scholarly journals Surgical Digitally Guided Planning for the Mini-Screw Assisted Rapid Palatal Expansion (MARPE) and Suture Perforation: MARPE Guide

2021 ◽  
Author(s):  
Cristiane Barros André ◽  
Bruno de Paula Machado Pasqua ◽  
José Rino Neto ◽  
Fábio Dupart Nascimento

The surgical planning digitally guided for the mini-screw assisted rapid palatal expansion (MARPE) technique consists of a three-dimensional positioning of MARPE and its mini-implants by a nasomaxillary anatomic evaluation. This technique also includes the simulation of the perforation areas on the midpalatal and transpalatal sutures. This type of planning is performed by superimposing the patients’ files (STL and DICOM). Correct positioning without colliding with the lateral tissues of the palate and the bicortical positioning of each mini-implant are important components of the case study. The MARPE device permits individualization of the height of the mini-implant rings in each region. To avoid incorrect insertion of the drill, the location of the midpalatal and transpalatal sutures was determined using digital planning. A positioning that avoids contact with important structures, such as the nasopalatine canal, while permitting bicortical drilling of the sutures is recommended. Then, a guide that reproduces MARPE positioning and another guide that reproduces the perforations are fabricated, providing exact reproducibility as performed virtually.

2021 ◽  
Vol 11 (15) ◽  
pp. 7110
Author(s):  
Marco Serafin ◽  
Luca Esposito ◽  
Viviana Conti ◽  
Rosamaria Fastuca ◽  
Manuel Lagravère ◽  
...  

The aim of this study was to compare the three-dimensional dentoskeletal effects of Haas-type and Hyrax-type expanders using primary teeth as anchorage for rapid palatal expansion (RPE). Thirty-four subjects in mixed dentition were divided according to their expander’s type: Hyrax (n = 16; 6F, 10M; mean age 8 ± 3 years) or Haas (n = 18; 14F, 4M; mean age 8 ± 2 years). Each patient underwent CBCTs before (T0) and after RPE (T1). Dentoskeletal changes were collected. A paired sample t-test and independent t-test were used to compare each variable within the same group and between groups, respectively, with a 5% significance. The Hyrax group showed an increase in all dentoskeletal parameters; skeletal expansion was significantly increased anteriorly (1.76 mm) and posteriorly (1.93 mm). The greatest dental expansion was observed in the anchorage unit (6.47 mm), about twice as much as permanent molars (3.42 mm). The same statistical significance of Haas group measurements was observed; anteriorly skeletal expansion (2.97 mm) was greater than posteriorly (1.93 mm) and dental expansion was greater on anchored teeth (6.80 mm) than non-anchored teeth (4.57 mm). No statistical significance was observed between Hyrax and Hass groups. CBCT analysis showed that, in RPE, the dental expansion was greater than skeletal expansion. No significant or clinical changes were observed between Hyrax and Haas appliances anchored to primary teeth.


Author(s):  
Larissa Braga dos Santos ◽  
Adriano Relvas Barreira de Oliveira ◽  
Mauro Lefrançois ◽  
Marcos Venício Azevedo ◽  
Pablo Sotelo ◽  
...  

Digital planning of the prosthesis associated with surgical planning increased predictability, since surgical guides indicate the best place for implant installation, thus reducing the number of complications, and the CAD/CAM system provides predictability in the preparation of final restorations, according to the procedure previously planned. Our study reported a digital workflow used for the guided installation of two dental implants in regions 14 and 16, extraction of tooth 15 and installation of a fixed prothesis over implants. After anamnesis and clinical evaluation, intra- and extra-oral photographs of the patient were performed, molding the upper arch with polyvinylsiloxane (2-step putty/light-body technique) and requesting computed tomography. The plaster model obtained was sent to the laboratory and scanned. The generated file (STL) was used to create a diagnostic wax-up that was aligned to the tomography (in DICOM format), enabling the three-dimensional planning of the implants, which generated a partial printed surgical guide after approval of the dentist. After six months, the patient received the provisional fixed prosthesis printed in PMMA (polymethylmethacrylate) on an intermediate in PEEK (polyetheretherketone) aiming to condition an emergency profile to receive a definitive prosthesis two months later, with zirconia-milled infrastructure on a ti-base. The correct understanding of the operator about the steps of the digital workflow (diagnosis, prosthetic planning, surgical planning, guide preparation, temporary and final restorations) gives the operator improved predictability at the time of surgery as well as satisfactory aesthetic and functional result of definitive restorations.


Author(s):  
Fábio Romano ◽  
Cássio Edvard Sverzut ◽  
Alexandre Elias Trivellato ◽  
Maria Conceição Pereira Saraiva ◽  
Tung T. Nguyen

2017 ◽  
Vol 22 (1) ◽  
pp. 89-97 ◽  
Author(s):  
Brian LaBlonde ◽  
Manuel Lagravere Vich ◽  
Paul Edwards ◽  
Katherine Kula ◽  
Ahmed Ghoneima

ABSTRACT Introduction: The aim of this multi-center retrospective study was to quantify the changes in alveolar bone height and thickness after using two different rapid palatal expansion (RPE) activation protocols, and to determine whether a more rapid rate of expansion is likely to cause more adverse effects, such as alveolar tipping, dental tipping, fenestration and dehiscence of anchorage teeth. Methods: The sample consisted of pre- and post-expansion records from 40 subjects (age 8-15 years) who underwent RPE using a 4-banded Hyrax appliance as part of their orthodontic treatment to correct posterior buccal crossbites. Subjects were divided into two groups according to their RPE activation rates (0.5 mm/day and 0.8 mm/day; n = 20 each group). Three-dimensional images for all included subjects were evaluated using Dolphin Imaging Software 11.7 Premium. Maxillary base width, buccal and palatal cortical bone thickness, alveolar bone height, and root angulation and length were measured. Significance of the changes in the measurements was evaluated using Wilcoxon signed-rank test and comparisons between groups were done using ANOVA. Significance was defined at p ≤ 0.05. Results: RPE activation rates of 0.5 mm per day (Group 1) and 0.8 mm per day (Group 2) caused significant increase in arch width following treatment; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Buccal alveolar height and width decreased significantly in both groups. Both treatment protocols resulted in significant increases in buccal-lingual angulation of teeth; however, Group 2 showed greater increases compared to Group 1 (p < 0.01). Conclusion: Both activation rates are associated with significant increase in intra-arch widths. However, 0.8 mm/day resulted in greater increases. The 0.8 mm/day activation rate also resulted in more increased dental tipping and decreased buccal alveolar bone thickness over 0.5 mm/day.


Micromachines ◽  
2016 ◽  
Vol 7 (4) ◽  
pp. 64 ◽  
Author(s):  
Kelly Goeckner ◽  
Venkatram Pepakayala ◽  
Jeanne Nervina ◽  
Yogesh Gianchandani ◽  
Sunil Kapila

2020 ◽  
Author(s):  
Daniel Palkovics ◽  
Francesco Guido Mangano ◽  
Katalin Nagy ◽  
Peter Windisch

Abstract Background: In the regenerative treatment of intrabony periodontal defects, surgical strategies are determined by defect morphologies. Clinical direct measurements and intraoral radiographs are the main tools in periodontal diagnostics and surgical planning, however in certain cases they don’t provide sufficient amount of information. Therefore, the application of cone-beam computed tomography (CBCT) in diagnosis and treatment planning of periodontally involved patients has been proposed. The aim of this study is to present a novel method for 3D visualization of intrabony periodontal defects on digital models reconstructed from CBCT datasets for diagnostics and treatment planning.Methods: 4 patients with a total of 6 intrabony periodontal defects were enrolled in the present study. 2 months following initial periodontal treatment CBCT scan is taken. Radiographic image processing (segmentation) of CBCT datasets were performed in a radiographic imaging software to acquire anatomically accurate, virtual three-dimensional polygon models of surgical areas. Intrasurgical and digital measurements were taken, and results were compared, to validate the accuracy of digital models.Results: Difference between intrasurgical- and digital measurements in depth and width of intrabony components of periodontal defects were 0,31±0,21 mm and 0,41±0,44 mm respectively.Conclusion: It can be concluded that, the described digital workflow is useful in the treatment of certain periodontal intrabony defect morphologies. However, to determine the exact use cases of such technology further studies and examination is necessary.Trial Registration: Retrospective Ethics Approval


2021 ◽  
Vol 9 (5) ◽  
pp. 497-500
Author(s):  
Kinnari Markana ◽  

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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