journal article·2025-10-15Open access

Skeletal, Dental, and Nasal Changes After Slow Maxillary Expansion Using Quad-Helix

Rabia Njie, Paul W. Major, Manuel Lagravere, Noura Alsufyani, Hollis Lai, Tarek El-Bialy

Applied Sciences· Volume 15· Issue 20

Abstract

The objective of this study was to assess the transverse maxillary skeletal, dental, and nasal effects of quad-helix treatment (slow maxillary expansion) in comparison to an untreated group. This study was performed on 24 patients. Before and after treatment, CBCT images for children who were treated with Wilson quad-helix were retrieved. The treatment group included 12 children with a mean age of 11.4 ± 1.2 years. The untreated control group had 12 matching patients aged 11.7 ± 0.7 years. AVIZO software (version 9.1) was utilized to place specific 3D anatomical landmarks. The segmentation of the nasal airway was performed using Mimics. The maxillary inter-molar width and inter-premolar widths increased significantly in the treatment group but not in the comparison group. These increases were statistically greater between groups. This study showed statistically significant increases in maxillary inter-molar and inter-premolar widths in patients who were treated with Wilson quad-helix to expand their upper arch. Buccal translation in the upper molars resulted after treatment. Quad-helix treatment caused more dental than skeletal effects. The nasal volume and surface area in the quad-helix group significantly increased.
Source: crossref · Quality: baseline

Research context

OpenAlex topics: Orthodontics and Dentofacial Orthopedics · Cleft Lip and Palate Research · dental development and anomalies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

Department of Dentistry, Faculty of Dentistry, Alsmarya University, Zliten 02101, Libya

Division of Orthodontics, Mike Petryk School of Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada

Department of Oral Medicine and Diagnostic Sciences, College of Dentistry, King Saud University, Riyadh 12372, Saudi Arabia

References (35)

Show source-provided references
1. Prevalence and distribution of selected occlusal characteristics in the US population, 1988–199110.1177/002203459607502S10 ↗
2. Maxillary transverse deficiency10.1016/S0889-5406(00)70202-2 ↗
3. Mills, J.R. (1982). Principles and Practice of Orthodontics, Churchill Livingstone.
4. Prevalence of posterior crossbite for orthodontic treatment timing10.17796/1053-4628-40.5.422 ↗
5. Primary posterior crossbite: Diagnosis and treatment
6. Evaluation of the treatment changes of functional posterior crossbite in the mixed dentition10.1016/j.ajodo.2005.03.030 ↗
7. Athanasiou, A.E. (1995). Orthodontic Cephalometry, Mosby-Wolfe.
8. Sutural growth of the upper face studied by the implant method10.3109/00016356609026122 ↗
9. Prevalence of temporomandibular dysfunction and its association with malocclusion in children and adolescents: An epidemiologic study related to specified stages of dental development
10. Electromyography of the temporalis and masseter muscles in children with unilateral cross-bite10.1111/j.1600-0722.1970.tb02092.x ↗
11. Activity of temporal and masseter muscles in children with a lateral forced bite
12. Class II Division 1 in New Dimension: Role of Posterior Transverse Interarch Discrepancy in Class II Division 1 Malocclusion During the Mixed Dentition Period
13. Expansion Changes by Removable Quad Helix Appliance on Constricted Maxilla in Growing Patients
14. Comparison of effectiveness of quad helix appliance with other slow maxillary expanders in children with posterior crossbite: A systematic review10.4103/JISPPD.JISPPD_85_17 ↗
15. Modular 3D lingual appliances. Part 4. Lingual arch
16. Slow maxillary expansion10.1016/0002-9416(78)90183-5 ↗
17. Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander10.2319/112315-799 ↗
18. Three-dimensional evaluation of dentoskeletal changes after posterior cross-bite correction by quad-helix or removable appliances10.1179/bjo.19.2.97 ↗
19. Skeletal and dental changes after maxillary expansion in the mixed dentition10.1016/S0889-5406(97)70191-4 ↗
20. Landmark identification error in posterior anterior cephalometrics
21. New algorithm for semiautomatic segmentation of nasal cavity and pharyngeal airway in comparison with manual segmentation using cone-beam computed tomography10.1016/j.ajodo.2016.06.024 ↗
22. Transverse dentoalveolar changes after slow maxillary expansion10.1016/j.ajodo.2010.06.025 ↗
23. Relationship between rapid maxillary expansion and nasal cavity size and airway resistance: Short- and long-term effects10.1016/j.ajodo.2006.10.034 ↗
24. Lanteri, V., Farronato, M., Ugolini, A., Cossellu, G., Gaffuri, F., Parisi, F.M.R., Cavagnetto, D., Abate, A., and Maspero, C. (2020). Volumetric changes in the upper airways after rapid and slow maxillary expansion in growing patients: A case-control study. Materials, 13.10.3390/ma13102239 ↗
25. Effects of orthopedic maxillary expansion on nasal cavity size in growing subjects: A low dose computer tomography clinical trial10.1016/j.ijporl.2012.07.008 ↗
26. Nasal cavity width changes following slow and rapid miniscrew-supported maxillary expansion10.21608/eos.2021.83829.1020 ↗
27. Pan, B., MacIntosh, D., Njie, R., Lui, A., Westover, L., and El-Bialy, T. (2025). The Effect of Upper Arch Expansion by Clear Aligners on Nasal Airway Volume in Children: A Preliminary Study. Appl. Sci., 15.10.3390/app15042134 ↗
28. The cervical vertebral maturation (CVM) method for the assessment of optimaltreatment timing in dentofacial orthopedics10.1053/j.sodo.2005.04.005 ↗
29. The effectiveness of non-surgical maxillary expansion: A meta-analysis10.1093/ejo/cjt044 ↗
30. Reliability of Traditional Cephalometric Landmarks as Seen in Three-Dimensional Analysis in Maxillary Expansion Treatments10.2319/010509-10R.1 ↗
31. Measuring Upper Airway Volume: Accuracy and Reliability of Dolphin 3D Software Compared to Manual Segmentation in Craniosynostosis Patients10.1016/j.joms.2013.07.034 ↗
32. A comparison of different treatment techniques for posterior crossbite in mixed dentition10.1016/S0889-5406(99)70240-4 ↗
33. The Evaluation of the Efficacy of Quad Helix vs. Non-Helical Appliance in Growing Patients Having Transverse Maxillary Discrepancy: A Randomized Clinical Trial
34. Superimposition of 3-dimensional cone-beam computed tomography models of growing patients10.1016/j.ajodo.2009.01.018 ↗
35. Clinical Application of 3D Imaging for Assessment of Treatment Outcomes10.1053/j.sodo.2010.08.012 ↗