A long-term study on the expansion effects of the cervical-pull facebow with and without rapid maxillary expansion

This study evaluates the long-term stability of maxillary expansion achieved by widening the inner bow of a facebow, with or without concurrent rapid maxillary expansion (RME) (Haas type), followed by treatment with fixed edgewise appliances. The parent sample included 154 nonextraction patients who started their orthodontic treatment during a defined time period. The exclusion criteria reduced the number of patients to 61 in the cervical-pull facebow group (CFB) and 41 in the RME-CFB group. All subjects were in the late-mixed to early-permanent dentition stage at the start of treatment. Dental casts were measured using a digital imaging system at four different times: start of treatment (T1), end of active treatment (T2), end of retention (T3), and postretention follow up (T4). The RME-CFB protocol produced a greater increase in maxillary arch width (6.1 mm) than did the CFB protocol (4 mm). The RME-CFB protocol provided greater net maxillary arch perimeter increase than did expansion with an inner bow of a cervical facebow. The RME-CFB group had three mm more arch perimeter 10 years after treatment completion than did the CFB group. The stability of expansion achieved with an inner bow of a facebow was equal to that achieved with a Haas-type RME appliance. Both expansion protocols retained 90% of the initial intermolar expansion 15 years after expansion.