Evaluation of the Skeletal and Dental Maxillary Expansion of Cleft Lip and Palate Patients Using Differential Opening Expander with Rapid Protocol and Maxillary Protraction

Authors

1 B.D.S. (2013) Aleppo University

2 Professor and Head of Orthodontic Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt

3 Professor and Head of Oral and Maxillofacial Surgery Department, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt

4 Lecturer of Orthodontics, Faculty of Dental Medicine for Girls, Al-Azhar University, Cairo, Egypt

Abstract

Purpose: This study aimed to describe the maxillary skeletal and dental changes in growing Cleft Lip and Palate (CLP) patients treated with rapid maxillary expansion using an Expander with Differential Opening (EDO) and maxillary protraction. Subjects and Methods: Eight CLP patients, aged from 8 to 12 years old, with maxillary hypoplasia were treated by maxillary expansion using EDO activated according to the RME protocol, followed by 6 months of maxillary protraction. Pre-treatment (T1) and post-treatment (T2) cone beam computed tomography were taken, and superimposition was done to evaluate the treatment outcomes. Results: There was a statistically significant increase in maxillary width and nasal cavity width in both the canine and molar regions, with a greater increase in canine region. There was a statistically significant increase in alveolar crest width and dental arch width in the molar region. The increases in anterior and posterior alveolar width were statistically significant, with more expansion achieved in the canine region. Conclusion: Using EDO in the rapid maxillary expansion protocol improves the maxillary constriction in growing CLP patients. This protocol increases the width of the maxilla, nasal cavity, alveolar crest, anterior and posterior alveolar bone and dental arch. There was better control in achieving more expansion in the intercanine region than molar region which makes the EDO an adequate alternative to traditional dental arch expanders.

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