Evaluation of pulp cavity/chamber changes after tooth-borne and bone-borne rapid maxillary expansions: a CBCT study usin
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ORIGINAL ARTICLE
Evaluation of pulp cavity/chamber changes after tooth-borne and bone-borne rapid maxillary expansions: a CBCT study using surface-based superimposition and deviation analysis Antonino Lo Giudice 1 & Rosalia Leonardi 1 & Vincenzo Ronsivalle 1 & Silvia Allegrini 2 & Manuel Lagravère 3 & Giuseppe Marzo 4 & Gaetano Isola 1 Received: 9 March 2020 / Accepted: 18 August 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Objectives To compare volume and shape changes of pulp chamber of maxillary posterior teeth between tooth-borne and boneborne maxillary expansions in adolescents. Materials and methods This study included 36 adolescents with bilateral maxillary crossbite who received tooth-borne rapid maxillary expansion (TB group, average age 14.4 years) or bone-borne rapid maxillary expansion (BB group, average age 14.7 years). Cone beam computed tomography (CBCT) was taken before treatment (T1) and after a 6month retention period (T2). Volumetric and shape changes of pulp chamber of maxillary first molars and premolars were detected by referring to a specific 3D digital technology involving deviation analysis of T1/T2 CBCT–derived models of pulp chamber. Student’s t tests were used to (1) compare T1 and T2 volumes of pulp chambers in TB and BB groups and (2) assess differences between the two groups in the post-treatment volumetric changes and in the percentage of matching of 3D pulp models. Results All investigated teeth showed a reduction of pulp volume, being this difference significant in both TB (p < 0.0001) and BB (p < 0.0001) groups. The volumetric reduction was greater in the TB group; also, subjects in the TB group showed a lower percentage of matching between T1 and T2 pulp models (p < 0.0001). The area most affected by shape change was that of pulp horns. Conclusions TB expander could induce a higher volumetric reduction of pulp chamber of posterior teeth compared with BB expander, in the short term. Clinical relevance The present findings add new information concerning the effects of RME protocols on pulp tissue. Keywords Tooth-borne RME . Bone-borne RME . RME side effects . Pulpal changes
Introduction * Antonino Lo Giudice [email protected] 1
Department of General Surgery and Surgical-Medical Specialties, Section of Orthodontics, School of Dentistry, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy
2
Private Practice, Pisa, Italy
3
Orthodontic Graduate Program, Edmonton Clinic Health Academy, University of Alberta, 5th Floor, 11405 - 87 Avenue NW, Edmonton, Alberta, Canada
4
Department of Life, Health and Environmental Sciences, University of L’Aquila, V.le San Salvatore, 67100 L’Aquila, Italy
Rapid maxillary expansion (RME) represents the most efficient treatment for the correction of transverse maxillary deficiency in growing subjects [1–3]. Findings from the highest levels of evidence confirm that this protocol accomplishes transverse expansion of the maxilla [1, 4, 5] and broadening of the nasal cavity [6, 7] along with individual
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