TOOTH-BORNE VS BONE-BORNE RAPID MAXILLARY EXPANDERS USING CBCT IMAGES: A NARRATIVE REVIEW
Main Article Content
Keywords
MARPE-type devices have a greater skeletal effect to dental-supported devices, and fewer dental-alveolar side effects, however, these effects depend on the skeletal age of the individual, the design and the placement site.
Abstract
CONTEXT: In the stomatognathic system, there are alterations at the transverse level of the upper jaw which can be treated with expansion devices with dental and skeletal anchorage, these have advantages or disadvantages according to their design and skeletal age.
OBJECTIVE: This narrative review analyzes the scientific literature on the effects of dental-supported and skeletal rapid maxillary expansion with the use of cone beam computed tomography (CBCT).
MATERIALS AND METHODS: An exhaustive search of digital databases was carried out to find relevant publications. Information was searched in English, Spanish and Portuguese. The search was performed in Pubmed, Springerlink, Google Academic, and Scielo. Articles such as editorials, literature reviews, letters to the editor, experimental animal studies and short communications were excluded. Studies such as case controls, systematic reviews, clinical cases, and meta-analyses were included.
RESULTS: Initially, 239 articles were identified and reviewed for relevance. One hundred ninety-nine studies were excluded as they did not meet the eligibility criteria. Forty-one studies were included, among them, 8 systematic reviews from which 2 were extracted data of major relevance, 1 prospective study, 19 clinical trials, 1 case report, 1 finite element study, 1 descriptive study, 1 pilot study, 9 retrospective studies were processed for data extraction.
CONCLUSIONS: MARPE-type devices have a greater skeletal effect to dental-supported devices, and fewer dental-alveolar side effects, however, these effects depend on the skeletal age of the individual, the design and the placement site.
References
1. Pham V, Lagravère MO. Alveolar bone level changes in maxillary expansion treatments assessed through CBCT. Int Orthod. 2017 Mar;15(1):103–13.
2. Baysal A, Uysal T, Veli I, Ozer T, Karadede I, Hekimoglu S. Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography. Korean J Orthod. 2013 Apr;43(2):83–95.
4. Lione R, Franchi L, Cozza P. Does rapid maxillary expansion induce adverse effects in growing subjects? Angle Orthod. 2013 Jan;83(1):172–82.
5. Copello FM, Marañón-Vásquez GA, Brunetto DP, Caldas LD, Masterson D, Maia LC, et al. Is the buccal alveolar bone less affected by mini-implant assisted rapid palatal expansion than by conventional rapid palatal expansion?-A systematic review and meta-analysis. Orthod Craniofac Res. 2020 Aug;23(3):237–49.
6. An JS, Seo BY, Ahn SJ. Differences in dentoskeletal and soft tissue changes due to rapid maxillary expansion using a tooth-borne expander between adolescents and adults: A retrospective observational study. Korean J Orthod. 2022 Mar 25;52(2):131–41.
7. Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. Korean J Orthod. 2017 Sep;47(5):313–22.
8. Gunyuz Toklu M, Germec-Cakan D, Tozlu M. Periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion appliances. Am J Orthod Dentofacial Orthop. 2015 Jul;148(1):97–109.
9. Lee KJ, Park YC, Park JY, Hwang WS. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):830–9.
10. Chun JH, de Castro ACR, Oh S, Kim KH, Choi SH, Nojima LI, et al. Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT. BMC Oral Health. 2022 Apr 8;22(1):114.
11. Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod. 2016 Sep;86(5):713–20.
12. Angelieri F, Cevidanes LHS, Franchi L, Gonçalves JR, Benavides E, McNamara JA Jr. Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):759–69.
13. Vidalón JA, Loú-Gómez I, Quiñe A, Diaz KT, Liñan Duran C, Lagravère MO. Periodontal effects of maxillary expansion in adults using non-surgical expanders with skeletal anchorage vs. surgically assisted maxillary expansion: a systematic review. Head Face Med. 2021 Nov 10;17(1):1–12.
14. Chung M, Lyu ZZ, Zhu BK, Wang XJ, Qu RY, Jiang LY. [Effects of mid-palatal suture opening and midfacial bony structure changes induced by maxillary skeletal expansion in adults]. Shanghai Kou Qiang Yi Xue [Internet]. 2021 Jun [cited 2022 Aug 1];30(3). Available from: https://pubmed.ncbi.nlm.nih.gov/34476453/
15. Tang H, Liu P, Liu X, Hou Y, Chen W, Zhang L, et al. Skeletal width changes after mini-implant-assisted rapid maxillary expansion (MARME) in young adults. Angle Orthod. 2021 May 1;91(3):301–6.
16. Coloccia G, Inchingolo AD, Inchingolo AM, Malcangi G, Montenegro V, Patano A, et al. Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature. Medicina [Internet]. 2021 Mar [cited 2022 Apr 22];57(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003431/
17. Sawchuk D, Currie K, Vich ML, Palomo JM, Flores-Mir C. Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review. Korean J Orthod. 2016 Sep;46(5):331–42.
18. Jia H, Zhuang L, Zhang N, Bian Y, Li S. Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:: A prospective cone beam computed tomography study. Angle Orthod. 2021 Jan;91(1):36.
19. Celenk-Koca T, Erdinc AE, Hazar S, Harris L, English JD, Akyalcin S. Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial. Angle Orthod. 2018 Nov;88(6):702–9.
20. Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, et al. Long-term effects of mini-screw–assisted rapid palatal expansion on airway:A three-dimensional cone-beam computed tomography study. Angle Orthod. 2020 Dec 14;91(2):195–205.
21. Kavand G, Lagravère M, Kula K, Stewart K, Ghoneima A. Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion. Angle Orthod. 2019 Feb 15;89(4):566–74.
22. Lagravère MO, Ling CP, Woo J, Harzer W, Major PW, Carey JP. Transverse, vertical, and anterior-posterior changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion 6 months post-expansion: A CBCT randomized controlled clinical trial. Int Orthod [Internet]. 2020 Jun [cited 2022 Apr 29];18(2). Available from:
https://pubmed.ncbi.nlm.nih.gov/32057733/
23. Kamran D, Talma E, Harzer W, M. L. Long term skeletal and dental changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents: Randomized clinical trial. Int Orthod. 2020 Jun 1;18(2):317–29.
24. Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015 Mar;85(2):253–62.
25. Bazargani F, Lund H, Magnuson A, Ludwig B. Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 1-year follow-up. Eur J Orthod [Internet]. 2021 Jun 8 [cited 2022 Apr 28];43(3). Available from: https://pubmed.ncbi.nlm.nih.gov/32761047/
26. Moon HW, Kim MJ, Ahn HW, Kim SJ, Kim SH, Chung KR, et al. Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study. Angle Orthod. 2019 Aug 28;90(1):13–22.
27. Zong C, Tang B, Hua F, He H, Ngan P. Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances [Internet]. Vol. 25, Seminars in Orthodontics. 2019. p. 46–59. Available from:
http://dx.doi.org/10.1053/j.sodo.2019.02.006
28. Cantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod. 2017 Nov 1;18(1):1–12.
29. Li Q, Tang H, Liu X, Luo Q, Jiang Z, Martin D, et al. Comparison of dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion. Angle Orthod. 2020 May 1;90(3):432–41.
30. Park JJ, Park YC, Lee KJ, Cha JY, Tahk JH, Choi YJ. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study. Korean J Orthod. 2017 Mar;47(2):77.
31. Yi F, Liu S, Lei L, Liu O, Zhang L, Peng Q, et al. Changes of the upper airway and bone in microimplant-assisted rapid palatal expansion: A cone-beam computed tomography (CBCT) study. J Xray Sci Technol. 2020;28(2):271–83.
32. Paredes N, Colak O, Sfogliano L, Elkenawy I, Fijany L, Fraser A, et al. Differential assessment of skeletal, alveolar, and dental components induced by microimplant-supported midfacial skeletal expander (MSE), utilizing novel angular measurements from the fulcrum. Prog Orthod. 2020 Jul 13;21(1):18.
33. Lee HK, Bayome M, Ahn CS, Kim SH, Kim KB, Mo SS, et al. Stress distribution and displacement by different bone-borne palatal expanders with micro-implants: a three-dimensional finite-element analysis. Eur J Orthod. 2014 Oct;36(5):531–40.
34. Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K. Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop. 2011 Oct;140(4):510–9.
35. Olmez H, Akin E, Karaçay S. Multitomographic evaluation of the dental effects of two different rapid palatal expansion appliances. Eur J Orthod [Internet]. 2007 Aug [cited 2022 Jul 24];29(4). Available from: https://pubmed.ncbi.nlm.nih.gov/17702798/
36. Tausche E, Hansen L, Hietschold V, Lagravère MO, Harzer W. Three-dimensional evaluation of surgically assisted implant bone-borne rapid maxillary expansion: a pilot study. Am J Orthod Dentofacial Orthop. 2007 Apr;131(4 Suppl):S92–9.
37. Khosravi M, Ugolini A, Miresmaeili A, Mirzaei H, Shahidi-Zandi V, Soheilifar S, et al. Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review. Int Orthod. 2019 Sep;17(3):425–36.
38. Garib DG, Henriques JF, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop [Internet]. 2006 Jun [cited 2022 Apr 29];129(6). Available from: https://pubmed.ncbi.nlm.nih.gov/16769493/
39. Lo Giudice A, Barbato E, Cosentino L, Ferraro CM, Leonardi R. Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review. Eur J Orthod. 2018 May 25;40(3):296–303.
40. Bastos RT da RM, Blagitz MN, Aragón MLS de C, Maia LC, Normando D. Periodontal side effects of rapid and slow maxillary expansion: Angle Orthod. 2019 Jul;89(4):651–60.
41. Akyalcin S, Schaefer JS, English JD, Stephens CR, Winkelmann S. A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion. Imaging Sci Dent. 2013 Jun;43(2):85–90.
42. Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de Lima EMS, Rizzatto SMD. Immediate effects of rapid maxillary expansion with Haas-type and hyrax-type expanders: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2011 Sep;140(3):366–76.
2. Baysal A, Uysal T, Veli I, Ozer T, Karadede I, Hekimoglu S. Evaluation of alveolar bone loss following rapid maxillary expansion using cone-beam computed tomography. Korean J Orthod. 2013 Apr;43(2):83–95.
4. Lione R, Franchi L, Cozza P. Does rapid maxillary expansion induce adverse effects in growing subjects? Angle Orthod. 2013 Jan;83(1):172–82.
5. Copello FM, Marañón-Vásquez GA, Brunetto DP, Caldas LD, Masterson D, Maia LC, et al. Is the buccal alveolar bone less affected by mini-implant assisted rapid palatal expansion than by conventional rapid palatal expansion?-A systematic review and meta-analysis. Orthod Craniofac Res. 2020 Aug;23(3):237–49.
6. An JS, Seo BY, Ahn SJ. Differences in dentoskeletal and soft tissue changes due to rapid maxillary expansion using a tooth-borne expander between adolescents and adults: A retrospective observational study. Korean J Orthod. 2022 Mar 25;52(2):131–41.
7. Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. Korean J Orthod. 2017 Sep;47(5):313–22.
8. Gunyuz Toklu M, Germec-Cakan D, Tozlu M. Periodontal, dentoalveolar, and skeletal effects of tooth-borne and tooth-bone-borne expansion appliances. Am J Orthod Dentofacial Orthop. 2015 Jul;148(1):97–109.
9. Lee KJ, Park YC, Park JY, Hwang WS. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):830–9.
10. Chun JH, de Castro ACR, Oh S, Kim KH, Choi SH, Nojima LI, et al. Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT. BMC Oral Health. 2022 Apr 8;22(1):114.
11. Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod. 2016 Sep;86(5):713–20.
12. Angelieri F, Cevidanes LHS, Franchi L, Gonçalves JR, Benavides E, McNamara JA Jr. Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2013 Nov;144(5):759–69.
13. Vidalón JA, Loú-Gómez I, Quiñe A, Diaz KT, Liñan Duran C, Lagravère MO. Periodontal effects of maxillary expansion in adults using non-surgical expanders with skeletal anchorage vs. surgically assisted maxillary expansion: a systematic review. Head Face Med. 2021 Nov 10;17(1):1–12.
14. Chung M, Lyu ZZ, Zhu BK, Wang XJ, Qu RY, Jiang LY. [Effects of mid-palatal suture opening and midfacial bony structure changes induced by maxillary skeletal expansion in adults]. Shanghai Kou Qiang Yi Xue [Internet]. 2021 Jun [cited 2022 Aug 1];30(3). Available from: https://pubmed.ncbi.nlm.nih.gov/34476453/
15. Tang H, Liu P, Liu X, Hou Y, Chen W, Zhang L, et al. Skeletal width changes after mini-implant-assisted rapid maxillary expansion (MARME) in young adults. Angle Orthod. 2021 May 1;91(3):301–6.
16. Coloccia G, Inchingolo AD, Inchingolo AM, Malcangi G, Montenegro V, Patano A, et al. Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature. Medicina [Internet]. 2021 Mar [cited 2022 Apr 22];57(3). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003431/
17. Sawchuk D, Currie K, Vich ML, Palomo JM, Flores-Mir C. Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review. Korean J Orthod. 2016 Sep;46(5):331–42.
18. Jia H, Zhuang L, Zhang N, Bian Y, Li S. Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:: A prospective cone beam computed tomography study. Angle Orthod. 2021 Jan;91(1):36.
19. Celenk-Koca T, Erdinc AE, Hazar S, Harris L, English JD, Akyalcin S. Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial. Angle Orthod. 2018 Nov;88(6):702–9.
20. Mehta S, Wang D, Kuo CL, Mu J, Vich ML, Allareddy V, et al. Long-term effects of mini-screw–assisted rapid palatal expansion on airway:A three-dimensional cone-beam computed tomography study. Angle Orthod. 2020 Dec 14;91(2):195–205.
21. Kavand G, Lagravère M, Kula K, Stewart K, Ghoneima A. Retrospective CBCT analysis of airway volume changes after bone-borne vs tooth-borne rapid maxillary expansion. Angle Orthod. 2019 Feb 15;89(4):566–74.
22. Lagravère MO, Ling CP, Woo J, Harzer W, Major PW, Carey JP. Transverse, vertical, and anterior-posterior changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion 6 months post-expansion: A CBCT randomized controlled clinical trial. Int Orthod [Internet]. 2020 Jun [cited 2022 Apr 29];18(2). Available from:
https://pubmed.ncbi.nlm.nih.gov/32057733/
23. Kamran D, Talma E, Harzer W, M. L. Long term skeletal and dental changes between tooth-anchored versus Dresden bone-anchored rapid maxillary expansion using CBCT images in adolescents: Randomized clinical trial. Int Orthod. 2020 Jun 1;18(2):317–29.
24. Lin L, Ahn HW, Kim SJ, Moon SC, Kim SH, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015 Mar;85(2):253–62.
25. Bazargani F, Lund H, Magnuson A, Ludwig B. Skeletal and dentoalveolar effects using tooth-borne and tooth-bone-borne RME appliances: a randomized controlled trial with 1-year follow-up. Eur J Orthod [Internet]. 2021 Jun 8 [cited 2022 Apr 28];43(3). Available from: https://pubmed.ncbi.nlm.nih.gov/32761047/
26. Moon HW, Kim MJ, Ahn HW, Kim SJ, Kim SH, Chung KR, et al. Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study. Angle Orthod. 2019 Aug 28;90(1):13–22.
27. Zong C, Tang B, Hua F, He H, Ngan P. Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances [Internet]. Vol. 25, Seminars in Orthodontics. 2019. p. 46–59. Available from:
http://dx.doi.org/10.1053/j.sodo.2019.02.006
28. Cantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod. 2017 Nov 1;18(1):1–12.
29. Li Q, Tang H, Liu X, Luo Q, Jiang Z, Martin D, et al. Comparison of dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion. Angle Orthod. 2020 May 1;90(3):432–41.
30. Park JJ, Park YC, Lee KJ, Cha JY, Tahk JH, Choi YJ. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study. Korean J Orthod. 2017 Mar;47(2):77.
31. Yi F, Liu S, Lei L, Liu O, Zhang L, Peng Q, et al. Changes of the upper airway and bone in microimplant-assisted rapid palatal expansion: A cone-beam computed tomography (CBCT) study. J Xray Sci Technol. 2020;28(2):271–83.
32. Paredes N, Colak O, Sfogliano L, Elkenawy I, Fijany L, Fraser A, et al. Differential assessment of skeletal, alveolar, and dental components induced by microimplant-supported midfacial skeletal expander (MSE), utilizing novel angular measurements from the fulcrum. Prog Orthod. 2020 Jul 13;21(1):18.
33. Lee HK, Bayome M, Ahn CS, Kim SH, Kim KB, Mo SS, et al. Stress distribution and displacement by different bone-borne palatal expanders with micro-implants: a three-dimensional finite-element analysis. Eur J Orthod. 2014 Oct;36(5):531–40.
34. Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K. Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop. 2011 Oct;140(4):510–9.
35. Olmez H, Akin E, Karaçay S. Multitomographic evaluation of the dental effects of two different rapid palatal expansion appliances. Eur J Orthod [Internet]. 2007 Aug [cited 2022 Jul 24];29(4). Available from: https://pubmed.ncbi.nlm.nih.gov/17702798/
36. Tausche E, Hansen L, Hietschold V, Lagravère MO, Harzer W. Three-dimensional evaluation of surgically assisted implant bone-borne rapid maxillary expansion: a pilot study. Am J Orthod Dentofacial Orthop. 2007 Apr;131(4 Suppl):S92–9.
37. Khosravi M, Ugolini A, Miresmaeili A, Mirzaei H, Shahidi-Zandi V, Soheilifar S, et al. Tooth-borne versus bone-borne rapid maxillary expansion for transverse maxillary deficiency: A systematic review. Int Orthod. 2019 Sep;17(3):425–36.
38. Garib DG, Henriques JF, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop [Internet]. 2006 Jun [cited 2022 Apr 29];129(6). Available from: https://pubmed.ncbi.nlm.nih.gov/16769493/
39. Lo Giudice A, Barbato E, Cosentino L, Ferraro CM, Leonardi R. Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review. Eur J Orthod. 2018 May 25;40(3):296–303.
40. Bastos RT da RM, Blagitz MN, Aragón MLS de C, Maia LC, Normando D. Periodontal side effects of rapid and slow maxillary expansion: Angle Orthod. 2019 Jul;89(4):651–60.
41. Akyalcin S, Schaefer JS, English JD, Stephens CR, Winkelmann S. A cone-beam computed tomography evaluation of buccal bone thickness following maxillary expansion. Imaging Sci Dent. 2013 Jun;43(2):85–90.
42. Weissheimer A, de Menezes LM, Mezomo M, Dias DM, de Lima EMS, Rizzatto SMD. Immediate effects of rapid maxillary expansion with Haas-type and hyrax-type expanders: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2011 Sep;140(3):366–76.
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Jul 15, 2023
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Imbaquingo Cristian, Bernal Marco, & Miriam Lima. (2023). TOOTH-BORNE VS BONE-BORNE RAPID MAXILLARY EXPANDERS USING CBCT IMAGES: A NARRATIVE REVIEW. Journal of Population Therapeutics and Clinical Pharmacology, 30(17), 236–248. https://doi.org/10.47750/jptcp.2023.30.17.020
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Author Biographies
Imbaquingo Cristian
Resident of the Specialty of Orthodontics at the University of Cuenca - Ecuador.
Bernal Marco
Resident of the Specialty of Orthodontics at the University of Cuenca - Ecuador.
Miriam Lima
Professor of Orthodontics Specialty at the University of Cuenca - Ecuador.