Abstract
Conventional rapid palatal expansion (RPE) has been proven to be a reliable treatment
for correcting transverse maxillary deficiency in young patients. However, side effects
including dental tipping and risk of periodontal problem limited its application to
young patients after the pubertal growth spurt. Surgically assisted rapid palatal
expansion (SARPE), a supplement to RPE, could be applied in skeletally mature patients.
However, SARPE was an invasive method, and the morbidity, risks and cost related to
surgical treatment might discourage many adult patients. The use of Microimplant-Assisted
Rapid Palatal Expansion (MARPE) appliance, which can potentially avoid surgical intervention,
is gaining popularity in treatment of maxillary transverse deficiency (MTD) in young
adolescent patients. However, the literature on the skeletal and dentoalveolar changes
with this appliance is scarce. To evaluate the immediate skeletal and dentoalveolar
changes in the transverse dimension with the maxillary skeletal expander (MSE), a
MARPE appliance with hybrid anchorage, using cone-beam computed tomography (CBCT).
Twenty-two patients (11 males and 11 females, mean age 14.97 ± 6.16 years) with transverse
maxillary deficiency were treated using the MSE (Biomaterials Korea, Inc., Seoul,
Korea). The appliance consisted of a central expansion screw that were welded to four
tubes that served as guides for microimplant placement. The microimplants were 1.8 mm
in diameter and 11 mm in length. The longer length of microimplants permitted bicortical
engagement of the palatal and nasal floor, reducing the force transmitted to the anchored
teeth during expansion. The appliance activation varied with age and skeletal maturity
of the patient. The expansion was terminated when 2–3 mm of overexpansion was achieved.
CBCT scans were taken before treatment (T1) and immediately after expansion (T2).
Measurements were taken to evaluate the amount of total expansion, skeletal expansion,
and angular dental tipping at the first molar region. A total expansion of 5.41 ± 2.18 mm
was achieved, 59.23 ± 17.75% of which was attributed to skeletal expansion (3.15 ± 1.64 mm)
with the first molars exhibiting buccal tipping of 2.56 ± 2.64°. The use of MARPE
appliances such as MSE can be used to correct transverse maxillary deficiency in adolescent
patients with minimal dentoalveolar side effects.
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Seminars in OrthodonticsAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Treatment of irregularity of the permanent or adult teeth.Dental Cosmos. 1860; 1 (pg): 599
- Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture.Am J Orthod Dentofac Orthop. 1961; 31: 73-90
- The biomechanics of rapid maxillary sutural expansion.Am J Orthod Dentofac Orthop. 2000; 118: 257-261
- Treatment timing for rapid maxillary expansion.Angle Orthod. 2001; 71: 343-350
- Surgically assisted rapid palatal expansion: a literature review.Am J Orthod Dentofacial Orthop. 2008; 133: 290-302
- Immediate and post-retention effects of rapid maxillary expansion investigated by computed tomography in growing patients.Angle Orthod. 2009; 79: 24-29
- A comparison of dentoalveolar inclination treated by two palatal expanders.Eur J Orthod. 2008; 30: 67-72
- Treatment and posttreatment skeletal effects of rapid maxillary expansion studied with low-dose computed tomography in growing subjects.Am J Orthod Dentofacial Orthop. 2008; 134: 389-392
- Multitomographic evaluation of the dental effects of two different rapid palatal expansion appliances.Eur J Orthod. 2007; 29: 379-385
- Post expansion evaluation of the midpalatal suture in children submitted to rapid palatal expansion: a CT study.J Clin Pediatr Dent. 2006; 31: 142
- Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion.Am J Orthod Dentofacial Orthop. 2004; 126: 569-575
- Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial.Am J Orthod Dentofacial Orthop. 2010; 137: 304-305
- Effects of a modified acrylic bonded rapid maxillary expansion appliance and vertical chin cap on dentofacial structures.Angle Orthodontist. 2002; 72: 61
- Skeletal alterations associated with the use of bonded rapid maxillary expansion appliance.Braz Dent J. 2011; 22: 334-339
- Miniscrew-assisted rapid palatal expander (MARPE): the quest for pure orthopedic movement.Dental Press J Orthod. 2016; 21: 17-23
- Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography.Am J Orthod Dentofacial Orthop. 2008; 134: 8
- Cone beam computed tomography in orthodontics: indications, insights, and innovations.Am J Orthod Dentofacial Orthop. 2016; 149: 583
- The surgery of oral and facial diseases and malformations: their diagnosis and treatment including plastic surgical reconstruction.J Am Med Assoc. 1939; 112: 2199
- Surgically assisted rapid maxillary expansion in adults.Int J Adult Orthodon Orthognath Surg. 1992; 7: 37-41
- Maxillary changes with bone-borne surgically assisted rapid palatal expansion: a prospective study.Am J Orthod Dentofacial Orthop. 2016; 149: 374-383
- Complications following surgically assisted rapid palatal expansion: a retrospective cohort study.J Oral Maxillofac Surg. 2012; 70: 2394-2402
- Application of a new viscoelastic finite element method model and analysis of miniscrew-supported hybrid hyrax treatment.Am J Orthod Dentofacial Orthop. 2013; 143: 426-435
- Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence.Angle Orthod. 2015; 85: 253-262
- Microimplant-assisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult.Am J Orthod Dentofacial Orthop. 2016; 149: 716-728
- Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient.Dental Press J Orthod. 2017; 22: 97-108
- Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults.Angle Orthod. 2016; 86: 713-720
- Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: a cone-beam computed tomography study.Korean J Orthod. 2017; 47: 77-86
- Diagnosis and treatment of transverse maxillary deficiency.Int J Adult Orthodon Orthognath Surg. 1995; 10: 75-96
- Skeletal, dentoalveolar and periodontal changes of skeletally matured patients with maxillary deficiency treated with microimplant assisted rapid palatal expansion appliance: a pilot study.AOS Trends Orthod. 2018; 8: 71-85
- 3-dimensional cone-beam computed tomography superimposition: a review.Semin Orthod. 2015; 21: 263-273
- The cervical vertebral maturation method: a user's guide.Angle Orthod. 2018; 88: 133
- Skeletal and dental changes accompanying rapid midpalatal suture opening.Am J Orthod. 1970; 58: 41-66
- Palatal expansion: just the beginning of dentofacial orthopedics.Am J Orthod. 1970; 57: 219-255
- A comparison of dental and dentoalveolar changes between rapid palatal expansion and nickel-titanium palatal expansion appliances.Am J Orthod Dentofacial Orthop. 2001; 119: 11-20
- Microimplant-assisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult.Am J Orthod Dentofacial Orthop. 2016; 149: 716-728
- In vitro validated finite element method model for a human skull and related craniofacial effects during rapid maxillary expansion.Proc Inst Mech Eng H. 2006; 220: 897-907
- On the FEM modeling of craniofacial changes during rapid maxillary expansion.Med Eng Phys. 2007; 29: 566-579
- Study of stress distribution and displacement of various craniofacial structures following application of transverse orthopedic forces–a three-dimensional FEM study.Angle Orthod. 2003; 73: 12-20
- Transverse dimension and long-term stability.Semin Orthod. 1999; 5: 171-180
- The effect of head rotation on cephalometric radiographs.Eur J Orthod. 2005; 27: 315-321
- Landmark identification error in posteroanterior cephalometric radiography. A systematic review.Angle Orthod. 2008; 78: 761-765
- Conventional frontal radiographs compared with frontal radiographs obtained from cone beam computed tomography.Angle Orthod. 2012; 82: 579-584
- Three-dimensional effects of pterygomaxillary disconnection during surgically assisted rapid palatal expansion: a cadaveric study.Oral Surg Oral Med Oral Pathol Oral Radiol. 2016; 121: 602-608
Article info
Publication history
Published online: February 11, 2019
Identification
Copyright
© 2019 Published by Elsevier Inc.
