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 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.

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.

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.

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 Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review

2021 ◽  
Author(s):  
Tamanna Hoque ◽  
Dilip Srinivasan ◽  
Sangeetha Morekonda Gnaneswar ◽  
Sushil Chakravarthi ◽  
Krishnaraj Rajaram
Keyword(s):  
Minimally Invasive ◽  
Treatment Modality ◽  
Computer Aided Design ◽  
Maxillary Expansion ◽  
Invasive Treatment ◽  
Comprehensive Review ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Nasal Floor ◽  
Computer Aided

Maxillary transverse deficiency routinely requires expansion of the palate. In prepubertal patients, Rapid Maxillary Expansion (RME) is a reliable treatment modality. However, in skeletally mature patients due to progressively interdigitated mid palatal suture, decreased elasticity of bone and increased stiffness of the osseous articulations of the maxilla with the adjoining bones, palatal expansion becomes challenging. Patients are frequently suggested to opt for more invasive procedures, like the Surgically Assisted Rapid Palatal Expansion (SARPE). The quest for minimally invasive expansion appliances with pure orthopaedic movement led researchers to incorporate mini-implants with conventional RME. Microimplant Assisted Rapid Palatal Expansion (MARPE) maximises skeletal expansion and minimises dentoalveolar undesirable effects and obviates the need for orthognathic surgery. This comprehensive review aims to discuss MARPE as an effective, non surgical, minimally invasive treatment modality for skeletally mature patients with maxillary transverse insufficiency. Furthermore, various designs of MARPE with different placement sites, lengths, and numbers of miniscrews along with the latest technological advancements to improve diagnosis and treatment planning using CBCT and intraoral scan, as well as the use of Computer-Aided Design/Computer-Aided Manufacturing (CAD-CAM) technology to custom fabricate three dimensional (3D) miniscrew insertion surgical guide, 3D laser-printed metallic mini-implant to enhance implant placement accuracy and comfort were discussed along with the clinical significance and limitations of the MARPE. Maxillary Skeletal Expander (MSE) is a unique lineage of MARPE when combined with facemask results in distraction osteogenesis like movement of midface and forms a promising basis for non surgical orthopaedic treatment modality for skeletal class III mature patients. Bone-anchored maxillary expansion appliances provide better vertical control, especially beneficial for hyperdivergent skeletal pattern patients. MARPE significantly increases transverse widths of the nasal floor, nasopharyngeal volume and significantly lowers mean nasal airway resistance thereby facilitating nasal breathing. MARPE results in greater orthopaedic expansion and safety, with fewer undesirable effects and high success rates.

scholarly journals Skeletal effects of mini-implant assisted rapid palatal expansion (MARPE) on the sagittal dimensions of the maxilla an in-vivo cone-beam computed tomography (CBCT) study

2021 ◽  
Vol 8 (1) ◽  
pp. 8-11
Author(s):  
Shymal Vairagi ◽  
Ashwith Hedge ◽  
Ajit Kalia ◽  
Salil Nene ◽  
Amit Raja
Keyword(s):  
Post Treatment ◽  
Alternative Methods ◽  
Maxillary Expansion ◽  
Linear Measurements ◽  
Treatment Groups ◽  
Palatal Expansion ◽  
Rapid Palatal Expansion ◽  
Skeletal Changes ◽  
Frankfort Horizontal Plane

Introduction -Transverse discrepancies of the maxilla are one of the most prevalent skeletal problems. Due to drawbacks of conventional RPE and invasive surgical expansion methods alternative methods were developed such as Mini Implant-supported rapid maxillary expansion (MARPE).Haas17 , Davis and Kronman18, Akkaya et al19 and many other studies have reported the maxillary response after MARPE on the sagittal dimensions, but their results were inconclusive. Aim - This study analyzed the effects on the maxilla in the sagittal dimension after Mini Implant assisted rapid palatal expansion (MARPE) in adolescents using CBCT. Material and method -A pretreatment CBCT image (T1) was taken as a standard initial record for all patients and post treatment CBCT (T2) was taken after three months in retention. The parameters SNA angle, Frankfort horizontal plane to NA angle, A-N perpendicular, ANS –PNS were measured and calculated for evaluation of the sagittal maxillary changes. Comparisons were then made between the two treatment groups (T1, T2). Result -There was a positive increase in both angular and linear measurements from pretreatment to post treatment measurements showing significant skeletal changes in sagittal dimension. Conclusion -The study concludes that there was statistically significant forward displacement of maxilla after transverse skeletal expansion in patients with transverse problems achieved through MARPE in adolescent patients.

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