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    The influence of orthopedic rapid maxillary expansion on the deviation of the nasal septum
    (Mre Press, 2023) Uzuncibuk, Hande; Marrapodi, Maria Maddalena; Fiorillo, Luca; Meto, Aida; Cicciu, Marco; Minervini, Giuseppe
    Nasal septal deviation (NSD) is one of the most common abnormalities impacting the maxillofacial development of children. Herein, we investigated the impact of orthopedic rapid maxillary expansion (RME) on the nasomaxillary complex and NSD in pediatric patients. The study sample consisted of a total of 40 patients divided into two groups. The experimental group included 26 patients (13 females and 13 males) with skeletal maxillary transversal constriction and NSD greater than 1 mm, while the control group comprised 14 patients (6 females and 8 males) with skeletal maxillary transversal constriction but no NSD. All the patients were treated for approximately 15 days with the tooth-tissue born RME device. The activation procedure was to turn the transversal Hyrax screw a quarter turn, twice a day. After that, the device was left in place for a period of five months to facilitate passive retention. Radiographic analysis was performed on posteroanterior (PA) cephalometric radiographs taken at pre-expansion (T1) and post-expansion (T2). The data were evaluated using the Mann-Whitney U and Wilcoxon Sign tests. The experimental group showed a statistically significant decrease (p < 0.05) in the distance from the axis of symmetry to middle of nasal septum (SNM-mid) and to inferior part of the nasal septum (SNI-mid) measurements, indicating a reduction in NSD. Additionally, both experimental and control groups showed a statistically significant increase (p < 0.05) in maxillofacial measurements, including the distance between the nose length (X-SNM and SNM-SNAC), width of the nasal cavity (Pir L-R), basal maxillary width (Mx L-R), vestibular cuspid of upper first molars (CVM + L-R) and lower first molars (CVM-L-R). Based on the study findings, RME was considered effective in achieving craniofacial improvement in pediatric patients with NSD, which positively impacted their healthy growth and development. The improvement in the nasomaxillary complex was similar between genders.
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    Photographic analysis of orofacial soft tissue alterations related to rapid maxillary expansion in pediatric patients
    (Mre Press, 2023) Uzuncibuk, Hande; Marrapodi, Maria Maddalena; Meto, Aida; Cervino, Gabriele; Cicciu, Marco; Minervini, Giuseppe
    Maxillary transverse deficiency is widely recognized as one of the most common skeletal issues in orthodontics, and rapid maxillary expansion (RME) is commonly employed as a treatment method. This study aimed to investigate the impact of RME on the soft tissues of the orofacial region in pediatric patients. The study included two groups: an experimental group comprising 30 patients (16 females and 14 males) with maxillary skeletal transverse deficiency who required rapid maxillary expansion (RME), and a control group consisting of patients (10 females and 10 males) who did not require RME or orthodontic treatment. Frontal and profile photographs were taken before and after RME for both groups. Frontal photographs were used to obtain 12 linear measurements, while profile photographs were used to perform 2 linear and 2 angular measurements using the protractor and pixel ruler software. Burstone-Legan, Steiner and Rickett's analyses were performed to determine the locations of the upper and lower lips. Student t-test, paired samples t-test and Mann-Whitney U test were used to evaluate the data. In the experimental group, there was a statistically significant increase in nose width and intercommissural distance at the end of the treatment (p < 0.05). Similarly, both the experimental and control groups showed a statistically significant increase in the dorsum of nose length at T2 compared to the initial measurement (p < 0.05). Furthermore, the male participants in the experimental group exhibited a statistically significantly higher increase in nose length and dorsum of the nose during the T1 and T2 periods compared to the female participants in the experimental group (p < 0.05). RME may lead to changes in soft tissues in pediatric patients and was observed to be gender-specific. However, these changes were not clinically noticeable, and long-term follow-up studies are needed to determine the long-term effects of these changes.
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    Prevalence of temporomandibular disorders in clear aligner patients using orthodontic intermaxillary elastics assessed with diagnostic criteria for temporomandibular disorders (DC/TMD) axis II evaluation: A cross-sectional study
    (Wiley, 2024) Uzuncibuk, Hande; Marrapodi, Maria Maddalena; Meto, Aida; Ronsivalle, Vincenzo; Cicciu, Marco; Minervini, Giuseppe
    Background: The objective of this investigation is to assess the relationship between the utilisation of orthodontic intermaxillary elastics and temporomandibular disorder (TMD) symptoms in clear aligner patients and to examine the correlation between the elastic usage time with the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)-Axis II Evaluation Forms.Methods: This study was carried out on a total of 40 clear aligner patients using intermaxillary elastics in the experimental group and 30 clear aligner patients who did not use any intermaxillary elastics in the control group. The data were evaluated using the Mann-Whitney U, chi-square, Fisher's exact chi-square, and Fisher Freeman Halton exact chi-square tests.Results: The characteristic pain intensity, mastication, mobility, communication, global and PHQ-9 scores of the experimental group were significantly higher than those of the control group (p < .05). The characteristic pain intensity score, interference score and chronic pain grade score of patients using Class III elastics were statistically significantly higher than those of patients using Class II elastics (p < .05). Patients who used elastics for less than 6 months had statistically significantly higher PHQ-9 scores than those who used elastics for more than 6 months (p < .05).Conclusions: Orthodontic treatment may affect occlusion, bite force and jaw movement, which may cause or worsen TMD symptoms, and the DC/TMD questionnaires can determine if orthodontic patients acquire TMD by assessing their psychosocial state and pain-related problems.