), after expansion but before fixed appliance therapy (T2), after fixed appliance therapy (T3), and at long-term observation (T4). The mean ages for the treated groups were approximately 9 years at T1, 12 years at T2, 14 years at T3, and 20 years at T4. Arch width, arch depth, arch perimeter, and molar angulation were assessed in all subjects at all observation times. T1-T2, T2-T3, T3-T4, and T1-T4 changes were compared statistically in the treated groups with respect to the CTRL.

RESULTS

Treatment with an RME-only or an RME-Sz followed by fixed appliances produced significant short-term and long-term increases in maxillary arch widths compared with the CTRL. The RME-Sz led to significantly more favorable results than the RME-only protocol: (1) significantly greater increases in the transverse width of the mandibular arch and mandibular arch perimeter in the long term, and (2) uprighting of the mandibular posterior teeth buccally, thus allowing for an amount of maxillary expansion that was clinically effective for the correction of moderate tooth size-arch size discrepancies. In the overall observation interval, the significant increases in maxillary and mandibular arch perimeters in the RME-Sz group were 3.8 and 3.7 mm, respectively, when compared with the CTRL. The RME-only protocol produced modest long-term increases in maxillary arch perimeter (2.6 mm); the average long-term increase in mandibular arch perimeter (2.0 mm) in the RME-only group was not statistically significant.

CONCLUSIONS

The RME-Sz led to significantly more favorable results than the RME-only protocol.

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  • Authors+Show Affiliations

    ,

    Graduate Orthodontic Program, University of Michigan, Ann Arbor, Mich 48109-1078, USA.

    , ,

    Source

    MeSH

    Analysis of Variance
    Cephalometry
    Child
    Dental Arch
    Dentition, Mixed
    Female
    Humans
    Male
    Malocclusion
    Mandible
    Orthodontic Appliances
    Orthodontic Appliances, Removable
    Orthodontics, Corrective
    Palatal Expansion Technique
    Prospective Studies
    Statistics, Nonparametric
    Treatment Outcome

    Pub Type(s)

    Controlled Clinical Trial
    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    16905065

    Citation

    O'Grady, Paul W., et al. "A Long-term Evaluation of the Mandibular Schwarz Appliance and the Acrylic Splint Expander in Early Mixed Dentition Patients." American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics, vol. 130, no. 2, 2006, pp. 202-13.
    O'Grady PW, McNamara JA, Baccetti T, et al. A long-term evaluation of the mandibular Schwarz appliance and the acrylic splint expander in early mixed dentition patients. Am J Orthod Dentofacial Orthop. 2006;130(2):202-13.
    O'Grady, P. W., McNamara, J. A., Baccetti, T., & Franchi, L. (2006). A long-term evaluation of the mandibular Schwarz appliance and the acrylic splint expander in early mixed dentition patients. American Journal of Orthodontics and Dentofacial Orthopedics : Official Publication of the American Association of Orthodontists, Its Constituent Societies, and the American Board of Orthodontics, 130(2), pp. 202-13.
    O'Grady PW, et al. A Long-term Evaluation of the Mandibular Schwarz Appliance and the Acrylic Splint Expander in Early Mixed Dentition Patients. Am J Orthod Dentofacial Orthop. 2006;130(2):202-13. PubMed PMID: 16905065.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - A long-term evaluation of the mandibular Schwarz appliance and the acrylic splint expander in early mixed dentition patients. AU - O'Grady,Paul W, AU - McNamara,James A,Jr AU - Baccetti,Tiziano, AU - Franchi,Lorenzo, PY - 2004/10/08/received PY - 2004/12/08/revised PY - 2004/12/08/accepted PY - 2006/8/15/pubmed PY - 2006/8/22/medline PY - 2006/8/15/entrez SP - 202 EP - 13 JF - American journal of orthodontics and dentofacial orthopedics : official publication of the American Association of Orthodontists, its constituent societies, and the American Board of Orthodontics JO - Am J Orthod Dentofacial Orthop VL - 130 IS - 2 N2 - INTRODUCTION: The aim of this prospective longitudinal clinical study was to evaluate the short-term and long-term changes in dental-arch dimensions in patients treated with either an acrylic splint rapid maxillary expander alone (RME-only) or a rapid maxillary expander combined with a mandibular removable Schwarz plate (RME-Sz) in the early mixed dentition, followed later by fixed appliances in the permanent dentition. METHODS: The dental casts of 27 RME-only patients were compared with those of 23 RME-Sz patients and 16 untreated controls (CTRL) with constricted maxillary arches at 4 times: pretreatment (T1), after expansion but before fixed appliance therapy (T2), after fixed appliance therapy (T3), and at long-term observation (T4). The mean ages for the treated groups were approximately 9 years at T1, 12 years at T2, 14 years at T3, and 20 years at T4. Arch width, arch depth, arch perimeter, and molar angulation were assessed in all subjects at all observation times. T1-T2, T2-T3, T3-T4, and T1-T4 changes were compared statistically in the treated groups with respect to the CTRL. RESULTS: Treatment with an RME-only or an RME-Sz followed by fixed appliances produced significant short-term and long-term increases in maxillary arch widths compared with the CTRL. The RME-Sz led to significantly more favorable results than the RME-only protocol: (1) significantly greater increases in the transverse width of the mandibular arch and mandibular arch perimeter in the long term, and (2) uprighting of the mandibular posterior teeth buccally, thus allowing for an amount of maxillary expansion that was clinically effective for the correction of moderate tooth size-arch size discrepancies. In the overall observation interval, the significant increases in maxillary and mandibular arch perimeters in the RME-Sz group were 3.8 and 3.7 mm, respectively, when compared with the CTRL. The RME-only protocol produced modest long-term increases in maxillary arch perimeter (2.6 mm); the average long-term increase in mandibular arch perimeter (2.0 mm) in the RME-only group was not statistically significant. CONCLUSIONS: The RME-Sz led to significantly more favorable results than the RME-only protocol. SN - 1097-6752 UR - https://www.unboundmedicine.com/medline/citation/16905065/A_long_term_evaluation_of_the_mandibular_Schwarz_appliance_and_the_acrylic_splint_expander_in_early_mixed_dentition_patients_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0889-5406(06)00542-7 DB - PRIME DP - Unbound Medicine ER -