Alveolar bone level changes in maxillary expansion treatments assessed through CBCT

Area of Science:

• Orthodontics
• Dentofacial Orthopedics
• Radiology

Background:

• Maxillary transverse deficiency is a common orthodontic concern.
• Maxillary expansion aims to correct this deficiency, but its effects on alveolar bone are debated.
• Cone-beam computed tomography (CBCT) offers detailed 3D imaging for assessing skeletal and dental changes.

Purpose of the Study:

• To quantify alveolar bone level changes following maxillary expansion using CBCT.
• To compare bone changes between bone-anchored expanders, tooth-borne expanders (Hyrax), and an untreated control group.

Main Methods:

• Sixty-one patients with maxillary transverse deficiency were divided into three groups: bone-anchored expander, tooth-borne expander, and untreated control.
• CBCT scans were taken at the start (T1) and after 6 months (T2).
• Landmark analysis using AVIZO software and statistical analysis (ICC, ANOVA) were performed to assess bone level changes.

Main Results:

• High intra-examiner reliability (ICC ≥ 0.99) was achieved for landmark measurements.
• All groups exhibited alveolar bone level changes less than 1mm, considered clinically insignificant.
• No statistically significant differences in bone changes were observed between groups, except for 8 minor distances.

Conclusions:

• Maxillary expansion treatments result in minimal and clinically insignificant alveolar bone level changes.
• Bone-anchored and tooth-borne expansion effects on alveolar bone are comparable to natural changes observed in untreated individuals.