Oropharyngeal dimensional changes following maxillary expansion with two different appliances: a CBCT study
Notice bibliographique
Résumé
Maxillary expansion is used to correct maxillary deficiencies, the most common technique is the Rapid Maxillary Expansion. Although there are several other treatment types depending on age such as surgery or archwire; maxillary expansion, have been related to the increase of the upper airway volume and minimal cross-sectional area (MCA). However, contradictory results regarding the measured changes in the oropharyngeal portion of upper airway have led to uncer-tainty about the real effect of maxillary expansion on the oropharynx dimensions. Moreover, there is no published research regarding oropharyngeal dimensional changes after the application of Damon philosophical treatment approach. Following the claim from Damon proponents that the therapeutic effect after its use in the constricted maxilla is a broader dental arch due to alveolar bone remodeling. We speculate if the oropharyngeal volume and MCA could also be increased. Therefore, the main objective of this study is to compare the vol-ume and MCA changes in the oropharyngeal space following maxillary expansion using the Damon system versus Hyrax appliances, assessed through CBCT imaging. A retrospective analysis of data from a randomized parallel clinical controlled trial with an allocation ratio of 1:1 was conducted. Patients between 11 to 17 years old, with maxillary transverse discrepancies in need of maxillary expansion, were included and randomly allocated into one of two treatment groups, Hyrax or Damon, in the orthodontic clinic at the University of Alberta, Edmonton Canada. Patients underwent CBCT imaging at three time-points: T1- before treatment and after clinical evaluation, to further evaluate and assist the clinicians on the diag-nosis on dental and craniofacial orthodontic discrepancies; T2- at 6 months, and T3- after com-pletion of all orthodontic treatment. The CBCT data was assessed through Invivo Software (Anatomage, San Jose, California, US) and Dolphin Software (Dolphin Imaging & Management Solutions, Chatsworth, California US). Reliability of measurements was done to certify the re-producibility of the research. In addition, a qualitative assessment of breathing function was done using the NOSE questionnaire modified from The NOSE Scale 2003 developed by the American Academy of Otolaryngology-Head and Neck Surgery Foundation. Repeated measures multivariate analysis of variance (MANOVA) and Bonferroni post-hoc tests were used to ana-lyse the differences between the treatment groups at each time-point and each software. A paired-sample t-test was applied to verify whether or not the changes were statistically signifi-cant. All the statistical analysis was made at a 5% significance level (95% CI) using IBM SPSS statistics 25 version (SPSS Inc, Chicago, IL). A reliability assessment was done evaluating intra-reliability and inter-reliability with a second examiner. All results ranged above the excellent range of 90%. Our study showed a sta-tistically significant increase in the oropharyngeal volume after 6 months maxillary expansion (T2), and after the completion of treatment (T3) when the oropharyngeal volume was evaluated in the Hyrax group with both software. Also, results showed a statistically significant increase in the MCA in the Hyrax group when evaluated with Dolphin software. The Invivo and Dolphin software showed they are statistically different when oropharyngeal dimensions were compared. Our results on the NOSE questionnaire showed no statistically significant improvement in breathing between time-points in both treatment groups. Future research should focus on airway function to correlate the dimensional changes to airflow and respiratory capacity function after maxillary expansion treatment. As well, the qualitative analysis with patient’s feedback by questionnaire could elucidate the patient’s breathing improvement after orthodontic therapy.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».