The posterior crossbite is a common type of malocclusion that might affect the normal growth pattern. Early treatment is recommended by rapid maxillary expansion with different appliances. This line of treatment needs a sufficient retention period to decrease the rate of relapse. The low level laser therapy has been used to enhance tissue regeneration. This study aims to compare the effect of rapid maxillary expansion with low level laser versus rapid maxillary expansion in children with posterior cross bite malocclusions.
This study aims to evaluate the effect of rapid maxillary expansion using the bonded Hyrax expander combined with low level Laser therapy versus rapid maxillary expansion alone. The investigators intend to recruit sixty subjects of both sexes, between the age of 7 and 14 years. Patients with posterior crossbites and patent Mid-palatal sutures will be randomized into one of the two groups of treatment. Full orthodontic records will be collected and the standard orthodontic radiographs will be replaced by cone beam computer tomographic images. The records will be taken before the maxillary expansion and after 6 months of retention. The skeletal, dentoalveolar, and soft tissue effects of the two interventions will be compared.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
DOUBLE
Enrollment
60
The expansion screw of the bonded-hyrax will be activated until the palatal cusps of the permanent maxillary first molars are opposing the buccal cusps of the permanent mandibular first molars
Ten sessions of 0.5 watts for 20 seconds at 4 points along the mid-palatal suture
Al-Azhar University
Cairo, Cairo Governorate, Egypt
RECRUITINGInter-jugale width
Horizontal distance between right and left Jugale points, in millimeters.
Time frame: six months of retention
Buccal maxillary width
Horizontal distance between the most lateral point on the right and left buccal alveolar plate at the level of the root trifurcation, in millimeters.
Time frame: six months of retention
Bone density of the mid-palatal suture
Average density of 200mm3 volume, in hounsfield units.
Time frame: six months of retention
Facial width
Horizontal distance between right and left zygomatico-temporal points in millimeter.
Time frame: six months of retention
Inter-infraorbitale width
Horizontal distance between right and left infraorbitale points
Time frame: six months of retention
Inter-lateral pterygoid width
Horizontal distance between right and left lateral pterygoid points in millimeters
Time frame: six months of retention
Nasal width
Horizontal distance between right and left lateral nasale points in millimeters
Time frame: six months of retention
Palatal maxillary width
Horizontal distance between the most lateral point on the right and left palatal alveolar plate at the level of the root trifurcation, in millimeters.
Time frame: six months of retention
Buccal alveolar bone thickness at the mesiobuccal root of the first maxillary permanent molar
Horizontal distance between the most lateral point on the buccal alveolar plate opposite to the midpoint of the width of the mesiobuccal root of the upper permanent maxillary first molar at the level of the trifurcation
Time frame: six months of retention
Buccal alveolar bone thickness at the distobuccal root of the first maxillary permanent molar
Horizontal distance between the most lateral point on the buccal alveolar plate opposite to the midpoint of the width of the distobuccal root of the upper permanent maxillary first molar at the level of the trifurcation, in millimeter.
Time frame: six months of retention
Palatal bone thickness
Horizontal distance between the most lateral point on the right and left palatal alveolar plates at the level of the trifurcation of the upper permanent maxillary first molar.
Time frame: six months of retention
Bi-gonial width
Horizontal distance between right and left gonion points in millimeters
Time frame: six months of retention
Inter-mental width
Horizontal distance between right and left mental foramen in millimeters
Time frame: six months of retention
alveolar tipping angle
Angle between the tangent to palatal alveolar bone at right and left first molar and the mid sagittal plane
Time frame: six months of retention
Dental tipping angle
Angle between the line passing through palatal root apex and palatal cusp tip of the right and left first molar and the mid sagittal plane
Time frame: six months of retention
Bone density of the nasal side of the Midpalatal suture
Average density in hounsfield units.
Time frame: six months of retention
Bone density of the oral side of the Midpalatal suture
Average density in hounsfield units.
Time frame: six months of retention
Upper airway dimension
Volume of the upper airway in mm3
Time frame: six months of retention
Intercanine width
Distance between the right and left canine cusp tips.
Time frame: six months of retention
Intermolar width
Distance between the right and left central fossae of the permanent maxillary first molar
Time frame: six months of retention
Inter-first premolar width
Distance between the right and left first premolar buccal cusp tips.
Time frame: six months of retention
Inter-second premolar width
Distance between the right and left first premolar buccal cusp tips.
Time frame: six months of retention
Pain score
Visual Analogue Scale from 1-100. Zero denoting no pain and 100 denoting the worst pain imaginable
Time frame: Day 1 of appliance activation
Day on which pain on activation stopped
The day on which the patient reports no pain with appliance activation
Time frame: Two weeks
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