Maxillary arch expansion along with fixed mechanotherapy using different expansion devices (original) (raw)

Methods of maxillary arch expansion in orthodontics: A literature review

International Journal of Applied Dental Sciences, 2021

The expansion of the arch has been one of the oldest means of creating space in the dental arches. The correction of transverse maxillary deficiency can be an important component of an orthodontic treatment plan. For the correction of transverse maxillary deficiency, based on the duration of time taken to achieve the desired expansion, expansion devices can be classified as-Rapid maxillary expansion devices and slow expansion devices. This article focuses on the various appliances that can be used for the expansion of maxillary arch.

Surgically assisted rapid palatal expansion to correct maxillary transverse deficiency

Annals of Maxillofacial Surgery, 2020

Original Article-Retrospective Study IntRoductIon Maxillary deficiency and accompanying crossbite is a common malocclusion encountered clinically with a prevalence of 4%-23%. [1] Maxillary transverse deficiency (MTD) can be treated either orthodontically using rapid maxillary expansion (RME) or surgically using surgically assisted rapid palatal expansion (SARPE). In children and adolescents, conventional orthodontic RME has been successful when used prior to sutural closure. [2-6] In skeletally mature patients, the possibility of successful maxillary expansion decreases as sutures close and resistance to mechanical forces increases. [2,4,6] SARPE is an effective method of addressing the severe maxillary transverse discrepancy in patients over the age of 15 years. In young adults and adults in their 20s and 30s, palatal expansion may result in the tipping of the molars with little expansion of the maxillary arch. It has also been suggested that the intermaxillary suture anterior to the incisive canal never ossifies until very late in life, resulting in some relapse. [7-9] A number of modifications for the traditional SARPE surgical technique have been described. The traditional method describes a midpalatal osteotomy between the two central incisors, followed by maxillary expansion using a tooth-or bone-borne device. [5] Various combinations of maxillary, pterygopalatine lateral nasal, septal, and palatine osteotomies have been used based

Dental and skeletal modifications in adult patients treated with Slow Maxillary Expander

Mondo Ortodontico, 2012

Objectives. Aim of this study is to evaluate the effi ciency of Slow Maxillary Expander (SME) in the correction of transversal defi ciency of the maxilla in adult patients, focusing on: intermolar and intermaxillary width and amount of dento-alveolar tipping. Materials and methods. This study was conducted on a sample of 16 patients (average age 31.6 years) in permanent dentition. Criteria for inclusion in the study are: non growing patients and availability of pre (T0) and post treatment (T1) postero-anterior teleradiographs. On these teleradiographs, a cephalometric analysis was conducted to evaluate dental and skeletal modifi cations. Results. Intermolar and intermaxillary width are signifi cantly increased (+5 mm and +3 mm respectively). Molar tipping is slightly increased at the end of expansion (+2.4°). Conclusions. The study shows that the SME can be regarded as an effi cient device and a helpful alternative in the treatment of the transverse maxillary defi ciency in adults, giving signifi cant dentoalveolar expansion with minimum molar tipping.

Rapid maxillary expansion. A study of the long-term effects

American Journal of Orthodontics and Dentofacial Orthopedics, 1996

A study was made to determine whether skeletal alterations usually produced by rapid maxillary expansion may be compensated for in time by growth and/or comprehensive orthodontic treatment. In 30 patients, orthodontic treatment was started with rapid maxillary expansion, followed by fixed appliances, not combined with any other form of orthopedic device. Mean treatment time was 3.1 years. Nine measurements from the Ricketts analysis were studied, based on lateral cephalometric radiographs. Records were taken before orthodontic treatment and after completion of active therapy. A statistical analysis was made of the nine variables used, reflecting the vertical and anteroposterior skeletal proportions of the face, contrasting the changes before and after treatment. Of all the variables studied, the four that change'with age according to the Ricketts analysis (mandibular plane angle, maxillary height, facial depth and facial convexity), yielded statistically significant differences after treatment, indicative of normal growth. The five remaining variables that remain constant with age according to the Ricketts analysis (facial axis, lower facial height, total facial height, palatal plane inclination and maxillary depth) showed no significant changes after treatment, also indicative of normal growth. (AM J ORTHOD DENTOFAC ORTHOP 1996;109:361-7.) S t u d i e s of skeletal changes after rapid maxillary expansion (RME) have to date been carried out using cephalometric data collected before and immediately after active expansion. It is widely accepted that these changes consist of a drop of the maxilla (generally in association with forward displacement) and a posterorotation of the mandible, due to the extrusion of the upper molars and the outward inclination of the upper alveolar process. This would generally improve patients with skeletal Class III malocclusions and worsen Class II and open bite problems. 1-13

A Comprehensive Review of Rapid Palatal Expansion and Mini- Screw Assisted Rapid Palatal Expansion

The objective of this review is to familiarize the dentists and orthodontists with the different methods of maxillary expansion. It undertakes a literature review of rapid palatal expansion (RPE) as well as the recently introduced method of mini-screw assisted rapid palatal expansion (MARPE). The contemporary literature with the help of 3D imaging helps answer the questions on how the skeletal and dental effects of mini-screw rapid palatal expansion compare to the effects of conventional rapid palatal expansion. In addition, the modification of expansion protocols such as alternate maxillary expansion and constriction, slow expansion are also covered in this review. The modifications of expansion appliances such as AMEX appliance and modification of MARPE appliances such as unilateral MARPE (U-MARPE) for the correction of unilateral posterior crossbite have been explained in this review.

Dental arch changes following rapid maxillary expansion

The European Journal of Orthodontics, 2008

The purpose of this research was to evaluate changes in upper arch dimension and form following rapid maxillary expansion (RME) using a modifi ed Haas appliance in the primary dentition. The sample comprised 49 children [17 males, 32 females, mean age 7 years 5 months, standard deviation (SD) 1 year 1 month] with a crossbite or maxillary crowding. Twenty patients had a normal SN-GoGn angle (7 males, 13 females, mean 33.25 degrees, SD 2.10), three were low angle (1 male, 2 females, mean 27.67 degrees, SD 2.31), and 22 were high angle (8 males, 14 females, mean 39.95 degrees, SD 3.15). The vertical dimensions of four patients could not be measured, due to the unavailability of radiographs. Expansion was undertaken to either correct a crossbite or treat maxillary crowding. The upper dental casts were analysed using a computerized system: before treatment (T1), at appliance removal (T2), and 2 years 4 months after appliance removal (T3). Using bootstrap statistical analysis applied to distance ratio values [Euclidean distance matrix analysis (EDMA)], it was found that 48 patients showed a change in arch form. In 40.82 per cent (n = 20, group A), the arch form changed from T1 to T2, T1 to T3, and T2 to T3. In 32.65 per cent (n = 16, group B), it varied from T1 to T2 but relapsed at T3 to the form of T1. For 24.5 per cent (n = 12, group C), it changed from T1 to T2 but maintained the same form at T3. The favourable characteristics for obtaining expansion, identifi ed by logistic regression analysis, were being male, of an immature stage of dental development (lateral incisor not fully erupted) and the presence of a lateral crossbite. Intercanine and intermolar widths, arch length, and the distance between the interincisive point and the line joining the canines (depth of the intercanine arch) at the different time points were analysed using a two-tailed t-test (P < 0.05). For the whole group, the increase in intercanine and intermolar width and in the depth of the intercanine arch was signifi cant. Comparison between groups A, B, and C was undertaken using an analysis of variance, but there was no signifi cant difference between the groups. This modifi ed type of Haas appliance was able to increase the transverse dimension of the maxillary dental arch in the mixed dentition. The most appropriate timing for treatment appears to be before the eruption of the permanent lateral incisors.

Skeletal and dentoalveolar changes in the maxillary bone morphology using two-arm maxillary expander

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2012

The purpose of this study was to evaluate the dental and skeletal changes in the maxillary bone morphology, produced by two-arm rapid palatal expansion appliances. The study included 22 girls with an average age of 11.9 years treated with RPE appliances at the Department of Pedodontics and Orthodontics, Faculty of Dentistry, Timisoara, Romania. We evaluated the changes on study casts, using an optical 3D scanner--Activity 101 (SmartOptics) and also on radiographs. The level of statistical significance was set by comparing the changes between pre and post treatment values. We also used the Pearson's correlation coefficient (r) to measure the strength of the association between the recorded measurements. The correlations were significant at p<0.05. Significant changes were found in intermolar width change, interpremolar width change, molar tipping and alveolar tipping. Less significant changes were found in molar rotation and palatal depth change. After rapid maxillary expansio...

Maxillary Skeletal Expansion with the Assistance of Ortho Implants: A Clinical Case Report

Medical and Clinical Case Reports, 2021

Introduction: The maxillary skeletal expander (MSE) with the assistance of ortho implants is used to perform rapid palatal expansion in patients who are no longer growing. This case report describes a 15-year-old boy with a bilateral posterior crossbite caused by transverse maxillary deficiency. Methods: A 10-mm MSE was placed with four ortho implants. The MSE was activated once per day for 20 days. Subsequently, a fixed appliance (MBT) was placed as corrective treatment. Results: An approximate expansion of 8 mm was achieved using the MSE. The posterior crossbite was corrected by increasing the transverse dimensions of the maxilla. An adequate inter-arch relationship similar to the class I molar and canine relationships was achieved, as were a 2-mm overjet and 2-mm overbite. Conclusions: The use of the MSE with the assistance of ortho implants is an alternative method of treatment that can be beneficial for patients who are no longer growing. This method avoids the use of surgical ...

Dental arch changes associated with rapid maxillary expansion: A retrospective model analysis study

Contemporary clinical dentistry

Transverse deficiency of the maxilla is a common clinical problem in orthodontics and dentofacial orthopedics. Transverse maxillary deficiency, isolated or associated with other dentofacial deformities, results in esthetic and functional impairment giving rise to several clinical manifestations such as asymmetrical facial growth, positional and functional mandibular deviations, altered dentofacial esthetics, adverse periodontal responses, unstable dental tipping, and other functional problems. Orthopedic maxillary expansion is the preferred treatment approach to increase the maxillary transverse dimension in young patients by splitting of the mid palatal suture. This orthopedic procedure has lately been subject of renewed interest in orthodontic treatment mechanics because of its potential for increasing arch perimeter to alleviate crowding in the maxillary arch without adversely affecting facial profile. Hence, the present investigation was conducted to establish a correlation betw...