Cone-Beam computed tomography evaluation of maxillary expansion in twins with cleft lip and palate

OBJECTIVE: The establishment of normal occlusal relationships in patients with cleft lip and palate using rapid maxillary expansion may promote good conditions for future rehabilitation. OBJECTIVE: This study describes the clinical case of monozygotic twins with unilateral cleft lip and palate at the age of mixed dentition, who were treated using the same rapid maxillary expansion protocol, but with two different screws (conventional and fan-type expansion screw). Results were evaluated using plaster models, intraoral and extraoral photographs, and Cone-Beam computed tomography (CBCT) scans obtained before the beginning of the treatment, (T1). METHODS: The patients were followed up for 6 months after maxillary expansion, when the same tests requested at T1 were obtained again for review (T2). T1 and T2 results were compared using lateral cephalometric tracings and measurements of the intercanine and intermolar distances in the plaster models using a digital caliper. RESULTS: The two types of expansion screws corrected the transverse discrepancy in patients with cleft lip and palate. The shape of the upper arches improved at 10 days after activation. CONCLUSION: CBCT scans provide detailed information about craniofacial, maxillary and mandibular changes resulting from rapid maxillary expansion. The most adequate screw for each type of malocclusion should be chosen after detailed examination of the dental arches

Aetiology diagnosis and treatment of posterior cross-bites in the primary dentition

Children who present with a posterior cross-bite in the primary dentition may be predisposed to long-term detrimental consequences if the condition is left untreated. Controversy exists in the literature as to the most appropriate time to treat this condition. Objectives. The aim of this review is to evaluate the need for correcting posterior cross-bites in the primary dentition based on the current understanding of the aetiology, likelihood of self-correction, and consequences of various forms of this malocclusion persisting into the mixed and permanent dentitions. A review of the reported treatment options for management of this condition is also presented. Methods. Literature pertaining to the epidemiology and management of posterior cross-bites in the primary dentition are reviewed. Conclusion. Posterior cross-bites in the primary dentition are relatively common and their causes are numerous. Because a significant proportion of posterior cross-bites self-correct beyond the primary dentition, routine correction in the primary dentition phase cannot be advocated. A unilateral posterior cross-bite as a result of a functional displacement of the mandible is one of the few malocclusions which should be considered for correction in the primary dentition. Further research is needed in the management of this condition