CBCT comparison of dental, dentoalveolar and skeletal treatment results of Hyrax expander and monocortical hybrid expander in late-adolescence

Document Type : Original Article

Authors

1 Department of Orthodontics, Minia University

2 orthodonntic department , faculty of dentistry, minia university

3 Department of orthodontics, Faculty of Dentistry, Minia University, Egypt.

Abstract

Objective: To compare skeletal and dentoalveolar treatment results of using a conventional Hyrax and Hybrid appliances in late-adolescent patients using CBCT scans.
Materials and Methods: eighteen patients with maxillary skeletal crossbites, aged between 18 and 21 were selected, divided randomly into a group treated with a conventional Hyrax, and a group with Hybrid appliance using palatal miniscrews with monocortical engagement. The Hybrid appliance was fabricated using a digital workflow; CBCT scans merged with intraoral digital scans, used to virtually position miniscews and fabricating a surgical guide through 3D printing. Both groups followed the same activation protocols. CBCT scans were taken for all patients before and after treatment. These were used for comparing dental, alveolar and skeletal treatment results. The resulting data were statistically analyzed using Shapiro Wilk Normality test and Kolmogorov test, and Paired t test between the pre and post treatment results.
Results: Transverse linear and angular measurements were higher in the Hyrax group due to increased buccal tipping, the dentoalveolar linear measurements showed buccal alveolar bone thinning in the Hyrax group, there was statistically significant increase in the right first premolar alveolar inclination in the Hyrax group showing more alveolar bone bending, and the skeletal linear measurements showed more parallel sutural opening with the Hybrid group .In both groups, opening happened more on the right side.
Conclusions: Sutural separation was possible with both appliances at the late-adolescent stage with comparable results. However, the Hybrid appliance exhibited less side effects, giving a qualitatively better expansion pattern.

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