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Original Research

Open Access

Photographic analysis of orofacial soft tissue alterations related to rapid maxillary expansion in pediatric patients

  • Hande Uzunçıbuk1
  • Maria Maddalena Marrapodi2
  • Aida Meto3,*,
  • Gabriele Cervino4,*,
  • Marco Cicciù5
  • Giuseppe Minervini6,7

1Department of Orthodontics, Dentistry Faculty, Trakya University, 22030 Edirne, Turkey

2Department of Woman, Child, and General and Specialist Surgery, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy

3Department of Dentistry, Faculty of Dental Sciences, University of Aldent, 1007 Tirana, Albania

4Department of Biomedical and Dental Sciences, Morphological and Functional images, University of Messina “G. Martino” Polyclinic, 98125 Messina, Italy

5Department of General Surgery and Medical-Surgical Specialties, School of Dentistry, University of Catania, 95123 Catania, Italy

6Saveetha Dental College and Hospitals, Saveetha Institute of Medical and Technical Sciences (SIMATS), Saveetha University, 600077 Chennai, India

7Multidisciplinary Department of Medical-Surgical and Dental Specialties, University of Campania Luigi Vanvitelli, 80138 Naples, Italy

DOI: 10.22514/jocpd.2024.031 Vol.48,Issue 2,March 2024 pp.26-39

Submitted: 04 March 2023 Accepted: 12 May 2023

Published: 03 March 2024

*Corresponding Author(s): Aida Meto E-mail:
*Corresponding Author(s): Gabriele Cervino E-mail:


Maxillary transverse deficiency is widely recognized as one of the most common skeletal issues in orthodontics, and rapid maxillary expansion (RME) is commonly employed as a treatment method. This study aimed to investigate the impact of RME on the soft tissues of the orofacial region in pediatric patients. The study included two groups: an experimental group comprising 30 patients (16 females and 14 males) with maxillary skeletal transverse deficiency who required rapid maxillary expansion (RME), and a control group consisting of patients (10 females and 10 males) who did not require RME or orthodontic treatment. Frontal and profile photographs were taken before and after RME for both groups. Frontal photographs were used to obtain 12 linear measurements, while profile photographs were used to perform 2 linear and 2 angular measurements using the “protractor” and “pixel ruler” software. Burstone-Legan, Steiner and Rickett’s analyses were performed to determine the locations of the upper and lower lips. Student t-test, paired samples t-test and Mann-Whitney U test were used to evaluate the data. In the experimental group, there was a statistically significant increase in nose width and intercommissural distance at the end of the treatment (p < 0.05). Similarly, both the experimental and control groups showed a statistically significant increase in the dorsum of nose length at T2 compared to the initial measurement (p < 0.05). Furthermore, the male participants in the experimental group exhibited a statistically significantly higher increase in nose length and dorsum of the nose during the T1 and T2 periods compared to the female participants in the experimental group (p < 0.05). RME may lead to changes in soft tissues in pediatric patients and was observed to be gender-specific. However, these changes were not clinically noticeable, and long-term follow-up studies are needed to determine the long-term effects of these changes.


Orthodontics; Maxillary expansion; Pediatrics; Soft tissue

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Hande Uzunçıbuk,Maria Maddalena Marrapodi,Aida Meto,Gabriele Cervino,Marco Cicciù,Giuseppe Minervini. Photographic analysis of orofacial soft tissue alterations related to rapid maxillary expansion in pediatric patients. Journal of Clinical Pediatric Dentistry. 2024. 48(2);26-39.


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