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    Density of the midpalatal suture after RME treatment - a retrospective comparative low-dose CT-study
    (Biomed Central Ltd, 2014) Schauseil, Michael; Ludwig, Bjoern; Zorkun, Berna; Hellak, Andreas; Korbmacher-Steiner, Heike
    Introduction: Rapid maxillary expansion (RME) is a common technique to improve the dental and skeletal transverse width in cases of constricted maxillary arches. Although retention after RME has been widely examined, there is still no clear statement about the minimal retention time in postpubertal patients and many practitioners have retention concepts varying between three and six months. Methods: This retrospective study consisted of 14 patients who were either treated with a Haas-type RME (6 patients) or a Hybrid-RME (8 patients). The average age was 15.8 years (min. 13.5 years, max. 23.0 years). Low-dose CT scans were taken initially before placement of the RME (T0), directly after maximal activation (T1) and (in six cases) also in retention after 6 months (T2). Using a 3D-software (OnDemand3D/Cybermed Inc.) in analogy to the method published by Franchi et al. (AJODO Volume 137/Number 4) all values were measured twice at an interval of 1 month to assess the method error and the intraoperator reliability.Statistical analysis was performed using SPSS 21 for Mac. Possible influences of the RME-type were assessed using the univariate ANOVA. Changes in the sutural density between the different points of time were examined using paired t-tests. Results: The density of the suture decreased significantly after expansion (T0-T1) with both types of RME (p = 0.000). In the retention period there was a significant increase of the sutural density (p = 0.007) although it did not achieve the initial level (p = 0.002). Conclusions: 1. The midpalatal suture was opened in all analysed patients. 2. In postpubertal patients a retention time of six months does not allow sufficient reorganization of the suture. 3. Therefore, a retention period longer than six months seems to be beneficial to prevent relapses in postpubertal patients.
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    Rapid-maxillary-expansion induced rhinological effects: a retrospective multicenter study
    (Springer, 2016) Motro, Melih; Schauseil, Michael; Ludwig, Bjorn; Zorkun, Berna; Mainusch, Saskia; Ates, Mustafa; Kucukkeles, Nazan
    Conventional dental-borne rapid maxillary expansion (RME) leads to a widening of the airways, followed by improved nasal breathing. Although combined skeletal-dental appliances are nowadays being inserted increasingly often and provide a force at the center of resistance in the nasomaxillary complex, no study exists so far that shows whether this treatment may improve the expansionary effect on the airways. In this study, low-dose computed tomography (CT) images from 31 patients (average age 14.63 +/- 0.38 years) were examined retrospectively. Both records (T0 = before expansion and T1 = immediately after maximum expansion) were taken in a time interval of 25 days to avoid growth influence. Five patients were treated with Hyrax RME, 6 patients with Hybrid RME, and 20 patients with acrylic cap RME. The total airway volume increased highly significantly (mean +/- 7272.6 mm 3; P < 0.001, power = 0.998), representing an average airway expansion of + 11.54 % (2.35 %/mm activation). While the nasopharynx and oropharynx showed highly significant expansion (P < 0.000, power = 0.999), the airway at the laryngopharynx did not change significantly (P > 0.779, power = 0.05). Although the patients were significantly older in the Hybrid RME group (P = 0.006), the positive rhinological effects were comparable within all groups of different appliances (P > 0.316). Hybrid RME may, therefore, be an advisable procedure in patients with nasomaxillary impairment and pronounced patient's age.