ABSTRACT
Background:
Maxillary crowding is a common orthodontic issue that can impact a patient’s oral health and overall well-being. The timing of orthodontic treatment plays a crucial role in achieving optimal results.
Materials and Methods:
Thirty patients who received early intervention with palatal expansion (Group A) and 30 patients who underwent late orthodontic treatment (Group B) were included in this study. The age range for Group A was 8–10 years, while Group B had an age range of 16–18 years. Pretreatment and posttreatment records, including dental models and cephalometric radiographs, were analyzed to assess the effectiveness of the respective treatments.
Results:
In Group A, the mean duration of treatment was 12 months, and the maxillary crowding was corrected by an average of 4.5 mm. In Group B, the mean treatment duration was 24 months, and maxillary crowding was corrected by an average of 3.2 mm. The early intervention group (Group A) exhibited a statistically significant reduction in treatment duration and greater correction of maxillary crowding compared to the late orthodontic treatment group (Group B) (P < 0.05).
Conclusion:
Early intervention with palatal expansion is an effective approach for correcting maxillary crowding, leading to shorter treatment duration and greater improvement compared to late orthodontic treatment.
KEYWORDS: Cephalometric radiographs, dental models, early intervention, late orthodontic treatment, maxillary crowding, oral health, orthodontic intervention, palatal expansion, patient satisfaction, treatment duration
INTRODUCTION
Maxillary crowding is a prevalent orthodontic concern that often necessitates timely intervention to prevent potential complications and achieve optimal outcomes. Timely intervention in orthodontic cases has been a subject of significant interest and debate within the field.[1]
Maxillary crowding occurs when there is insufficient space in the upper jaw to accommodate the erupting permanent teeth, leading to misalignment and malocclusion.[2] It not only affects the aesthetic appearance of an individual’s smile but can also impact oral health by increasing the risk of periodontal disease and dental caries.[3]
Early intervention with palatal expansion involves addressing maxillary crowding during the mixed dentition phase, typically between the ages of 8 and 10 years.[4] This approach aims to create additional space in the maxillary arch to accommodate erupting permanent teeth, potentially reducing the need for extensive orthodontic treatment later in life. In contrast, late orthodontic treatment is initiated after the complete eruption of permanent teeth, often during adolescence.[5]
To date, there is a paucity of comprehensive studies comparing the outcomes of these two treatment modalities for maxillary crowding. Therefore, this research seeks to provide valuable insights into the relative effectiveness of early intervention with palatal expansion and late orthodontic treatment.
This study is expected to shed light on the benefits and drawbacks of each treatment approach, ultimately guiding orthodontic practitioners in making informed decisions regarding the management of maxillary crowding in their patients.
MATERIALS AND METHODS
Study design
This study employed a retrospective comparative design to assess the effectiveness of early intervention with palatal expansion and late orthodontic treatment in correcting maxillary crowding.
Study sample
A total of 60 patients were included in this study, with 30 patients in each treatment group. Group A consisted of patients who underwent early intervention with palatal expansion, while Group B comprised patients who received late orthodontic treatment. The inclusion criteria were as follows:
Group A: Patients aged 8–10 years with maxillary crowding.
Group B: Patients aged 16–18 years with maxillary crowding.
Data collection
Pretreatment records: Pretreatment data were collected for all patients, including clinical examinations, dental models, and cephalometric radiographs. These records served as the baseline measurements for maxillary crowding assessment.
Treatment procedures
Group A (early intervention with palatal expansion): patients in this group received rapid maxillary expansion using a palatal expander device, following a standardized protocol. Treatment duration and expansion parameters were recorded.
Group B (late orthodontic treatment): Patients in this group underwent traditional orthodontic treatment, which included fixed appliances (braces) to correct maxillary crowding. Treatment duration and specific techniques employed were documented.
Posttreatment records: Posttreatment data were collected after the completion of orthodontic interventions, including clinical examinations, dental models, and cephalometric radiographs. These records were used to assess the extent of maxillary crowding correction achieved.
Data analysis
Statistical analysis was performed using appropriate tests, including t-tests and Chi-square tests, to compare the two treatment groups. The primary outcome measures were changes in maxillary crowding and treatment duration. Statistical significance was set at P < 0.05.
RESULTS
Patient demographics
The study included a total of 60 patients, with 30 patients in each treatment group. The demographic characteristics of the patients in both groups are summarized in Table 1.
Table 1.
Patient demographics
| Characteristic | Group A (early intervention) | Group B (late orthodontic) |
|---|---|---|
| Age (years) | Mean±SD | Mean±SD |
| 9.4±0.8 | 17.2±0.9 | |
| Gender (male/female) | 14/16 | 12/18 |
Maxillary crowding correction
The primary outcome measure of this study was the correction of maxillary crowding. Table 2 presents the pretreatment and posttreatment values for maxillary crowding in both groups.
Table 2.
Maxillary crowding correction
| Group | Pretreatment crowding (mm) | Posttreatment crowding (mm) | Mean change (mm) |
|---|---|---|---|
| Group A | 7.8±1.2 | 3.3±0.9 | 4.5±1.1 |
| Group B | 8.0±1.0 | 4.8±1.2 | 3.2±1.0 |
Treatment duration
The duration of orthodontic treatment in both groups was also recorded. Table 3 provides the mean treatment duration in months for each group.
Table 3.
Treatment duration
| Group | Mean treatment duration (months) |
|---|---|
| Group A | 12.4±1.6 |
| Group B | 24.8±2.3 |
Statistical analysis was performed to compare the effectiveness of the two treatment groups. A paired t-test was used to analyze the changes in maxillary crowding within each group, while an independent t-test was used to compare the mean changes between the two groups. The results indicated that the early intervention group (Group A) exhibited a statistically significant reduction in treatment duration and greater correction of maxillary crowding compared to the late orthodontic treatment group (Group B) (P < 0.05).
The results presented in Tables 2 and 3 demonstrate that early intervention with palatal expansion (Group A) led to a more significant reduction in maxillary crowding compared to late orthodontic treatment (Group B). Additionally, the early intervention group had a substantially shorter treatment duration, highlighting the potential advantages of addressing maxillary crowding during the mixed dentition phase.
These findings suggest that early intervention with palatal expansion may offer a more efficient and effective approach for correcting maxillary crowding, which can contribute to improved oral health outcomes and patient satisfaction.
DISCUSSION
The findings of this study provide valuable insights into the effectiveness of two distinct approaches for addressing maxillary crowding: early intervention with palatal expansion and late orthodontic treatment. Our analysis of 60 patients, with 30 in each treatment group, revealed significant differences in maxillary crowding correction and treatment duration between the two approaches.
Maxillary crowding correction
Our results demonstrate that early intervention with palatal expansion (Group A) resulted in a more substantial reduction in maxillary crowding (4.5 ± 1.1 mm) compared to late orthodontic treatment (Group B) (3.2 ± 1.0 mm). This observation aligns with previous research suggesting that addressing maxillary crowding during the mixed dentition phase can lead to more favorable outcomes.[1] The palatal expansion technique employed in Group A effectively created additional space in the maxillary arch, allowing for better alignment of the permanent teeth.
Treatment duration
Furthermore, the early intervention group (Group A) exhibited a significantly shorter mean treatment duration (12.4 ± 1.6 months) compared to the late orthodontic treatment group (Group B) (24.8 ± 2.3 months). This finding underscores the potential time-saving benefits associated with early intervention, which may reduce the overall burden on patients and their families.
Clinical implications
The implications of these results are noteworthy for orthodontic practitioners and their patients. Early intervention with palatal expansion appears to offer a more efficient and effective approach for correcting maxillary crowding, with shorter treatment durations and greater crowding reduction. This approach aligns with the concept of interceptive orthodontics, which emphasizes the importance of addressing orthodontic issues at an early stage.[2]
CONCLUSION
In conclusion, early intervention with palatal expansion emerges as a promising approach for correcting maxillary crowding, offering not only substantial crowding reduction but also a significantly shorter treatment duration compared to late orthodontic treatment.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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