Three-dimensional assessment of morphologic changes of the maxilla: a comparison of 2 kinds of palatal expanders

Abstract

Previous studies of the morphologic changes of the maxilla after palatal expansion have used 2-dimensional methodologies. In the present study, we used a 3-dimensional surface laser scanning technique and computerized cast analysis, in addition to analysis of anteroposterior cephalograms, to assess the morphologic changes of the palate by 2 kinds of expanders: tissue borne (Haas; n = 9) and tooth borne (Hyrax; n = 10). Cast analysis demonstrated that, although all patients started treatment with similar malocclusion, treatment outcomes were different depending on the appliance used. Both appliances generated maxillary expansion (ie, improved mean surface area, mean intermolar linear distance, and mean perimeter) (P <.05). However, the appliances performed differently to achieve the final expansion. Haas appliances demonstrated a greater orthopedic movement (ie, improvement of the mean interpalatal distance) (P <.05), and Hyrax appliances demonstrated dentoalveolar expansion by increasing the mean palatal angulation of the alveolus (P <.05). Anteroposterior cephalometric analysis showed that both appliances increased mean maxillary width and mean intermolar distance significantly (P <.05). On the other hand, differences in nasal cavity width and upper incisal apex distance were not statistically significant (P >.05). This new 3-dimensional methodology proved useful for comparing treatment outcomes by evaluating the morphologic changes induced by palatal expansion and generated a better visualization of these outcomes.