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.

scholarly journals Assessment of respiratory muscle strength and airflow before and after microimplant-assisted rapid palatal expansion

2019 ◽  
Vol 89 (5) ◽  
pp. 713-720 ◽  
Author(s):  
Camilla Juliana Storto ◽  
Aguinaldo Silva Garcez ◽  
Hideo Suzuki ◽  
Karla Garcez Cusmanich ◽  
Islam Elkenawy ◽  
...  
Keyword(s):  
Muscle Strength ◽  
Nasal Cavity ◽  
Respiratory Muscle ◽  
Alveolar Bone ◽  
Peak Flow ◽  
Respiratory Muscle Strength ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Before And After

ABSTRACT Objectives: To assess alterations in respiratory muscle strength and inspiratory and expiratory peak flow, as well as skeletal and dental changes in patients diagnosed with transverse maxillary deficiency before and after microimplant-assisted rapid maxillary expansion (MARPE). Materials and Methods: Twenty patients (13 female and 7 male) were assessed by respiratory tests in three different periods: T0 initial, T1 immediately after expansion, and T2 after 5 months. Tests included: maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP), oral expiratory peak flow, and inspiratory nasal flow. Cone-beam computed tomography measurements were performed in the maxillary arch, nasal cavity, and airway before and immediately after expansion. Results: There was a significant increase in MIP between T0 and T2 and MEP between T0 and T1 (P<.05). Oral and nasal peak flow increased immediately after and 5 months later, especially in patients with initial signs of airway obstruction (P<.05). In addition, after expansion there was a significant enlargement of the nasal cavity, alveolar bone, and interdental widths at the premolar and molar region. Molars tipped buccally (P<.05) but no difference was found in premolar inclination. MARPE increased airway volume significantly. Conclusions: Skeletal changes promoted by MARPE directly affected airway volume, resulting in a significant improvement in muscle strength and nasal and oral peak flow.

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 Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:

2020 ◽  
Vol 91 (1) ◽  
pp. 36-45
Author(s):  
Haichao Jia ◽  
Li Zhuang ◽  
Nan Zhang ◽  
Yuanyuan Bian ◽  
Song Li
Keyword(s):  
Alveolar Bone ◽  
Growth Spurt ◽  
Height Loss ◽  
Success Rates ◽  
Pubertal Growth Spurt ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Pubertal Growth ◽  
Before And After ◽  
Bone Height

ABSTRACT Objective To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. Materials and Methods Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. Results The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01). Conclusions MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.

scholarly journals Observational Study Regarding Possible Side Effects of Miniscrew-Assisted Rapid Palatal Expander (MARPE) with or without the Use of Corticopuncture Therapy

Biology ◽  
2021 ◽  
Vol 10 (3) ◽  
pp. 187
Author(s):  
Eugen Silviu Bud ◽  
Cristina Ioana Bică ◽  
Mariana Păcurar ◽  
Petru Vaida ◽  
Alexandru Vlasa ◽  
...  
Keyword(s):  
Observational Study ◽  
Orthodontic Appliances ◽  
Maxillary Expansion ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Basal Bone ◽  
Fixed Orthodontic Appliances ◽  
Before And After ◽  
Palatal Mucosa ◽  
Mid Palatal Suture

The use of maxillary expanders has the effect of distancing the maxillary bones at the level of the median palatal suture. During maxillary expansion, the main resistance forces occur at the zygomatico-maxillary sutures, and not in the median palatal suture, which is the basic principle on which this method is based. In this observational study, we evaluated possible complications at the skeletal and dentoalveolar level after palatal split using miniscrew-assisted rapid palatal expansion (MARPE) associated or not with corticopuncture (CP) therapy. The study included 27 patients with maxillary transverse deficiency and unilateral or bilateral cross-bite. Skeletal and dentoalveolar changes were evaluated using cone beam computed tomography (CBCT) images acquired before and after expansion. The mid-palatal suture was separated in 88.88% of cases, buccal bone height of the alveolar crest had decreased at first molar both at oral and palatal level by approximately 2.07 mm in 40.7% of cases whilst the remaining 59.3% showed insignificant bone loss, with canines exhibiting buccal tipping of 4.10° in 62.5% of cases. Changes of the occlusal planes were observed in 10 cases (37%). Maxillary canines tended to show symmetric buccal inclinations relative to the maxillary basal bone. Six patients; 22.22% showed hypertrophy/hyperplasia of the palatal mucosa associated with ulcerations, erythema, itching, and discomfort in the area. Swelling at the mid-palatal suture after split was observed in all cases and was caused by the resultant force. No cases of necrosis of the palatal mucosa were observed. Although occlusal modifications occur after palatal split, especially in unilateral cross-bite cases, these changes can be treated with the help of fixed orthodontic appliances.

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 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.

Bone density of the midpalatal suture 7 months after surgically assisted rapid palatal expansion in adults

2011 ◽  
Vol 139 (4) ◽  
pp. S109-S116 ◽  
Author(s):  
Silvia Petrick ◽  
Thorsten Hothan ◽  
Volker Hietschold ◽  
Matthias Schneider ◽  
Winfried Harzer ◽  
...  
Keyword(s):  
Bone Density ◽  
Midpalatal Suture ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion

Evaluation of the midpalatal suture during rapid palatal expansion in children: a CT study

2005 ◽  
Vol 29 (3) ◽  
pp. 231-238 ◽  
Author(s):  
Omar Gabriel da Silva Filho ◽  
Tulio Silva Lara ◽  
Araci Malagodi de Almeida ◽  
Helena Cristina da Silva
Keyword(s):  
Computerized Tomography ◽  
Mixed Dentition ◽  
Midpalatal Suture ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Anterior Nasal Spine ◽  
The Impact

The midpalatal suture of 18 children submitted to rapid palatal expansion with the Haas fixed expander and ranging in age from 5 years 2 months to 10 years 5 months was evaluated with computerized tomography. The posterior nasal spine undergoes the impact of RPE in patients in the primary and mixed dentition stages, similarly to the anterior nasal spine though to a lesser extent. The average opening of the midpalatal suture was 2.21 mm in the anterior nasal spine region and 0.95 mm in the posterior nasal spine region.

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