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Transverse, Vertical, and Antero-posterior changes between Tooth-borne versus Dresden Bone-borne Rapid Maxillary Expansion: A Randomized Controlled Clinical Trial Open Access


Other title
Cone-beam Computed Tomography
Three-dimensional Anatomical Landmarks
Three-dimensional Reference Plane Analysis
Accuracy and Reliability
Maxillary Transverse Constriction
Rapid Maxillary Expansion
4-band Hyrax Tooth-borne expander
Dresden Bone-borne expander
Type of item
Degree grantor
University of Alberta
Author or creator
Ling, Connie
Supervisor and department
Lagravere, Manuel (Dentistry - Orthodontics)
Examining committee member and department
Major, Paul (Dentistry - Orthodontics)
Carey, Jason (Mechanical Engineering)
Wiltshire, William (Orthodontics, University of Manitoba)
Flood, Patrick (Dentistry)
Medical Sciences-Dentistry
Date accepted
Graduation date
2016-06:Fall 2016
Master of Science
Degree level
Objectives: 1) To identify accurate and easily repeatable (intra-examiner reliability) 3-D landmarks in the cranial base, maxilla, and mandible which can be used to quantify treatment changes after rapid maxillary expansion (RME). 2) To compare the transverse, vertical and antero-posterior, skeletal and dental post-treatment changes for the Dresden Bone-borne expander, 4-band Tooth-borne expander, and an untreated control group. Methods: Fifty adolescents with maxillary transverse constriction were randomly assigned into one of three groups according to type of expander: 2-point Dresden-type Bone-borne RME (B-RME; n = 17, mean age = 14.1 years), 4-band Tooth-borne RME (T-RME; n = 17, mean age = 13.7 years), or the untreated control group (n = 16, mean age = 13.3 years). The Dresden B-RME had a unique set-up where one side was anchored by a temporary anchorage device (TAD-side), and the other side was anchored to a shortened implant (implant-side). Cone-beam computed tomography (CBCT) scans were taken at 0.3-mm voxel size before treatment (T1), and 6 months later (T2). The CBCT data were coded, and then loaded into 3-D visualization software (AVIZO 8.1 software) by a blinded examiner for measurement. The transverse, vertical and sagittal changes of the maxilla was evaluated. Dental changes at the level of the pulp horn, buccal alveolar bone and root apex were evaluated on upper molars, upper premolars, upper canines, and lower molars. Repeated measures Multivariate analysis of variance (rm-MANOVA) and Bonferroni post-hoc tests were performed to identify significant differences between groups at each landmark and time-point. Results: Transverse a) T-RME group showed symmetrical maxillary premolar and molar expansion. b) The B-RME appliance configuration showed asymmetrical maxillary molar expansion. c) The TAD-anchor side of B-RME, showed greater molar crown displacement (mean 1.84 mm) than the Implant-anchor side, with statistical significance of p
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