scholarly journals Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Aldin Kapetanović ◽  
Christina I Theodorou ◽  
Stefaan J Bergé ◽  
Jan G J H Schols ◽  
Tong Xi
Keyword(s):  
Systematic Review ◽  
Success Rate ◽  
Observational Studies ◽  
Risk Of Bias ◽  
Late Adolescents ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Adolescents And Adults ◽  
Maxillary Deficiency

Summary Background Miniscrew-Assisted Rapid Palatal Expansion (MARPE) is a non-surgical treatment for transverse maxillary deficiency. However, there is limited evidence concerning its efficacy. Objectives This systematic review aims to evaluate the efficacy of MARPE in late adolescents and adults by assessing success rate and skeletal and dental transverse maxillary expansion, as well as treatment duration, dental and periodontal side effects and soft tissue effects. Search methods Seven electronic databases were searched (MEDLINE, Embase, Cochrane Library, Web of Science, Scopus, ProQuest and ClinicalTrials.gov) without limitations in November 2020. Selection criteria Randomized and non-randomized clinical trials and observational studies on patients from the age of 16 onwards with transverse maxillary deficiency who were treated with MARPE and which included any of the predefined outcomes. Data collection and analysis Inclusion eligibility screening, data extraction and risk of bias assessment were performed independently in duplicate. When possible, exploratory meta-analyses of mean differences (MDs) with their 95% confidence intervals (CIs) were conducted, followed by the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) analysis of the evidence quality. Results Eight articles were included: two prospective and six retrospective observational studies. One study had a moderate risk of bias, whereas seven studies had a serious risk of bias. GRADE quality of evidence was very low. MARPE showed a high success rate (mean: 92.5%; 95%CI: 88.7%–96.3%), resulting in a significant skeletal width increase (MD: 2.33 mm; 95%CI: 1.63 mm–3.03 mm) and dental intermolar width increase (MD: 6.55 mm; 95%CI: 5.50 mm–7.59 mm). A significant increase in dental tipping, a decrease in mean buccal bone thickness and buccal alveolar height, as well as nasal soft tissue change was present (P < 0.05). The mean duration of expansion ranged from 20 to 126 days. Limitations One of the main drawbacks was the lack of high-quality prospective studies in the literature. Conclusions and implications MARPE is a treatment modality that is associated with a high success rate in skeletal and dental maxillary expansion. MARPE can induce dental and periodontal side effects and affect peri-oral soft tissues. Given the serious risk of bias of the included studies, careful data interpretation is necessary and future research of higher quality is strongly recommended. Registration PROSPERO (CRD42020176618). Funding No grants or any other support funding were received.

scholarly journals Rapid Maxillary Expansion and Nocturnal Enuresis in Children and Adolescents: A Systematic Review of Controlled Clinical Trials

2021 ◽  
Vol 2021 ◽  
pp. 1-10
Author(s):  
Khaled Khalaf ◽  
Dina Mansour ◽  
Zain Sawalha ◽  
Sima Habrawi
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Children And Adolescents ◽  
Nocturnal Enuresis ◽  
Risk Of Bias ◽  
Maxillary Expansion ◽  
Controlled Clinical Trials ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Alternative Treatment Option

Objectives. To evaluate the effectiveness of rapid palatal expansion in the treatment of nocturnal enuresis among 6–18-year-old children and adolescents. Methods. Comprehensive searches were carried out in 6 electronic databases (EBSCO, ProQuest, Clinical Key, Science Direct, SCOPUS, and OVID) and supplemented by additional manual searches in 4 orthodontic journals until June 2020. Randomized controlled clinical trials (RCTs) and controlled clinical trials (CCTs) of children and adolescents aged 6–18 years old of both genders who underwent rapid palatal expansion and were considered unresponsive to previous conventional nocturnal enuresis treatment were included in this review. Risk of bias of individual trials was assessed using the Risk of Bias in Non-randomized Studies of Interventions (ROBINS-I) assessment tool for CCTs and the revised Cochrane Risk-of-Bias tool for RCTs (RoB 2). Results. Four studies met all inclusion criteria and were finally included in this systematic review, of which one was an RCT and three were CCTs. Reduction in nocturnal enuresis frequency was reported in all included studies with varying rates and methods of reporting, but most studies reported a statistically significant reduction in the number of wet nights per week. The average range of becoming completely dry 1 year after treatment with an RME was 0%–60%. Also, there was a statistically significant correlation between an improvement in bedwetting and an increase in nasal volume after the use of RME. Conclusion. A rapid palatal expansion device may be considered as an alternative treatment option of the nocturnal enuresis condition with guarded prognosis when other treatment modalities have failed.

scholarly journals Surgically Assisted Rapid Palatal Expansion and Mini-screw Assisted Rapid Palatal Expansion - A review

2021 ◽  
Vol 3 (30) ◽  
pp. 21-29
Author(s):  
Vijay Vaghela ◽  
Keyword(s):  
Surgical Technique ◽  
Treatment Option ◽  
Surgical Approach ◽  
Patient Acceptance ◽  
Late Adolescents ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Adolescents And Adults ◽  
Maxillary Arch

This review was undertaken to compare the effects of surgically assisted rapid palatal expansion (SARPE) and mini-screw assisted rapid palatal expansion (MARPE). Discrepancies in the transverse relation between maxillary and mandibular dentition can result in the development of posterior cross bite. For the correction of posterior cross bite, maxillary expansion is frequently undertaken. The conventional approach for maxillary expansion includes expansion screw being anchored to the maxillary teeth and is known and rapid palatal expansion (RPE) appliance. However, RPE can only be applied in growing individuals and is not as effective in late adolescents and adults. In such patients, surgically assisted rapid palatal expansion (SARPE) technique is used to expand the maxillary arch. As this procedure involves surgery, it deters many patients from choosing SARPE as a treatment option. Recently a non-surgical technique of expansion of maxillary arch has been introduced that can be applied to late adolescents and adults using palatal mini-screws. This technique is known as mini-screw assisted rapid palatal expansion (MARPE). In this review, the studies in the current literature regarding the SARPE and MARPE expansion techniques as compared to conventional RPE were included. It was observed that both SARPE and MARPE are effective methods for achieving maxillary expansion. With both techniques being effective, the advantage of MARPE over SARPE is the non-surgical approach which leads to higher patient acceptance and lower rate of complications.

scholarly journals MODERN PERSPECTIVES ON RAPID PALATAL EXPANSION

2021 ◽  
Vol 9 (5) ◽  
pp. 497-500
Author(s):  
Kinnari Markana ◽  
Keyword(s):  
Transverse Dimension ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Negative Effects ◽  
Palatal Expansion ◽  
Beneficial Effects ◽  
Rapid Palatal Expansion ◽  
Mini Implants ◽  
Maxillary Deficiency ◽  
Skeletal Expansion

Maxillary deficiency in the transverse dimension is a common problem in children. The conventional management of such malocclusion is with conventional rapid maxillary expansion. The beneficial effects of such an orthodontic therapy are explained in detail in the literature. But there are also negative effects of conventional rapid maxillary expansion. Thus, the improvements in the methods of expansion has led to discovery of miniscrew assisted rapid palatal expansion. The miniscrew assisted rapid palatal expansion are supported by mini implants and thus enable better skeletal expansion of maxilla. This article will discuss the favourable effects, negative effects, and clinical uses of conventional and miniscrew assisted rapid palatal expansion.

scholarly journals Correction of transverse maxillary deficiency and anterior open bite in an adult Class III skeletal patient

2016 ◽  
Vol 6 ◽  
pp. 166-170
Author(s):  
Prerna Hoogan Teja ◽  
Samarjit Singh Teja ◽  
Rabindra S. Nayak ◽  
Abhijit Bagade ◽  
Manu Rashmi Sharma
Keyword(s):  
Transverse Dimension ◽  
Open Bite ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Anterior Open Bite ◽  
Palatal Expansion ◽  
Posterior Crossbite ◽  
Rapid Palatal Expansion ◽  
Dental Crowding ◽  
Maxillary Deficiency

Transverse maxillary deficiency may be associated with sagittal or vertical problems of the maxilla or mandible. It may contribute to unilateral or bilateral posterior crossbite, anterior dental crowding, and unesthetic black buccal corridors on smiling. An adequate transverse dimension is important for stable and proper functional occlusion. Surgically, assisted rapid palatal expansion has been the treatment of choice to resolve posterior crossbite in skeletally mature patients. The following case report presents an adult Class III skeletal patient with an anterior open bite and bilateral posterior crossbite which was treated by surgically assisted rapid maxillary expansion with satisfactory outcomes.

scholarly journals Custom fabrication of cast splint microimplant-assisted rapid palatal expansion appliances for treatment of maxillary deficiency in young adults

2021 ◽  
Vol 11 ◽  
pp. 247-253
Author(s):  
Bushra Sufyan Almaqrami ◽  
Huwate Saireke ◽  
Wang Xiying ◽  
Peter Ngan ◽  
Cao Hui ◽  
...  
Keyword(s):  
Young Adults ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Custom Design ◽  
Casting Unit ◽  
Custom Made ◽  
Retention Device ◽  
Maxillary Deficiency ◽  
Palatal Mucosa

Background: The objective of this article was to illustrate the process in the fabrication of a custom cast splint Microimplant-Assisted Rapid Palatal Expansion (MARPE) appliance for treatment of maxillary deficiency in young adults. Findings: The fabrication of a custom-made MARPE appliance allows the casting base to design according to the shape of the patient’s palate close to the palatal mucosa. In this new design, one end consists of a casting body, inserting hole, and teeth retention device (circumferential rings) connected to the other end by a jackscrew. Connection of all parts in the integral casting unit increases the strength of the expansion appliance and avoids distortion, deformation, or damage to the palatal mucosa due to increased resistance from the oromaxillofacial area. Conclusion: This custom design can improve the clinical outcome of maxillary expansion, especially in patients with narrow and high-arched palates.

scholarly journals Evaluation of factors related to the success of miniscrew-assisted rapid palatal expansion

2020 ◽  
Author(s):  
Cibele B. Oliveira ◽  
Priscila Ayub ◽  
Fernanda Angelieri ◽  
Wilson H. Murata ◽  
Selly S. Suzuki ◽  
...  
Keyword(s):  
Success Rate ◽  
Negative Correlation ◽  
Significant Negative Correlation ◽  
Maxillary Expansion ◽  
Bone Maturation ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Maturation Stages ◽  
Implant Anchorage ◽  
Stage D

ABSTRACT Objectives To evaluate whether the success of miniscrew-assisted rapid palatal expansion (MARPE), performed in patients with advanced bone maturation is related to factors such as midpalatal suture (MPS) maturation, age, sex, or bicortical mini-implant anchorage. Materials and Methods Twenty-eight cone beam computed tomography (CBCT) scans of adults and post-pubertal adolescents treated by MARPE were included in the sample. CBCT images before (T0) and after expansion (T1) were used to evaluate the skeletal changes and the success or failure of MARPE. Axial images of MPS were extracted from T0 and classified into one of the five maturation stages. The correlation between MARPE success and the factors of age, sex, MPS maturation, and bicortical mini-implant anchorage was investigated. Results Only the age showed a statistically significant negative correlation with MARPE success and all the skeletal measures. There was an 83.3% success rate among individuals aged 15 to 19 years, 81.8% from 20 to 29 years, and 20% from 30 to 37 years. MPS maturation showed a negative correlation with the expansion effect. Subjects with stages B or C of MPS maturation showed a 100% success rate, followed by stage D (62.5%) and stage E (58.3%). Conclusions As age increased, there was a decrease in MARPE success and the skeletal effects of maxillary expansion. Sex and bicortical mini-implant anchorage were not shown to be relevant factors. There was no correlation between MPS maturation and MARPE success; however, it was observed that all cases of MARPE failure were classified as stage D or E of MPS maturation.

scholarly journals Comparative dimensional tomographic study of the mandibular condyle of individuals with transverse maxillary deficiency

2017 ◽  
Vol 15 (4) ◽  
pp. 242
Author(s):  
Andréa Guedes Barreto Gonçales ◽  
Victor Tieghi Neto ◽  
Eduardo Sanches Gonçales ◽  
Ana Lúcia Álvares Capelozza
Keyword(s):  
Computed Tomography ◽  
Statistical Analysis ◽  
Mandibular Condyle ◽  
Cone Beam ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Maxillary Deficiency ◽  
Posterior Anterior ◽  
Paired T Test

Transverse maxillary deficiency is characterized by posterior uni or bilateral crossbite, crowded and rotated teeth, as well as high palate. Its treatment in adult individuals is surgically assisted rapid palatal expansion. The aim of this study was to verify the occurrence of dimensional alterations in the mandibular condyles of patients with TMD submitted to surgically assisted maxillary expansion. Measurements of the mandibular condyles using the DISTANCE tool in cone beam computed tomography iCat software were performed. The values obtained were submitted to statistical analysis by the paired t-test and the results showed statistically significant dimensional reduction in the axial posterior-anterior lateral (-0.74mm), axial posterior-anterior lateral left (-0.90mm) and coronal medium right (-1.24mm) dimensions. The coronal inferior (1.13mm), coronal inferior left (1.78mm) and coronal superior-inferior right (0.76mm) measurements showed statistically significant dimensional increase. The results allowed us to conclude that dimensional alterations occurred in the mandibular condyles in individuals with maxillary transversal deficiency that underwent surgically assisted rapid palatal expansion (SAPE), which can be understood by remodeling, since they are characterized by dimensional increase or reduction, depending on the location where the measurement was performed.

RAPID PALATAL EXPANSION AND ITS FEATURES

ASJ. ◽  
2020 ◽  
Vol 2 (40) ◽  
pp. 20-22
Author(s):  
A.K. Al Dzhafari ◽  
S.A. Ulyanovskaya
Keyword(s):  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Maxillofacial Region ◽  
Posterior Teeth ◽  
Anatomical Features ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Congenital Deformities ◽  
Upper Jaw ◽  
Mid Palatal Suture

Rapid Maxillary expansion or palatal expansion as it is sometimes called, occupies unique niche in dentofacial therapy. Rapid Maxillary expansion (RME) is a skeletal type of expansion that involves the separation of the mid-palatal suture and movement of the maxillary shelves away from each other. RME effects the maxillary complex, palatal vaults, maxillary anterior and posterior teeth, adjacent periodontal structures to bring about an expansion in the maxillary arch. Morphogenesis and anatomical features of the upper jaw determine the choice of the method of rapid palatal expansion with narrowing of the upper dentition, as an effective method for eliminating congenital deformities of the maxillofacial region. The majority of dental transverse measurements changed significantly as a result of RME. The maturity of the maxillofacial structures determines the timing and degree of success of rapid palatal dilatation treatment.

Would midpalatal suture characteristics help to predict the success rate of miniscrew-assisted rapid palatal expansion?

2021 ◽  
Author(s):  
Adriana Souza de Jesus ◽  
Cibele Braga de Oliveira ◽  
Wilson Humio Murata ◽  
Selly Sayuri Suzuki ◽  
Ary dos Santos-Pinto
Keyword(s):  
Success Rate ◽  
Midpalatal Suture ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion

scholarly journals Evaluation of the Nasolabial Angle in Orthodontic Diagnosis: A Systematic Review

2021 ◽  
Vol 11 (6) ◽  
pp. 2531
Author(s):  
Vincenzo Quinzi ◽  
Licia Coceani Paskay ◽  
Nicola D’Andrea ◽  
Arianna Albani ◽  
Annalisa Monaco ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hyaluronic Acid ◽  
Class Ii ◽  
Cochrane Library ◽  
Class Iii ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Nasolabial Angle ◽  
Registration Number ◽  
Teeth Extraction

Background: This study is a systematic literature review aiming at identifying the variation of the average nasolabial angle (NLA) in various orthodontic situations. The NLA is one of the key factors to be studied in an orthodontic diagnosis for the aesthetics of the nose and facial profile. Methods: Out of 3118 articles resulting from four search engines (PubMed, Cochrane Library, Turning Research Into Practice (TRIP) and SciELO), the final study allowed the analysis and comparison of only 26 studies. These included studies have considered the NLA in the following cases: teeth extraction, class II malocclusion, class III malocclusion, rapid palatal expansion (RPE), orthognathic surgery, and non-surgical rhinoplasty with a hyaluronic acid filler. Results: The results indicate that teeth extraction and the use of hyaluronic acid fillers significantly affect the NLA. Conclusions: This systematic review shows that a statistically significant change in NLA values occurs in: extractive treatments of all four of the first or second premolars in class I patients; in class II patients with upper maxillary protrusion; in patients with maxillary biprotrusion, except for cases of severe crowding; and in patients undergoing non-surgical rhinoplasty with a hyaluronic acid filler. Trial registration number: PROSPERO CRD42020185166

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