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NiTi Expansion in Operated Unilateral Cleft Palate Patients

Objective: To evaluate the efficacy of nickel-titanium expander for maxillary expansion and the skeletal and dental changes associated with the expander in operated cleft palate patients. Materials and methods: Ten male unilateral cleft lip and palate patients in the age group of 9 to 13 years with transverse maxillary deficiency and with no history of bone grafting procedure, were selected from the patients visiting the combined cleft lip and palate clinic/orthodontic clinic. Results: Orthopedic expansion of maxillary segments ranged from 2 to 5 mm, constituted 25% of total expansion. Maxillary Intermolar width measured at cuspal tips and palatal gingival margins (T-16, 26 and G-16, 26) increased by a mean of 8.6 mm (p < 0 .001) and 5.4 mm (p < 0 .001). Maxillary Inter premolar width measured at cuspal tips and palatal gingival margins (T-14, 24 and G-14, 24) increased by a mean of 5.6 mm (p < 0.001) and 4.7 mm (p < 0 .001). Maxillary intercanine width measured at cuspal tips and palatal gingival margins (T-13, 23 and G-13, 23) increased by a mean of 4.3 mm (p < 0.01) and 3.38 mm (p < 0.01). Postexpansion changes measured on the mandibular dental casts showed insignificant changes except in the intermolar area. Mandibular intermolar width measured at cuspal tips and lingual gingival margins (T-36, 46 and G-36, 46) increased by a mean of 0.6 mm (p < 0.05). The dental expansion constituted for 75% total expansion. Mandibular, occlusal plane angles increased by 2 to 3° resulting in increased TAFH. Conclusion: NiTi expansion in operated cleft patients, showed mainly orthodontic expansion. The significant change in the maxillary intermolar region is due to the direct placement of NiTi palatal expander to 16, 26.