@article{nokey,

title = {Facial soft tissue changes in patients following rapid maxillary expansion in children: A systematic review},

author = {Nafisa Marium Molla and Raisa Queiroz Catunda and Karla Carpio Horta and Heesoo Oh and Manuel O. Lagravère},

url = {https://www.sciencedirect.com/science/article/pii/S1761722725001421?pes=vor&utm_source=scopus&getft_integrator=scopus},

doi = {https://doi.org/10.1016/j.ortho.2025.101107},

year  = {2026},

date = {2026-06-01},

journal = {International Orthodontics},

volume = {24},

issue = {2},

abstract = {Background: Non-surgical rapid maxillary expansion (RME) has been widely investigated regarding skeletal effects, although fewer studies have assessed the associated soft tissue changes, which is an important factor to consider, as orthodontic treatment aims to achieve occlusal harmony and an aesthetically pleasing soft tissue balance. This systematic review examines the existing literature on facial soft tissue changes following rapid maxillary expansion (RME) in children with a maxillary transverse deficiency. Material and methods: A systematic search was conducted up to July 2025 in four major databases, including Embase (via Ovid), Medline (via Ovid), PubMed, Cochrane Library, and Google Scholar. Studies focused on children receiving RME were included. The risk of bias was assessed using the Revised Cochrane risk-of-bias tool for randomized trials and the ROBINS-I tool for the Risk of Bias in Non-randomized Studies of Interventions. This review followed the protocols recommended by the Preferred Reporting Items for a Systematic Review and Meta-analysis (PRISMA) guidelines. Results: Of the 1379 articles found, 15 included PICOS-based inclusion criteria: five randomized controlled trials, four cohort studies, and six controlled clinical trials. Alar width (0.5 to 2.21 mm), alar base width (0.17 to 2.81 mm), and nasolabial angle (0.9 degrees) increased significantly after RME treatment. Five studies were found to have a low risk of bias, seven had a moderate risk of bias, one had a serious risk of bias, and two had some concerns. Conclusions: Our findings suggest that RME results in variable soft tissue facial changes over time. The findings resulted statistically significant for alar width, alar base width, and nasolabial angle, showing changes in the facial soft tissues after non-surgical rapid maxillary expansion, especially in the nasal area. These results, which are directly related to the anatomical effects of the rapid maxillary expansion, need careful consideration by clinicians as the skeletal and the consequent soft tissue changes may be influenced by different factors, i.e. patient age, appliance activation and follow-up duration.},

keywords = {Facial Soft Tissue, implant supported rapid maxillary expansion, malocclusion, nasal changes, Rapid Maxillary Expansion, tooth-bone-borne rapid maxillary expansion},

pubstate = {forthcoming},

tppubtype = {article}

}

@article{nokey,

title = {Airway changes in growing Class II patients treated with Herbst appliance: A randomized controlled trial (RCT) comparing dental and skeletal anchorage},

author = {Luísa Schubach da Costa Barreto and Bruno Moreira das Neves and Deise Caldas Kuhlman and Nathalia Barbosa Palomares and Felipe de Assis Ribeiro Carvalho and Heeyeon Suh and Jonas Bianchi and Heesoo Oh and Klaus Barretto Dos Santos Lopes Batista and José Augusto Mendes Miguel },

url = {https://pubmed.ncbi.nlm.nih.gov/41417024/},

doi = {https://doi.org/10.1080/08869634.2025.2601531},

year  = {2025},

date = {2025-12-19},

journal = {Cranio - Journal of Craniomandibular and Sleep Practice},

pages = {1-13},

abstract = {Objective: To evaluate changes in the oropharyngeal airway (OP) with Herbst appliances using either dental or skeletal anchorage (HDA vs. HSA) in growing patients with Class II division 1 malocclusion. Design, Setting, and Participants: Forty patients (12.6 ± 1.4 years) at the peak of pubertal growth were randomized (HDA= 20; HSA= 20), for 12 months. Outcomes: change in OP volume, airway length and cross-sectional areas (minimum, maximum, average), by CBCT. Results: Thirty-four patients completed the study (HDA= 19; HSA= 15); and intention-to-treat (ITT) analysis was applied. Within-group analysis revealed a significant improvement for minimum axial area (HDA, p =.0061). Between-group comparisons showed significantly higher mean values in the HSA group for volume (p =.0044), airway length (p =.004), maximum cross-sectional area (p =.0188), and average area (p =.0122). Conclusions: HSA and HDA increased OP dimensions in growing Class II patients. Although HSA did not demonstrate a statistically superior effect, the dimensional changes represent morphological adaptations. Long-term studies are required to determine respiratory benefits.},

keywords = {Airway Changes, Angle Class II, Cone-beam computed tomography (CBCT), malocclusion, orthodontic appliances},

pubstate = {published},

tppubtype = {article}

}

@article{Molla2025,

title = {Comparison of soft tissue facial changes in patients 7–11 years of age with and without maxillary expansion utilizing CBCTs and 3D facial scans: A preliminary study},

author = {Nafisa Molla and Heesoo Oh and Giseon Heo and Raisa Catunda and Manuel Lagravère},

url = {https://www.sciencedirect.com/science/article/pii/S1761722725000336?via%3Dihub},

doi = {https://doi.org/10.1016/j.ortho.2025.100998},

year  = {2025},

date = {2025-09-01},

urldate = {2025-09-01},

journal = {International Orthodontics},

volume = {23},

issue = {3},

abstract = {Background: The objectives of this study are to evaluate the effects of maxillary expansion over a period of 12 months on facial soft tissue measurements in children aged 7–11 years with a maxillary transverse deficiency of at least 5 mm or bilateral posterior crossbite, utilizing both CBCTs and 3D facial scans, by comparison to a control group. Material and methods: Data was collected from 32 patients and consisted of two groups: control and treatment (Hyrax expansion via RME, 1 turn/day). Each patient in each group underwent CBCTs, 3D facial scans and hand-wrist radiographs at two time points: pre-treatment (T0), and after the completion of expansion at post-retention (T1, 12 months). CBCTs were assessed using 3D Slicer software and 3D facial scans were assessed using OrthoInsight 3D software. The soft tissue measurements evaluated included the following: alar width, alar base width, mouth width, philtrum width, nasal tip prominence, nasolabial angle, upper lip to E-line, lower lip to E-line, upper lip height, height of vermillion of upper lip, lower lip height, height of nose, lower facial height and intercanthal width. Statistical analysis included intra- and inter-rater variability, measurement error calculation and MANOVA tests. Results: From a total of 32 patients with two sets of imaging records, no statistically significant differences were found between the two groups over the one-year observation. However, when comparing the two modalities utilized in this study (CBCT imaging and 3D facial scanning), the correlation was not as optimal for specific outcome variables such as alar base width and intercanthal width, potentially due to anatomic, imaging protocols and patient related factors. Conclusion: The findings of this study suggest that the children in both groups experienced similar facial soft tissue changes.},

keywords = {3D Imaging, Facial Soft Tissue, malocclusion, Rapid Maxillary Expansion},

pubstate = {published},

tppubtype = {article}

}

@article{Moon2024,

title = {Establishing Occlusion for Cleft Lip and Palate Patient},

author = {Stacey H. Moon and Olivia Yue and Mark Vaughan and Heeyeon Suh and Heesoo Oh},

url = {https://scholar.kyobobook.co.kr/article/detail/4050069418395},

year  = {2024},

date = {2024-06-03},

journal = {Journal of the Korean Cleft Lip and Palate Society},

volume = {27},

number = {1},

pages = {6-17},

abstract = {Craniofacial cleft patients commonly present with under-developed maxilla, which may have a profound effect not only on their soft tissue facial appearance but also skeletal discrepancy and dental malocclusion. This case report presents the treatment of a 14-year-old girl with a Class III skeletal and dental malocclusion. Her occlusion is complicated by a maxillary anterior right osseous cleft, retrognathic narrow maxilla with associated anterior and posterior crossbite, dental crowding, retained primary teeth, and several missing permanent teeth including maxillary premolars, both permanent maxillary lateral incisors, and all third molars. Our treatment plan consisted of extractions of the remaining primary teeth, maxillary expansion, protraction of maxilla and substitution of the maxillary left premolar for a lateral incisor tooth. The need for orthognathic surgery was also explained to the patient prior to the start of the treatment. The treatment was successfully completed with fixed appliances, rapid palatal expander (RPE), facemask (FM), maxillary segmental advancement with the fistula closure, and alveolar bone graft and elastics. Septorhinoplasty was completed towards the end of the treatment. Orthodontic treatment was completed in 48 months. The maxillary anterior teeth were aesthetically restored after the orthodontic treatment was completed. The retention consisted of maxillary and mandibular Hawley retainers.},

keywords = {Class III, cleft lip, Dental Crowding, malocclusion, Rapid Palatal Expander (RPE)},

pubstate = {published},

tppubtype = {article}

}

@article{Oh2022d,

title = {Craniofacial growth and morphology among intersecting clinical categories},

author = {R Knigge and A Hardin and K Middleton and K McNulty and H Oh and M Valiathan and D Duren and R Sherwood},

url = {https://pubmed.ncbi.nlm.nih.gov/35076186/},

doi = {10.1002/ar.24870},

year  = {2022},

date = {2022-02-11},

journal = {Anatomical Record (Hoboken)},

abstract = {Differential patterns of craniofacial growth are important sources of variation that can result in skeletal malocclusion. Understanding the timing of growth milestones and morphological change associated with adult skeletal malocclusions is critical for developing individualized orthodontic growth modification strategies. To identify patterns in the timing and geometry of growth, we used Bayesian modeling of cephalometrics and geometric morphometric analyses with a dense, longitudinal sample consisting of 15,407 cephalograms from 1,913 individuals between 2 and 31 years of age. Individuals were classified into vertical facial types (hyper-, normo-, hypo-divergent) and anteroposterior (A-P) skeletal classes (Class I, Class II, Class III) based on adult mandibular plane angle and ANB angle, respectively. These classifications yielded eight facial type-skeletal class categories with sufficient sample sizes to be included in the study. Four linear cephalometrics representing facial heights and maxillary and mandibular lengths were fit to standard double logistic models generating type-class category-specific estimates for age, size, and rate of growth at growth milestones. Mean landmark configurations were compared among type-class categories at four time points between 6 and 20 years of age. Overall, morphology and growth patterns were more similar within vertical facial types than within A-P classes and variation among A-P classes typically nested within variation among vertical types. Further, type-class-associated variation in the rate and magnitude of growth in specific regions identified here may serve as targets for clinical treatment of complex vertical and A-P skeletal malocclusion and provide a clearer picture of the development of variation in craniofacial form.},

keywords = {cephalometrics, craniofacial growth, geometric morphometrics, growth modeling, malocclusion},

pubstate = {published},

tppubtype = {article}

}