Digital Workflow for CBCT-Guided Customized Miniscrew-Assisted Rapid Palatal Expansion (3D Digital MARPE): A Clinical Innovation

Miniscrew-assisted rapid palatal expansion (MARPE) has added a new dimension to the world of orthodontics with its use in skeletal expansion of transverse problems in adult population. However, there are few limitations noted with the use of prefabricated MARPE designs such as adaptation to the palate or minscrew fit in cases of high arched palate, which compromises with the anchorage and final outcome. The aim of this article is to use digital workflow to 3d print a MARPE with the aid of cone beam computed tomography, which would overcome the deficiencies of a prefabricated MARPE design and would provide greater rigidity and anchorage value, and predictable skeletal expansion.

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Rapid palatal expansion: Part 1. Mineralization pattern of the midpalatal suture in cats☆, ☆☆, ★

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/s0889-5406(98)70245-8 ◽

1998 ◽

Vol 113 (4) ◽

pp. 371-378 ◽

Cited By ~ 2

Author(s):

A VARDIMON ◽

T BROSH ◽

A SPIEGLER ◽

M LIEBERMAN ◽

S PITARU

Keyword(s):

Midpalatal Suture ◽

Palatal Expansion ◽

Rapid Palatal Expansion

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RAPID PALATAL EXPANSION AND ITS FEATURES

ASJ. ◽

10.31618/asj.2707-9864.2020.2.40.23 ◽

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.

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

American Journal of Orthodontics and Dentofacial Orthopedics ◽

10.1016/j.ajodo.2020.04.035 ◽

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

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

Applied Sciences ◽

10.3390/app11062531 ◽

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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Condylar Changes in Children with Posterior Crossbite after Maxillary Expansion: Tridimensional Evaluation

Children ◽

10.3390/children8010038 ◽

2021 ◽

Vol 8 (1) ◽

pp. 38

Author(s):

Rosamaria Fastuca ◽

Helga Turiaco ◽

Fausto Assandri ◽

Piero A. Zecca ◽

Luca Levrini ◽

...

Keyword(s):

Rapid Maxillary Expansion ◽

3D Analysis ◽

Maxillary Expansion ◽

3D Slicer ◽

Palatal Expansion ◽

Posterior Crossbite ◽

Rapid Palatal Expansion ◽

Before And After ◽

Condylar Position ◽

Caucasian Patients

(1) Background: To investigate condylar position in subjects with functional posterior crossbite comparing findings before and after rapid maxillary expansion (RME) treatment through 3D analysis; (2) Methods: Thirty-two Caucasian patients (14 males, mean age 8 y 8 m ± 1 y 2 m; 18 females mean age 8 y 2 m ± 1 y 4 m) with functional posterior crossbite (FPXB) diagnosis underwent rapid palatal expansion with a Haas appliance banded on second deciduous upper molars. Patients’ underwent CBCT scans before rapid palatal expansion (T0) and after 12 months (T1). The images were processed through 3D slicer software; (3) Results: The condylar position changes between T1 and T0 among the crossbite and non-crossbite sides were not statistically significant, except for the transversal axis. At T1, the condyles moved forward (y axis) and laterally (x axis), they also moved downward (z axis) but not significantly; (4) Conclusions: Condilar position in growing patients with functional posterior crossbite did not change significantly after rapid maxillary expansion.

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

European Journal of Orthodontics ◽

10.1093/ejo/cjab005 ◽

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.

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