The effect of rapid maxillary expansion on the height of the maxillary central incisor interdental papilla

Purpose: In rapid maxillary expansion, the alveolar crest resorbs in the sutural region and a diastema forms in the area between the central incisors. This may be a predisposing factor for papillary recession between the central central incisors. Based on this situation, we aimed to examine the changes in papillary heights of patients who underwent rapid maxillary expansion and fixed orthodontic treatment. Method: Our study is a retrospective study using file and image records. In our study, the records of patients who underwent rapid maxillary expansion treatment followed by fixed orthodontic treatment in Aydın Adnan Menderes University Faculty of Dentistry, Department of Orthodontics between January 2015 and December 2021 were examined. In the archive, 356 records of patients who received fixed treatment after rapid maxillary expansion were found. We excluded 143 patients who did not meet the inclusion criteria. Of the 213 patients included in the study, 142 (66.7%) were female and 71 (33.3%) were male. The ages of the patients ranged between 12 and 26 years, with a mean age of 16.91 years. Using the Jemt classification, papillary height changes were analyzed on intraoral patient photographs taken from the frontal view before (T1) and after (T2) treatment. The difference between T1 and T2 (Jemt) was defined as the dependent variable. Age, gender, duration of treatment, type of rapid maxillary expansion used, crown morphologies, gingival biotype, growth and development potential of the patients before treatment, interproximal contact length of the central incisors, axial angles of the central incisors, interdental distance between the central incisors, overlapping of the central incisors on the mesial edges, upper incisor angle and distance values of the patients were defined as independent variables. The suitability of the research data for normal distribution was determined by Kolmogorov-Smirnov test. Frequency analysis was used to determine the demographic information of the patients. Binary logistic regression analysis was performed to determine the effect of independent variables on the presence of papillary recession. ROC analysis was performed to determine the cut-off point of the research data with significant results. 95 % confidence interval (p<.05) was used for the significance level when creating the research report. Results: In 89 of 213 patients included in the study, papillary recession was observed between T1 and T2 according to Jemt scoring. Conclusion: Age, distance between alveolar crest and central incisor contact point, interdental distance between central incisors, interproximal contact length, T1- T2 incisor angle and distance changes were found to be factors associated with papillary recession. Keywords: Jemt classification, papillary recession, rapid maxillary expansion, RME.