Cephalometric evaluation of rapid and slow maxillary expansion in patients with BCLP: Secondary data analysis from a randomized clinical trial

Abstract

ABSTRACT Objective: To compare the dentoskeletal effects of rapid (RME) and slow (SME) maxillary expansion in patients with bilateral complete cleft lip and palate (BCLP). Materials and Methods: This was a secondary analysis of a previous randomized controlled trial (RCT). Forty-six patients (34 male, 12 female) with BCLP and posterior crossbite (mean age of 9.2 years) were randomly assigned to two study groups. Group RME comprised subjects treated with Haas/Hyrax expander. Group SME included patients treated with quad-helix appliance. Cone-beam computed tomography (CBCT) was performed before expansion (T1) and after appliance removal at the end of a 6-month retention period (T2) for a previous RCT that compared the transverse skeletal effects of RME and SME. CBCT-derived cephalometric images were generated and cephalometric analysis was performed using Dolphin Imaging Software (Chatsworth, Calif). Intergroup comparisons were performed using t tests (P < .05). Results: Baseline forms were similar between groups. No significant differences between RME and SME groups were found. Conclusions: Rapid and slow maxillary expansion produced similar sagittal and vertical changes in patients with BCLP. Both Haas/Hyrax and quad-helix appliances can be used in patients with vertical facial pattern. Clinical relevance: RME and SME can be equally indicated in the treatment of maxillary arch constriction in patients with BCLP.