scholarly journals Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

2021 ◽  
Vol 17 (1) ◽  
Author(s):  
Heinz Winsauer ◽  
Andre Walter ◽  
Christos Katsaros ◽  
Oliver Ploder
Keyword(s):  
Complication Rate ◽  
Cone Beam Ct ◽  
Predictor Variable ◽  
Adult Patients ◽  
Maxillary Expansion ◽  
Maximum Expansion ◽  
Palatal Expansion ◽  
Expansion Protocol ◽  
Expansion Pattern ◽  
Common Technique

Abstract Introduction Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC). Methods This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others. Results Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects’ complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019). Conclusions 1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%. 2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed. 3. Complications were significantly associated with age. 4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients. Trial registration Consecutive cohort study, Review Board No. EK-2-2014/0016.

scholarly journals Success And Complication Rate of Miniscrew Assisted Non-Surgical Palatal Expansion In Adults - A Consecutive Study Using A Novel Force-Controlled Polycyclic Activation Protocol

2021 ◽  
Author(s):  
Heinz Winsauer ◽  
Andre Walter ◽  
Christos Katsaros ◽  
Oliver Ploder
Keyword(s):  
Complication Rate ◽  
Cone Beam Ct ◽  
Predictor Variable ◽  
Adult Patients ◽  
Maxillary Expansion ◽  
Maximum Expansion ◽  
Palatal Expansion ◽  
Expansion Protocol ◽  
Expansion Pattern ◽  
Common Technique

Abstract Introduction: Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC).Methods: This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others.Results: Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects' complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019).Conclusions:1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%.2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed.3. Complications were significantly associated with age.4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients.Trial registration: consecutive cohort study, Review Board No. EK-2-2014/0016

scholarly journals Skeletal, Dentoalveolar, and Periodontal Changes of Skeletally Matured Patients with Maxillary Deficiency Treated with Microimplant-assisted Rapid Palatal Expansion Appliances: A Pilot Study

2018 ◽  
Vol 8 ◽  
pp. 71-85 ◽  
Author(s):  
Peter Ngan ◽  
Uyen Kelly Nguyen ◽  
Tung Nguyen ◽  
Timothy Tremont ◽  
Chris Martin
Keyword(s):  
Alveolar Bone ◽  
Adult Patients ◽  
Matched Pair ◽  
Limited Information ◽  
Maxillary Expansion ◽  
Midpalatal Suture ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Before And After ◽  
Suture Opening

Introduction Microimplant-assisted rapid palatal expansion (MARPE) has recently been offered to adult patients for correcting maxillary transverse deficiency. However, there is limited information in the literature on the success of this appliance and its skeletal and dental effects on skeletally matured patients. The purpose of this study was to investigate the immediate skeletal, dentoalveolar, and periodontal response to MARPE appliance using cone-beam computed tomography in a skeletally matured patient as assessed by the cervical vertebral maturation method. Materials and Methods Eight consecutively treated patients (2 females, 6 males; mean age of 21.9 ± 1.5 years) treated with a maxillary skeletal expander were included in the study. Measurements were taken before and after expansion to determine the amount of midpalatal suture opening, upper facial bony expansion, alveolar bone bending, dental tipping, and buccal bone thickness (BBT). Data were analyzed using a one-way ANOVA and matched-pair t-test (α = 0.05). Results Midpalatal suture separation was found in 100% of the patients with no dislodged microimplants. Total maxillary expansion was attributed to 41% skeletal, 12% alveolar bone bending, and 48% dental tipping. Pattern of midpalatal suture opening was found to be parallel in both the coronal and axial planes. On average, the absolute dental tipping ranged from 4.17° to 4.96° and the BBT was reduced by an average of 39% measured at the premolars and molars. Conclusions The MARPE appliance can be a clinically acceptable, nonsurgical treatment option for correcting mild to moderate maxillary transverse discrepancies for skeletally matured adult patients with a healthy periodontium.

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.

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

Children ◽  
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.

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 &lt; 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 Long-Term Results of a Modified Removable Expansion Plate to Increase Arch Length: A Series of 10 Cases

2020 ◽  
Vol 54 (4) ◽  
pp. 374-381
Author(s):  
Alka M. Banker ◽  
Rahul P. Muchhadia ◽  
Bhagyashree B. Desai ◽  
Priyanka A. Shah
Keyword(s):  
Transverse Dimension ◽  
Rapid Maxillary Expansion ◽  
Permanent Dentition ◽  
Long Term Results ◽  
Maxillary Expansion ◽  
Fixed Appliance ◽  
Palatal Expansion ◽  
Fixed Appliances ◽  
Complexity Cost

Crowding, protrusion, and class II or end-on occlusion are malocclusions frequently associated with a narrow transverse dimension. The goal of expansion is to reduce the need for extractions in permanent dentition through elimination of arch length discrepancies as well as correction of bony base imbalances. Gaining arch length makes the subsequent fixed appliance treatment easier and shorter. Palatal expansion is usually achieved by using fixed rapid maxillary expansion, but because of the complexity, cost, and increased laboratory steps, this step is sometimes omitted. We have modified the design and screw activation protocol of the removable Schwarz plate in such a way that it gives efficient and stable expansion as well as arch perimeter gain with simpler mechanics. We present the long-term results of 10 such cases treated with this modified expander followed by fixed appliances.

scholarly journals Efeitos da expansão rápida de maxila na audição: revisão sistemática da literatura

2016 ◽  
Vol 21 (0) ◽  
Author(s):  
Claudine Devicari Bueno ◽  
Camila Zander Neves ◽  
Pricila Sleifer ◽  
José Renato Prietsch ◽  
Erissandra Gomes
Keyword(s):  
Hearing Loss ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Palatal Expansion Technique ◽  
Palatal Expansion ◽  
Expansion Technique

RESUMO Objetivo Verificar os efeitos provocados pela expansão rápida de maxila na audição. Estratégia de pesquisa Conduziu-se uma busca no mês de janeiro de 2016, usando as palavras-chave “hearing loss”, “hearing”, “rapid maxillary expansion” e “palatal expansion technique” nas bases de dados MEDLINE, SciELO e Bibliografia Brasileira de Odontologia (BBO). Critérios de seleção Foram selecionados artigos em inglês, português e espanhol, publicados até janeiro de 2016, sem limitação de data inicial, cuja abordagem metodológica referisse os efeitos da expansão rápida de maxila na audição. Resultados A estratégia de busca resultou na seleção de oito artigos, classificados como ensaios clínicos. Os estudos constataram que a expansão rápida de maxila realizada em crianças e/ou adolescentes melhora os limiares de audibilidade e as medidas de imitância acústica. Conclusão A expansão rápida da maxila provocou melhora na audição, apesar da diversidade e das limitações metodológicas dos estudos analisados.

scholarly journals The Relation between the Position of Maxilla and Rapid Maxillary Expansion Failure

2021 ◽  
Vol 7 (2) ◽  
pp. 49-54
Author(s):  
Fatih Celebi
Keyword(s):  
Multiple Logistic Regression Analysis ◽  
Vertical Direction ◽  
Late Adolescence ◽  
Rapid Maxillary Expansion ◽  
Growth Potential ◽  
Maturation Stage ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Anterior Position ◽  
Cervical Vertebral Maturation

Introduction: The palatal expansion may be a challenging treatment in late adolescents who has passed the peak of skeletal growth. The success rate of palatal expansion in these patients decreases due to decreased growth potential. Aim: It was aimed to determine any clinical/radiological indicator to be used as a predictor in the failure of rapid maxillary expansion (RME) in late adolescence. Materials and methods: The records of the patients who had undergone RME therapy between the years 2013-2019 were evaluated. The patients were allocated into two groups according to expansion success: successful (S-RME) and failed (F-RME) RME groups. Fifty systemically healthy patients in the cervical vertebral maturation stage 5/6 were enrolled (35 females, 15 males). Eleven patients were (10 females, one male) in the F-RME group, and 39 patients were (25 females, 14 males) in the S-RME group. Five cephalometric (related to maxillary position) and three clinical variables (age, gender, and CVMS) were evaluated. Variables were subjected to multiple logistic regression analysis for setting a prediction model and detecting predictors. Results: Patients with CVMS-6 had a 16.8-fold higher risk of palatal expansion failure than CVMS-5. 1 mm anterior position of PNS increased the risk of failure 2.9 times. 1 mm reduction in the distance between the PNS and cranial base in the vertical direction increased 60% the risk of RME failure. Conclusion: The CVM stage of the patient, along with the vertical and sagittal position of the PNS, were found to be the possible predictors of RME success in late adolescence.

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.

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