Excessive Rapid Palatal Expansion with Latham Appliance for Distal Repositioning of Protruded Premaxilla in Bilateral Cleft Lip and Alveolus

2006 ◽  
Vol 43 (6) ◽  
pp. 673-677 ◽  
Author(s):  
Eiji Fukuyama ◽  
Susumu Omura ◽  
Kiyohide Fujita ◽  
Kunimichi Soma ◽  
Katsuyuki Torikai
Keyword(s):  
Cleft Lip ◽  
Maxillary Expansion ◽  
Orthopedic Treatment ◽  
Primary Operation ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Postoperative Changes ◽  
Bilateral Cleft Lip ◽  
Plaster Casts ◽  
The Ideal

Objective: This article reports a case of bilateral cleft lip and alveolus (BCLA) for which excessive rapid palatal expansion with a Latham appliance was performed for preoperative alignment of the protruded premaxilla. Postoperative changes of maxillary width were investigated with serial plaster casts. Patient and Results: A 3-month-old girl presented with complete BCLA in which the premaxilla was markedly protruded. Preoperative alignment of the protruded premaxilla with a Latham appliance was planned to facilitate primary lip repair. The appliance was placed when the patient was 4.5 months old. The necessary palatal expansion was estimated to be 7.0 mm in order to move the premaxilla backward into the ideal position. After palatal expansion and posterior repositioning of the protruded premaxilla, the primary operation, including cheiloplasty and gingivoperiosteoplasty, was performed when the patient was 7 months old. Excessive maxillary expansion might be a cause of transverse maxillomandibular discrepancy. Measurement with serial plaster casts demonstrated that maxillary widths increased from 42.3 mm pretreatment to 49.0 mm after orthopedic treatment but relapsed markedly to 43.5 mm at 3 months after the primary operation. Therefore, the net change of maxillary widths was only 1.2 mm. After alignment of the protruded premaxilla, tension-free soft tissue repairs were performed, and a harmonious alveolar arch was obtained without change in maxillary width. Conclusion: These results indicate that this method is useful for preoperative management of BCLA with protruded premaxilla.

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 < 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.

Orthodontic-Surgical Approach for Treating Skeletal Class III Malocclusion With Severe Maxillary Deficiency in Isolated Cleft Palate

2018 ◽  
Vol 56 (3) ◽  
pp. 400-407 ◽  
Author(s):  
Kohei Nakatsugawa ◽  
Hiroshi Kurosaka ◽  
Kiyomi Mihara ◽  
Susumu Tanaka ◽  
Tomonao Aikawa ◽  
...  
Keyword(s):  
Cleft Palate ◽  
Surgical Approach ◽  
Orthodontic Treatment ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Class Iii ◽  
Maxillary Expansion ◽  
Rapid Palatal Expansion ◽  
Isolated Cleft Palate ◽  
Maxillary Deficiency

Orthodontic treatment in patients with orofacial cleft such as cleft lip and palate or isolated cleft palate is challenging, especially when the patients exhibit severe maxillary growth retardation. To correct this deficiency, maxillary expansion and protraction can be performed in the first phase of orthodontic treatment. However, in some cases, the malocclusion cannot be corrected by these procedures, and thus, skeletal discrepancy remains when the patients are adolescents. These remaining problems occasionally require various orthognathic treatments according to the degree of the discrepancy. Here, we describe one case of a female with isolated cleft palate and hand malformation who exhibited severe maxillary deficiency until her adolescence and was treated with multiple orthognathic surgeries, including surgically assisted maxillary expansion (surgically assisted rapid palatal expansion), LeFort I osteotomy, and bilateral sagittal split osteotomy in order to correct severe skeletal discrepancy and malocclusion. The treatment resulted in balanced facial appearance and mutually protected occlusion with good stability. The purpose of this case report is to show the orthodontic treatment outcome of 1 patient who exhibited isolated cleft palate and subsequent severe skeletal deformities and malocclusion which was treated by an orthodontic-surgical approach.

Effects of Presurgical Orthopedic Treatment in Infants with Complete Bilateral Cleft Lip and Palate

1998 ◽  
Vol 35 (3) ◽  
pp. 227-232 ◽  
Author(s):  
Katsuaki Mishima ◽  
Toshio Sugahara ◽  
Yoshihide Mori ◽  
Katsuhiro Minami ◽  
Masayoshi Sakuda
Keyword(s):  
Discriminant Analysis ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Three Dimensional ◽  
Predictor Variables ◽  
Measuring Apparatus ◽  
Orthopedic Treatment ◽  
Wire Frame ◽  
Bilateral Cleft Lip ◽  
Posterior Shift

Objective To align the protruding premaxilla in infants with bilateral cleft lip and palate (BCLP), an intraoral appliance (i.e., Hotz plate) and an extraoral appliance consisting of a band covering the head and elastics are used as a presurgical orthopedic treatment in our clinic. The aim of this study was to analyze the configuration and position of the premaxilla and the vomer in infants with BCLP and to investigate the factors generating deviation and bending of the vomer and twisting of the premaxilla. Patients Palatal casts were obtained serially from 10 infants with complete BCLP from 1 to 3 months of age. Measurements These casts were automatically measured using a highly accurate contact-type measuring apparatus. After three-dimensional wire frame models generated from the serial casts were automatically superimposed, the magnitude and direction of the shift were calculated. A discriminant analysis was used for investigation of predictor variables generating the twisting or bending vomer. Results and Conclusions The vomer was found to be bent in two infants and the premaxilla was twisted in three infants. In the infants whose vomers were bent, the magnitude of the posterior shift of the premaxilla was greater than that of the inferior shift. A discriminant analysis indicated that at 1 month of age, a greater inclination and a smaller deviation of the vomer and a longer distance between the cleft edges of the lateral segments had a tendency to be associated with bending of the vomer or twisting of the premaxilla.

Analysis of the dentoalveolar effects of slow and rapid maxillary expansion in complete bilateral cleft lip and palate patients: a randomized clinical trial

2015 ◽  
Vol 20 (7) ◽  
pp. 1837-1847 ◽  
Author(s):  
Arthur César de Medeiros Alves ◽  
Daniela Gamba Garib ◽  
Guilherme Janson ◽  
Araci Malagodi de Almeida ◽  
Louise Resti Calil
Keyword(s):  
Clinical Trial ◽  
Randomized Clinical Trial ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Rapid Maxillary Expansion ◽  
Maxillary Expansion ◽  
Bilateral Cleft Lip

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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