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THE EDWARD H.  ANGLE  SOCIETY OF  ORTHODONTISTS Midwest Component Annual Meeting Orlando, Florida January 29 th _  February 2 nd 2011
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC MAXILLARY SINUS CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS Valmy Pangrazio-Kulbersh, DDS, MS
CONTRIBUTORS ,[object Object],[object Object],[object Object]
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC AIRWAY CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS ,[object Object]
[object Object],[object Object],[object Object],Haas AJ.  Long term Post treatment Evaluation of Rapid Palatal Expansion.  Angle Orthod.  1980;50:189-217. INTRODUCTION
[object Object],[object Object],[object Object],[object Object],.  INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],HISTORY
[object Object],[object Object],[object Object],[object Object],[object Object],.  .  INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],. INTRODUCTION
. INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],[object Object],[object Object],INTRODUCTION
[object Object],[object Object],[object Object],INTRODUCTION
[object Object],INTRODUCTION
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC AIRWAY CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS ,[object Object]
METHODS AND MATERIALS
[object Object],[object Object],[object Object],[object Object],METHODS AND MATERIALS
[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],METHODS AND MATERIALS
[object Object],METHODS AND MATERIALS
Palatal Maxillary Width (mm) PMW  METHODS AND MATERIALS
Buccal Maxillary Width (mm) BMW  METHODS AND MATERIALS
Palatal CEJ to X (˚) PCEJ-X  METHODS AND MATERIALS
Buccal CEJ to X (˚) BCEJ-X  METHODS AND MATERIALS
Buccal Cusp Tip to X (˚) BCusp-X  METHODS AND MATERIALS
Posterior Nasal Width (mm) PNW  P METHODS AND MATERIALS
Nasal  Floor Width (mm) NFW  METHODS AND MATERIALS
Anterior Nasal Width (mm) NWH/NWL  P NWH NWL METHODS AND MATERIALS
Maxillary Width (mm) MaxW  METHODS AND MATERIALS
Alar Width (mm)  METHODS AND MATERIALS
Maxillary Sinus Volume (mm³) MSV  METHODS AND MATERIALS
METHODS AND MATERIALS Posterior airway Volume (mm³) PAV
[object Object],[object Object],[object Object],METHODS AND MATERIALS
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC AIRWAY CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS ,[object Object]
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 16.369 18.977 2.608 <.001 * within group Bonded 13.78 15.99 2.21 <.001 * within group Sig at start NS 0.398 0.423 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 20.869 23.32 2.451 <.001 * within group Bonded 17.67 19.57 1.9 <.001 * within group Sig at start NS 0.551 0.297 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 24.162 26.8 2.638 <.001 * within group Bonded 20.5 22.35 1.85 <.001 * within group Sig at start * 0.788 0.100 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 26.638 29.838 3.2 <.001 * within group Bonded 22.03 23.81 1.78 <.001 * within group Sig at start * 1.42 0.002 * Interaction effects
RESULTS
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 31.45 33.423 1.973 <.001 * within group Bonded 24.98 26.61 1.63 <.001 * within group Sig at start * 0.343 0.473 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 38.085 41.108 3.023 <.001 * within group Bonded 30.64 32.94 2.3 <.001 * within group Sig at start * 0.723 0.314 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 44.131 47.162 3.031 <.001 * within group Bonded 35.32 37.76 2.44 <.001 * within group Sig at start * 0.591 0.331 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 50.95 55.28 4.33 <.001 * within group Bonded 40.39 43.25 2.86 <.001 * within group Sig at start * 1.47 0.018 Interaction effects
RESULTS
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 25.28 28.36 3.09 <.001 * within group Bonded 25.21 26.9 1.69 <.001 * within group Sig at start NS 1.40 0.003 * Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 41.09 44.30 3.22 <.001 * within group Bonded 40.95 42.31 1.36 <.001 * within group Sig at start NS 1.86 0.001 * Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 37.315 41.31 3.99 <.001 * within group Bonded 37.08 38.1 1.02 <.001 * within group Sig at start NS 2.97 <.001 * Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 58.86 61.45 2.58 <.001 * within group Bonded 47.68 49.66 1.98 <.001 * within group Sig at start * 0.60 0.19 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 27.36 29.65 2.92 <.001 * within group Bonded 21.53 23.18 1.65 <.001 * within group Sig at start * 0.64 0.072 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 23.462 25.62 2.15 <.001 * within group Bonded 18.84 20.86 2.02 <.001 * within group Sig at start * 0.13 0.776 Interaction effects
[object Object],* P≤.05 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 22.80 23.61 0.81 0.14 within group Bonded 22.59 24.03 1.44 0.01 * within group Sig at start NS -0.63 0.37 Interaction effects
[object Object],* P≤.05 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 16.28 17.71 1.43 0.02 * within group Bonded 16.48 17.84 1.36 0.008 * within group Sig at start NS 0.07 0.92 Interaction effects
[object Object],* P≤.05 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 34.72 36.06 1.34 0.006 * within group Bonded 36.00 37.24 1.24 0.048 * within group Sig at start NS 0.10 0.88 Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 21796.4 24352.3 2582.9 <.001 * within group Bonded 27674.8 29412.1 1737.3 <.001 * within group Sig at start NS 845.6 NS Interaction effects
[object Object],* P≤.003 RESULTS T1 T2 T1 to T2 Significance Change over time  Banded 11858.9 19277.9 -7418.6 NS within group Bonded 11518.7 11423.6 95.1 NS within group Sig at start NS 340,2 NS Interaction effects
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC MAXILLARY SINUS CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS ,[object Object]
[object Object],[object Object],[object Object],[object Object],DISCUSSION
[object Object],[object Object],[object Object],[object Object],DISCUSSION
[object Object],[object Object],[object Object],DISCUSSION
Vanarsdall, Herberger TA: rapid palatal expansion:Long term stability and  periodontal implication, unpublished thesis, Philadelphia 1987, university  of Pennsylvania ,[object Object],[object Object],[object Object],[object Object],[object Object]
Showed that thinning of the buccal alveolar bone and increase in width of the lingual alveolar was more prominent with the Hass type of expander vs. the hyrax type. Daniela  Gamba  Gaig,  Jose fernando castanha Henriques, Guillerme janson,  Marco  roberto  Freitas, Adriano Yacubian  Fernandez.  Periodontal  effects  of  rapid  maxillary  expansion  with  tooth  tissue borne appliance and tooth borne  expanders a computed tomography evaluation. Am J Orthod dentofacial orthop  2006;129:749-758
Daniela Gamba Gaig,  Jose  fernando  castanha Henriques,  Guillerme janson,  Marco  roberto  Freitas, Adriano  Yacubian  fernandez.  Periodontal  effects  of  rapid  maxillary  expansion  with  tooth  tissue borne appliance and tooth borne  expanders a computed tomography evaluation. Am J Orthod dentofacial orthop  2006;129:749-758 ,[object Object],[object Object],[object Object],[object Object],[object Object]
DISCUSSION
[object Object],[object Object],[object Object],DISCUSSION
[object Object],DISCUSSION
[object Object],[object Object],[object Object],DISCUSSION
[object Object],[object Object],[object Object],DISCUSSION
[object Object],DISCUSSION
[object Object],[object Object],[object Object],[object Object],DISCUSSION
[object Object],DISCUSSION
CBCT EVALUATION OF SKELETAL, DENTAL, AND VOLUMETRIC AIRWAY CHANGES ASSOCIATED WITH TWO TYPES OF MAXILLARY EXPANDERS ,[object Object]
[object Object],[object Object],[object Object],CONCLUSIONS
WHERE DO WE GO FROM HERE?
INITIAL 14 años 2 meses  CVM 4
 
 
1/9/07 EXPANSION COMPLETED 1 vuelta por día durante 1 mes 15 días  Expansion obtenida 12mm
10/2/07 (5 MONTHS OF PROTRACTION) Periodo de retención  5 meses
 
 
3/18/08 Tiempo de tratamiento 22 meses
 
Sean meadows 4/15/08
 
Un mes de posisionador  y ajuste oclusal
 
 
WORKS CITED
WORKS CITED
 
 

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