Journal articles: 'Maxillary Skeletal Expander (MSE)'

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Moon, Hyung-Wook, Min-Jung Kim, Hyo-Won Ahn, Su-Jung Kim, Seong-Hun Kim, Kyu-Rhim Chung, and Gerald Nelson. "Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study." Angle Orthodontist 90, no. 1 (August 28, 2019): 13–22. http://dx.doi.org/10.2319/050619-316.1.

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ABSTRACT Objective To evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence. Materials and Methods A sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired t-test, independent t-test, Pearson's chi-square test, and Spearman correlation analysis were performed. Results The MSE group produced greater dental expansion (P < .05), whereas skeletal expansion was similar in both groups (P = .859). The C expander group had more alveolar bone inclination change (P < .01), and the MSE group had more buccal tipping of the anchorage teeth (P < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group (P < .01 or <.001). Formation of dehiscences was more frequent in the MSE group (P < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness. Conclusions The incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.

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Lo Giudice, Antonino, Vincenzo Quinzi, Vincenzo Ronsivalle, Stefano Martina, Orazio Bennici, and Gaetano Isola. "Description of a Digital Work-Flow for CBCT-Guided Construction of Micro-Implant Supported Maxillary Skeletal Expander." Materials 13, no. 8 (April 12, 2020): 1815. http://dx.doi.org/10.3390/ma13081815.

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The introduction of miniscrew-assisted rapid palatal expansion (MARPE) has widened the boundaries of orthodontic skeletal correction of maxillary transversal deficiency to late adolescence and adult patients. In this respect, Maxillary Skeletal Expander (MSE) is a particular device characterized by the engagement of four miniscrews in the palatal and nasal cortical bone layers. Thus, the availability of sufficient supporting bone and the perforation of both cortical laminas (bi-corticalism) are two mandatory parameters for mini-screw stability, especially when orthopedic forces are used. Virtual planning and construction of MSE based on cone-beam computed tomography (CBCT)-derived stereolithography (.stl) files have been recently described in the literature. In this manuscript we described: (a) a user-friendly digital workflow which can provide a predictable placement of maxillary skeletal expander (MSE) appliance according to the patient’s anatomical characteristics, (b) the construction of a positional template of the MSE that allows lab technician to construct the MSE appliance in a reliable and accurate position, according to the virtual project planned by the orthodontist on the patient CBCT scans. We also described a case report of an adult female patient affected by skeletal transversal maxillary deficiency treated with MSE appliance that was projected according to the described workflow.

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Sarraj, Mohamad, Sercan Akyalcin, Hong He, Jun Xiang, Ghaddy AlSaty, Tugce Celenk-Koca, Christina DeBiase, Chris Martin, Khaled AlSharif, and Peter Ngan. "Comparison of skeletal and dentoalveolar changes between pure bone-borne and hybrid tooth-borne and bone-borne maxillary rapid palatal expanders using cone-beam computed tomography." APOS Trends in Orthodontics 11 (April 10, 2021): 32–40. http://dx.doi.org/10.25259/apos_160_2020.

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Objectives: The objectives of the study were to compare the skeletal, dentoalveolar, and periodontal changes between two types of microimplant-assisted rapid maxillary expansion appliances: The bone-anchored maxillary expanders (BAME) and the tooth-bone-anchored maxillary skeletal expander (MSE). Materials and Methods: Thirty-four patients with a transverse maxillary deficiency were divided into two groups; the first group (16 patients, average age 14.9 years) was treated with the MSE appliance, and the second group (18 patients, average age 13.8 years) was treated with the BAME appliance. Cone-beam computed tomography scans were taken at pre-treatment (T1) and immediately post-expansion (T2) to measure the changes in midpalatal suture opening, total expansion (TE), alveolar bone bending, dental tipping (DT), and buccal bone thickness. Data were analyzed using paired t-test and two-sample t-test. Results: Midpalatal suture separation was found in 100% of the patients in both groups. The TE at the first molar was 5.9 mm in the MSE group and 4.7 mm in the BAME group. The skeletal contributions were 56% and 83% of TE for the MSE and BAME groups, respectively. Significantly less dental buccal tipping and buccal bone loss were found with the BAME group. The midpalatal suture in both groups exhibited a parallel opening pattern in the axial plane. Conclusion: The use of BAME appliance resulted in greater skeletal effects, less dental tipping, and less buccal bone reduction compared to MSE appliance (immediately after maxillary expansion).

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Karanxha, Lorena, Daniele Cantarella, Ney Alberto Paredes, Ryo Hamanaka, Massimo Del Fabbro, and Won Moon. "Premolar and Molar Inclination Changes Following Micro-Implant-Assisted Maxillary Skeletal Expander (MSE): A Three-Dimensional Analysis and Visualization." Applied Sciences 12, no. 17 (August 31, 2022): 8742. http://dx.doi.org/10.3390/app12178742.

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Background: To assess the changes in the inclination of the premolar and molar during a maxillary expansion with a micro-implant-assisted skeletal expander (MSE). Materials and Methods: A total of 21 patients (16 females, 5 males) with a mean age of 18.6 ± 4.5 (range 11.3–26.3 years) with a transverse maxillary deficiency were included in this study. They all received an MSE appliance for the maxillary skeletal expansion. The activation protocol consisted of about 0.5 mm expansion a day until a diastema was observed and continued with about 0.25 mm a day until the desired transverse relationship between the maxilla and mandible was achieved. OnDemand3D software was used for the measurements of the inclination change in the maxillary premolars and molars, pre- and post-expansion. Graphpad was used to compare the mean change in each tooth with the zero value (no change), and the p values of these changes with every tooth were calculated. Moreover, the changes and the mean values of all the teeth on the left and right sides were calculated separately. Results: A total of sixteen measurements were conducted for each patient. The first premolars tipped palatally after the expansion, while the second premolars and molars tipped buccally. The changes were significant for the molars and the left second premolar. Conclusions: The MSE induced some changes in the tooth inclination. The first premolars moved palatally, most likely due to perioral musculature and mastication force, while the first and second molars moved buccally. The second molar buccal movement is most likely due to the craniofacial rotation caused by the MSE as they were not subject to the expansion force.

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Moon, Won. "Class III treatment by combining facemask (FM) and maxillary skeletal expander (MSE)." Seminars in Orthodontics 24, no. 1 (March 2018): 95–107. http://dx.doi.org/10.1053/j.sodo.2018.01.009.

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Shih, Sin-Ni, Kwok-Hing Ho, Chih-Wei Wang, Kai-Long Wang, Shun-Chu Hsieh, and Heng-Ming Chang. "Management of Class III Malocclusion and Maxillary Transverse Deficiency with Microimplant-Assisted Rapid Palatal Expansion (MARPE): A Case Report." Medicina 58, no. 8 (August 4, 2022): 1052. http://dx.doi.org/10.3390/medicina58081052.

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Microimplant-assisted rapid palatal expansion (MARPE) has been demonstrated successfully in maxillary expansion in late adolescence and adulthood. The maxillary advancement accompanied by expansion is frequently anticipated, which is beneficial for the treatment of class III malocclusion. Airway volume increase can also be noted in some cases from the measurement of cone beam computerized tomography (CBCT) after expansion. The objective of this case report is to demonstrate the feasibility of applying MARPE on late adolescence patients with maxillary transverse deficiency and to present the changes in transverse and anteroposterior dimensions as well as the volume increase in velopharyngeal airway after MARPE. A 15-year-old female presented class III skeletal pattern. She had maxillary transverse deficiency with moderate crowding and posterior/anterior crossbites. Maxillary Skeletal Expander (MSE; Biomaterials Korea Inc.) type-2 was used as a MARPE device in this case. After four weeks of maxillary expansion, a significant amount of expansion was achieved and the anterior crossbite was spontaneously corrected. Fixed appliance treatment was commenced four weeks after MARPE with 0.022-slot preadjusted brackets (MBT prescription). Temporary anchorage devices (TADs) were placed over the mandibular buccal shelves for posterior teeth distalization and crowding relief. After 25 months of treatment, the facial profile was improved with maxillary advancement (SNA: 83° to 83.5°) and mandibular backward rotation (SNB: 83° to 82°; SN-MP: 34.5° to 35°). In this case, MARPE not only engenders significant transverse correction but also aids in anteroposterior change. The treatment effects of maxillary advancement and mandibular backward rotation can lead to a more esthetic profile in skeletal class III cases.

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Bud, Eugen-Silviu, Mariana Păcurar, Alexandru Vlasa, Ana Petra Lazăr, Luminița Lazăr, Petru Vaida, and Anamaria Bud. "Retrospective Case Series Regarding the Advantages of Cortico-Puncture (CP) Therapy in Association with Micro-Implant Assisted Rapid Palatal Expander (MARPE)." Applied Sciences 11, no. 3 (February 1, 2021): 1306. http://dx.doi.org/10.3390/app11031306.

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Transverse maxillary deficiency currently affects 8–23% of adults. One of the most widely used orthodontic treatments today in patients with transverse maxillary defects is the maxillary skeletal expander (MSE). This was a retrospective observational imaging study regarding structural bone changes that may occur during healing after the placement of micro-implant assisted rapid palatal expanders (MARPE) in combination with cortico-puncture (CP) therapy. Regarding the magnitude of the mid-palatal suture opening, the mean split at the anterior nasal spine (ANS) and the posterior nasal spine (PNS) was 3.76 and 3.12 mm, respectively. The amount of split at the PNS was smaller than at the ANS, approximately 85% of the distance, showing that the opening of the midpalatal suture was almost parallel in the sagittal plane. On average, one-half of the anterior nasal spine (ANS) moved more than the contralateral by 0.89 mm. In the present study, we show that MARPE associated with CP therapy had a positive outcome on the midpalatal suture opening. This occurred in safe conditions, without post-surgery bleeding, and showing healing at the corticotomy level, with no signs of swelling or sepsis, which are side effects usually associated with more complex surgical treatments. Our results suggest that non-surgical palatal expansion, assisted by MARPE and CP, is achievable and predictable in young adults.

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Saluja, Garauv, Akanksha Shukla, Gurkeerat Singh, Varun Goyal, Raj Kumar Singh, and Nishant Gupta. "Skeletal Expansion with GSR Expander." Orthodontic Journal of Nepal 11, no. 1 (August 16, 2021): 61–64. http://dx.doi.org/10.3126/ojn.v11i1.39090.

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This article reports two cases treated with a modified Miniscrew Assisted Rapid Palatal Expander (MARPE) that was fabricated in-office. Two female patients aged 15 years and 18 years were treated for maxillary expansion. An in-office modified GSR Expander was used. The appliance was secured in the patient’s maxillary arch using four miniscrews. Expansion was carried out for 4 weeks and 2 weeks respectively. Considerable opening of mid palatal suture with skeletal expansion was observed. An economical and effective alternative to stock made MARPE with better adaptability and clinical modifiability.

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Clement, Evan A., and N. R. Krishnaswamy. "Skeletal and Dentoalveolar Changes after Skeletal Anchorage-assisted Rapid Palatal Expansion in Young Adults: A Cone Beam Computed Tomography Study." APOS Trends in Orthodontics 7 (June 1, 2017): 113–19. http://dx.doi.org/10.4103/2321-1407.207220.

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Objective The aim of this study was to evaluate skeletal and dentoalveolar changes before and after skeletal anchorage-assisted rapid palatal expansion in young adults by cone beam computed tomography. Materials and Methods This pilot study included ten patients with a mean age of 21.5 years with maxillary transverse deficiency treated with the skeletal expander. Three dimensional evaluation of the changes before and after expansion was evaluated with Cone Beam CT. Statistical analysis was performed using paired t-test. Results Skeletal expander produced an increase in maxillary transverse dimension at the skeletal, alveolar, and dental level. The maximum expansion was at the level of dentition, and the least amount of expansion was at the level of the frontonasal suture. There was also evidence of sutural divergence and buccal tipping. Conclusion The maxillary skeletal expander is an effective method for correction of maxillary transverse deficiency without surgery in adults.

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Conroy-Piskai, Cara, Maria Therese S. Galang-Boquiren, Ales Obrez, Maria Grace Costa Viana, Nelson Oppermann, Flavio Sanchez, Bradford Edgren, and Budi Kusnoto. "Assessment of vertical changes during maxillary expansion using quad helix or bonded rapid maxillary expander." Angle Orthodontist 86, no. 6 (May 16, 2016): 925–33. http://dx.doi.org/10.2319/112315-799.

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ABSTRACT Objective: To determine if there is a significantly different effect on vertical changes during phase I palatal expansion treatment using a quad helix and a bonded rapid maxillary expander in growing skeletal Class I and Class II patients. Materials and Methods: This retrospective study looked at 2 treatment groups, a quad helix group and a bonded rapid maxillary expander group, before treatment (T1) and at the completion of phase I treatment (T2). Each treatment group was compared to an untreated predicted growth model. Lateral cephalograms at T1 and T2 were traced and analyzed for changes in vertical dimension. Results: No differences were found between the treatment groups at T1, but significant differences at T2 were found for convexity, lower facial height, total facial height, facial axis, and Frankfort Mandibular Plane Angle (FMA) variables. A comparison of treatment groups at T2 to their respective untreated predicted growth models found a significant difference for the lower facial height variable in the quad helix group and for the upper first molar to palatal plane (U6-PP) variable in the bonded expander group. Conclusion: Overall, both the quad helix expander and the bonded rapid maxillary expander showed minimal vertical changes during palatal expansion treatment. The differences at T2 suggested that the quad helix expander had more control over skeletal vertical measurements. When comparing treatment results to untreated predicted growth values, the quad helix expander appeared to better maintain lower facial height and the bonded rapid maxillary expander appeared to better maintain the maxillary first molar vertical height.

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Serafin, Marco, Rosamaria Fastuca, and Alberto Caprioglio. "CBCT Analysis of Dento-Skeletal Changes after Rapid versus Slow Maxillary Expansion on Deciduous Teeth: A Randomized Clinical Trial." Journal of Clinical Medicine 11, no. 16 (August 20, 2022): 4887. http://dx.doi.org/10.3390/jcm11164887.

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The aim of the present study was to compare skeletal and dental changes after rapid maxillary expansion (RME) and slow maxillary expansion (SME) performed by a Leaf Expander (LE) with upper deciduous teeth as anchorage and using 3D CBCT (Cone Beam Computed Tomography) analysis. Mixed dentition patients were randomly divided in two groups, according to the different expansion used anchored on maxillary primary second molars: the RME group (n = 16) was treated with a Hyrax type expander, whereas the SME group (n = 16) was treated with an LE expander. CBCT scans were performed before (T1) and after treatment (T2) and analyzed with a custom landmarks system. A paired t-test was used for intragroup analysis between T1 and T2, and a Student t-test was used for intergroup analysis; statistical significance was set at 0.05. Both RME and SME groups showed a statistically significant increase in dental and skeletal diameters. Group comparisons between T1 and T2 showed a significant expansion rate in the RME group for upper permanent molars (p = 0.025) but not for deciduous molars (p = 0.790). Moreover, RME showed higher increases for skeletal expansion evaluated at nasal walls (p = 0.041), whereas at pterygoid plates did not show any significant differences compared with the SME group (p = 0.849). A significant transverse expansion could be achieved with the expander anchored on deciduous teeth. RME and SME produced effective both skeletal and dentoalveolar transverse expansion; RME produced more anterior expansion than SME but less control regarding the permanent molar decompensation. SME by LE therefore could be an efficient and helpful alternative in the treatment of transverse maxillary deficiency in growing patients.

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Celenk-Koca, Tugce, Aslihan Ertan Erdinc, Serpil Hazar, Lacey Harris, Jeryl D. English, and Sercan Akyalcin. "Evaluation of miniscrew-supported rapid maxillary expansion in adolescents: A prospective randomized clinical trial." Angle Orthodontist 88, no. 6 (August 13, 2018): 702–9. http://dx.doi.org/10.2319/011518-42.1.

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ABSTRACT Objectives: To evaluate and compare the dental and skeletal changes with conventional and miniscrew-supported maxillary expansion appliances in adolescents. Materials and Methods: Forty patients were divided into two groups, with one group receiving a tooth-borne expander and the other group receiving an expander supported by four miniscrews (bone-borne). Multiplanar coronal and axial slices obtained from cone-beam computed tomography images were used to measure the changes in transverse skeletal widths, buccal bone thickness, tooth inclination, and root length. Paired t-tests and independent-sample t-tests were used to compare the two expansion methods. Results: Bone-borne expansion increased the maxillary suture opening more than 2.5 times than tooth-borne expansion both anteriorly and posteriorly. Between the maxillary first premolars, sutural expansion accounted for 28% and 70% of the total transverse width increase in the tooth-borne and bone-borne expander groups, respectively. Similarly, 26% and 68% of the total expansion was of skeletal nature in the tooth-borne and bone-borne expander groups between the maxillary first molars. The pattern of expansion was variable, with most of the patients in both groups demonstrating a triangular-shaped sutural opening that was wider anteriorly. Subjects in the conventional group experienced significantly more buccal bone reduction and greater buccal inclination of the teeth. No significant differences were observed for root length measurements between the two groups. Conclusion: Use of bone-borne expansion in the adolescent population increased the extent of skeletal changes in the range of 1.5 to 2.8 times that of tooth-borne expansion and did not result in any dental side effects.

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Lanteri, Valentina, Andrea Abate, Davide Cavagnetto, Alessandro Ugolini, Francesca Gaffuri, Alessandro Gianolio, and Cinzia Maspero. "Cephalometric Changes Following Maxillary Expansion with Ni-Ti Leaf Springs Palatal Expander and Rapid Maxillary Expander: A Retrospective Study." Applied Sciences 11, no. 12 (June 21, 2021): 5748. http://dx.doi.org/10.3390/app11125748.

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Background: The aim of this study is to evaluate and compare, through bidimensional cephalometry, skeletal and dental changes obtained from a rapid maxillary expander (RME) and a Ni-Ti leaf spring expander (Leaf) and compare them with an untreated control group. Methods: Records consisted of lateral cephalograms obtained before and after maxillary expansion of patients that underwent orthodontic treatment at the Department of Biomedical, Surgical and Dental Sciences. The Leaf expander group consisted of 9 males (mean age = 7.5 ± 0.9 years old) and 11 females (mean age = 8.2 ± 0.6 years old). The RME group of the present study was composed of 11 males (mean age = 7.8 ± 0.6 years old) and 12 females (mean age = 8.1 ± 0.5 years old). Digital cephalograms were traced using Dolphin Imaging software v.11.1 (Dolphin Imaging and Management Solutions; Los Angeles, CA, USA), which calculated all reported measurements. Each subject was assigned a random identification number, and the examiner was blinded to the subject when measuring. The difference between the two experimental times in all groups was evaluated using the Student’s t-test for dependent variables. The difference between the two evaluation times in each group for all the variables was used to perform a one-way ANOVA test between the three groups. Results: No statistically significant difference was noted, apart from the angle between the upper incisor and the SN and PP planes, which showed an average decrease of 3.25 and 2.55, respectively, and the angle between the lower incisors and the mandibular plane, which showed an average increase of 2.85 degrees. The one-way ANOVA showed no statistically significant difference between the three groups. Conclusions: It appears that the leaf expander and the RME present similar effects such as dental and skeletal changes.

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Pharande, Shilpa Venkatesh. "Assessment of Immediate Skeletal Changes after Alternate Rapid Maxillary Expansion and Constriction – A Case Report." Journal of Evolution of Medical and Dental Sciences 10, no. 34 (August 23, 2021): 2954–59. http://dx.doi.org/10.14260/jemds/2021/604.

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The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-Ramec (alternate rapid maxillary expansion and contraction) protocol is an efficient method for early treatment of skeletal Class III malocclusion. This case report shows the results of using a hyrax bonded maxillary expander with the Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 12-year-old patient with skeletal class III malocclusion with anterior as well as the unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analysing the skeletal changes that have occurred after using the AltRamec protocol. The objective of this case report is to assess skeletal changes after using the Alt-RAMEC protocol.

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Lombardo, Luca, Giulia Occhiuto, Emanuele Paoletto, Bortolo Giuliano Maino, and Giuseppe Siciliani. "Class II treatment by palatal miniscrew-system appliance: A case report." Angle Orthodontist 90, no. 2 (March 12, 2019): 305–13. http://dx.doi.org/10.2319/080218-559.1.

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ABSTRACT This case shows that using a rapid palatal expander (RPE) and then a pendulum appliance anchored to palatal miniscrews is an option for improving treatment management in a noncompliant patient requiring maxillary expansion and molar distalization in the late mixed dentition. First, an RPE was used to expand the maxillary arch. Then, a modified pendulum appliance was used to distalize the maxillary first permanent molars. Optimal positioning of two palatal miniscrews enabled both appliances to be supported by skeletal anchorage. Treatment was finished using multibracket fixed appliances, and after 2 years, skeletal Class I as well as dental Class I canine and molar relationships were achieved.

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Vadivel, Aarthi, D. Muralidharan, R. Thirunavukkarasu, C. Nirupama, J. Tamizhmani, and C. Prasanth. "Miniscrew-assisted Rapid Palatal Expander – Non-surgical Method for Maxillary Expansion in Young Adults Based on Histological Review." Asian Pacific Journal of Health Sciences 8, no. 4 (October 17, 2021): 121–25. http://dx.doi.org/10.21276/apjhs.2021.8.4.20.

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Expansion is one of the most effectual orthopedic procedures for the treatment of maxillary constriction. Slow and rapid palatal expansion (RPE) are two reliable and commonly used procedures to correct transverse maxillary deficiencies. RPE produces good adaptation at skeletal level in children and adolescents. By late adolescence, the mid-palatal suture allows only limited skeletal expansion and may produce undesirable dental effects. Miniscrew-assisted RPE (MARPE) extended not only skeletal effects with fewer dental changes but also the age limit of nonsurgical maxillary expansion treatment. This review article evaluates the role of MARPE in widening the scope of non-surgical orthodontic treatment from various aspects with a focus on recent studies.

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Lee, Hye-Jeong, Jae Hyun Park, Hye Young Seo, Sung-Kwon Choi, Na-Young Chang, Kyung-Hwa Kang, and Jong-Moon Chae. "A CBCT Evaluation of Nasal Septal Deviation and Related Nasofacial Structures after Maxillary Skeletal Expansion." Applied Sciences 12, no. 19 (October 3, 2022): 9949. http://dx.doi.org/10.3390/app12199949.

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Background: The aim of this study was to evaluate three-dimensional (3D) changes in nasal septal deviation (NSD) and related nasofacial structures after maxillary skeletal expansion (MSE). Methods: This retrospective study evaluated 28 patients aged 12.0–48.4 years (mean age, 20.4 ± 7.3 years; 12 males, 16 females) diagnosed with transverse maxillary deficiency and treated with MSE. Cone-beam computed tomography (CBCT) images were taken at pre-expansion (T1), post-expansion (T2), and 6-months after MSE (T3) and were reoriented. Three-dimensional coordinates (x,y,z) were constructed using nasion (N) as the reference point (0,0,0). A paired-sample t-test and an independent sample t-test were performed to investigate and compare the 3D changes of the NSD and nasofacial structures after MSE, depending on the direction and amount of NSD and the amount of midpalatal expansion (MPE). Results: NSD was alleviated at T3–T1 in the coronal plane; nasal septal length increased significantly. The absolute nasal floor (NF) angle (2.06° at T1) decreased at T2–T1 (p > 0.05) and increased at T3–T2 (p < 0.05). The midface moved forward and downward, and pogonion (Pog) and menton (Me) moved downward and backward. There were no significant differences between the higher and lower NSD groups and greater and lesser MPE groups. Conclusions: Consequently, NSD was alleviated with variable positive nasofacial changes after MSE in both the short and long term. Therefore, MSE can be used to improve or camouflage facial deformities.

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Suetenkov, Dmitry, Irina Firsova, Aziz Kubaev, Taisiya Kochkonyan, Natalia Oleynikova, Olga Popkova, Evgenii Evert, et al. "A MODIFIED METHOD FOR RAPID PALATAL EXPANSION ANCHORED ON MINI-IMPLANTS." Archiv Euromedica 12, no. 1 (January 16, 2022): 84–90. http://dx.doi.org/10.35630/2199-885x/2022/12/1.19.

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In modern orthodontic practice, a narrow upper jaw is often corrected using teeth-anchored expanders. As a result of skeletal expansion, dental orthodontic appliances have an adverse effect both on the teeth and on the supporting tissues. An analysis of the issues associated with dental fixation devices, as well as the results of combined orthodontic & surgical treatment with Surgically Assisted Rapid Palatal Expansion (SARPE), has allowed us to develop a palatal expander anchored on miniimplants. This method has been tested through the upper jaw expansion in patients in their post-pubertal period. The article offers a view at the changes in the skeletal and dental parameters during rapid maxillary expansion with the proposed expander. Skeletal expansion of the upper dentition in this case is achieved with minor changes in the lateral teeth inclination, thus allowing to minimize the risk of side effects typical for teeth-anchored expanders: root resorption, alveolar bone buccal thickness reduction, marginal bone reduction, and gum recession. The method proposed for upper jaw skeletal narrowing treatment with a palatal expander supported by mini-implants improves the upper airway.

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Nojima, Lincoln Issamu, Matilde da Cunha Gonçalves Nojima, Amanda Carneiro da Cunha, Natan Oliveira Guss, and Eduardo Franzotti Sant’Anna. "Mini-implant selection protocol applied to MARPE." Dental Press Journal of Orthodontics 23, no. 5 (October 2018): 93–101. http://dx.doi.org/10.1590/2177-6709.23.5.093-101.sar.

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Abstract Introduction: Rapid maxillary expansion (RME) is the therapy of choice to correct skeletal transverse dimension in children and adolescents, associating orthopedic and dental effects. In an attempt to prevent the undesirable dentoalveolar effects and optimize the potential of skeletal expansion in individuals in advanced stages of skeletal maturation, the miniscrew-assisted rapid palatal expander (MARPE) was proposed by Lee et al. in 2010. Objective: This paper presents a systematized protocol for selection of miniscrews indicated for MARPE, by the evaluation of cone-beam computed tomographies (CBCT). Variables related with the bone and soft tissue thicknesses at the palatal regions of interest, as well as in relation to the fixation rings of miniscrews of the palatal expander are analyzed and discussed to provide better performance in the clinical practice.

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d’Apuzzo, Fabrizia, Ludovica Nucci, Bruno M. Strangio, Alessio Danilo Inchingolo, Gianna Dipalma, Giuseppe Minervini, Letizia Perillo, and Vincenzo Grassia. "Dento-Skeletal Class III Treatment with Mixed Anchored Palatal Expander: A Systematic Review." Applied Sciences 12, no. 9 (May 5, 2022): 4646. http://dx.doi.org/10.3390/app12094646.

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Bone-anchored appliances for the treatment of Class III malocclusions have recently been found to reduce the dentoalveolar effects caused by conventional tooth-borne devices while also improving orthopaedic outcomes in growing patients. The goal of this systematic review was to compare the outcomes of skeletal Class III interceptive treatment with dental anchoring devices to those achieved with mixed anchored palatal expanders. The inclusion criteria were as follows: patients who were treated with hybrid anchored palatal expanders and different maxillary advancement appliances. Study quality was estimated using the Newcastle–Ottawa scale. A search on the Pubmed, Scopus, Embase and Cochrane Library databases yielded 350 papers. Following the initial abstract selection, 65 potentially acceptable papers were thoroughly examined, resulting in a final selection of 9 articles. The results in the short-term showed that combined tooth-borne and bone-borne appliances for rapid maxillary expansion might be recommended in protocols of skeletal Class III treatment to obtain more skeletal effects and reduce side effects on the upper teeth.

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Jackson, Gregory W., and Neal D. Kravitz. "Expansion/Facemask Treatment of an Adult Class III Malocclusion." Case Reports in Dentistry 2014 (2014): 1–6. http://dx.doi.org/10.1155/2014/270257.

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The orthodontic treatment of class III malocclusion with a maxillary deficiency is often treated with maxillary protraction with or without expansion. Skeletal and dental changes have been documented which have combined for the protraction of the maxilla and the correction of the class III malocclusion. Concerning the ideal time to treat a developing class III malocclusion, studies have reported that, although early treatment may be the most effective, face mask therapy can provide a viable option for older children as well. But what about young adults? Can the skeletal and dental changes seen in expansion/facemask therapy in children and adolescents be demonstrated in this age group as well, possibly eliminating the need for orthodontic dental camouflage treatment or orthognathic surgery? A case report is presented of an adult class III malocclusion with a Class III skeletal pattern and maxillary retrusion. Treatment was with nonextraction, comprehensive edgewise mechanics with slow maxillary expansion with a bonded expander and protraction facemask.

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Miranda, Felicia, José Carlos da Cunha Bastos, Alexandre Magno dos Santos, Luiz Sergio Vieira, Aron Aliaga-Del Castillo, Guilherme Janson, and Daniela Garib. "Miniscrew-anchored maxillary protraction in growing Class III patients." Journal of Orthodontics 47, no. 2 (March 13, 2020): 170–80. http://dx.doi.org/10.1177/1465312520910158.

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The aim of this article is to report a case series of a miniscrew-anchored maxillary protraction therapy (MAMP). Two male patients presenting with Class III malocclusion were included in this report. The treatment consisted of a hybrid expander and two miniscrews at the anterior region of the mandible anchoring Class III elastics for maxillary protraction. Effective maxillary length, ANB angle and Wits appraisal increased after treatment. Slight dental effects were observed. MAMP therapy produced substantial skeletal effects and might be a good treatment option for Class III growing patients.

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Mobrici, P., C. Lanteri, M. Beretta, and A. Caprioglio. "Dental and skeletal modifications in adult patients treated with Slow Maxillary Expander." Mondo Ortodontico 37, no. 5 (December 2012): 41–46. http://dx.doi.org/10.1016/j.mor.2012.04.003.

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Shetty, Sanjana, and Naazia Shaikh. "Effect of alternate rapid maxillary expansion and constriction on pharyngeal airway– A case report." IP Journal of Otorhinolaryngology and Allied Science 5, no. 1 (April 15, 2022): 13–16. http://dx.doi.org/10.18231/j.ijoas.2022.004.

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The Alt-RAMEC protocol was introduced by Liou in the year 2005. It allows for sutural mobilisation by opening and closing the RME screw for 7-9 weeks. Maxillary protraction after the use of Alt-RAMEC (Alternate Rapid Maxillary Expansion and Contraction) protocol is an efficient method for early treatment skeletal Class III malocclusion. This case report shows the results of the using hyrax bonded maxillary expander with Alt-RAMEC protocol to treat a maxillary hypoplasia Class III malocclusion. A 10-year-old patient with skeletal class III malocclusion with anterior as well as unilateral posterior crossbite was treated using this protocol. CBCT scans were taken before and after expansion. These CBCT scans were used for assessing and analyzing the airway tissue changes that have occurred after using Alt-RAMEC protocol. The objective of this case report is to assess airway changes after using Alt-RAMEC protocol.

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Vella, Massimiliano, Paolo Cressoni, Cinzia Tripicchio, Eleonora Mainardi, and Luca Esposito. "Early Treatment with a Slow Maxillary Ni–Ti Leaf Springs Expander." Applied Sciences 11, no. 10 (May 17, 2021): 4541. http://dx.doi.org/10.3390/app11104541.

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The aim of this brief report is to analyse the available literature on the clinical outcomes of a particular appliance for slow maxillary expansion that consists of one or more nickel–titanium springs. Materials and methods: The main medical databases (Scopus, Web of Sciences, Pubmed and Google Scholar) were scanned up to January 2020 using “slow maxillary expan*”, “slow palatal expan*”, “leaf expander” and “NiTi Palatal Expander” as keywords. Skeletal changes in the maxilla after expansion with the Leaf Expander (L.E.) or similar appliances were taken into consideration while reviewing relevant manuscripts. The review focuses on the comparison between the L.E. and conventional expanders (i.e., Haas and Hyrax) regarding the increase in both the distance between the palatal cusps of the upper first molars and the distance between the palatal cusps of the upper second deciduous molars, as well as the increment of nasal structures and pain connected to expansion procedures. Results: Bibliographic research retrieved 32 articles that were considered eligible for the present study. The limited number of articles currently available in international medical databases is allegedly partly due to the fact that these expanders are currently produced by only one patent holder company, which affects its diffusion. Conclusion: Despite the reduced number of published articles, due to the recent introduction of the L.E. device, most of the authors have found that the effects of the L.E. device are clinically and radiographically comparable to those achievable with the rapid palatal expander.

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Xiao, Wang, Siling Liu, Yanqin Lu, Lei Lei, Ning Liu, Xiaoping Shen, Yuhong He, and Ousheng Liu. "Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander." Applied Bionics and Biomechanics 2021 (March 31, 2021): 1–11. http://dx.doi.org/10.1155/2021/8874833.

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The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48 mm and 54.20 ± 3.17 mm to 37.87 ± 2.26 mm ( P < 0.05 ) and 56.65 ± 3.10 mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25 mm3 to 23134.70 ± 3918.84 mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99 Pa to 30.70 ± 3.17 Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31 m/s to 5.85 ± 0.37 m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14 Pa/ml/s to 0.08 ± 0.06 Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

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Kim, Tae-Gyun, Young-Jun Lee, Jong-Moon Chae, and Na-Young Chang. "Treatment of a Growing Patient with Skeletal Class III Malocclusion Using Face Mask and Maxillary Skeletal Expander." Clinical Journal of Korean Association of Orthodontists 11, no. 2 (June 30, 2021): 102–14. http://dx.doi.org/10.33777/cjkao.2021.11.2.102.

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Dr, Shilpa Pharande, Nandlal Toshniwal Dr, Ravindra Manerikar Dr, Abhijit Misal Dr, and Kishor Chougule Dr. "Early Treatment of Class III Malocclusion Using Alternate Rapid Maxillary Expansion and Constriction (Alt-RAMEC) Protocol with Facemask Therapy: A Case Report." International Journal of Pharma and Bio Sciences 12, no. 1 (January 28, 2022): 47–54. http://dx.doi.org/10.22376/ijpbs/lpr.2022.12.1.l47-54.

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Orthodontists face difficulty when it comes to treating Class III malocclusion. It is best to treat it at the growing stage with dentofacial orthopedics. Maxillary protraction using the Alternate Rapid Maxillary Expansion and Contraction (Alt-RAME) technique is an effective approach for treating skeletal Class III malocclusion at an early age. A 9-year-old female patient came to the Department of Orthodontics with a complaint of backwardly placed upper teeth and un-aesthetic dental as well as facial appearance. Intraoral examination revealed an anterior cross-bite of 1 mm. Molar relation was class III on the right side and super Class I on the left side. Slight crowding in lower arch and spacing in maxillary arch due to unerupted teeth was seen. The patient was diagnosed with Class III skeletal pattern associated with maxillary retrusion, average growth pattern, Class III molar relation on right side, super Class I molar relation on left side and a protrusive lower lip. The early treatment of such cases is essential, so that maxillary retrusion can be corrected with the help of orthopedic intervention. It was decided that the correction of skeletal Class III malocclusion will be done using Alt-RAMEC protocol along with facemask. Use of Alt-RAMEC protocol for correction of Class III malocclusion due to maxillary retrusion can help in early correction of Class III skeletal pattern and helps improving overall profile of the patient. This case report shows the result of using a hyrax bonded maxillary expander with Alt-RAMEC protocol along with a facemask to treat a Class III malocclusion associated with maxillary hypoplasia. A 9-year-old patient with skeletal class III malocclusion and anterior crossbite was treated using this protocol.

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Tome, Wakako, and Won Moon. "The prevalence of posterior tongue tie in patients with transverse maxillary deficiency." Australasian Orthodontic Journal 37, no. 2 (January 1, 2021): 294–300. http://dx.doi.org/10.21307/aoj-2021.033.

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Abstract Objectives To investigate the prevalence of posterior tongue tie in orthodontic patients using numerical and clinical assessment methods in order to identify an association between posterior tongue tie and transverse maxillary deficiency. Materials and methods Seventy-nine participants from an orthodontic clinic were divided into two groups. The first group of 44 patients exhibited a skeletally narrow maxilla and required maxillary skeletal expansion (MSE group) and 35 patients without a transverse discrepancy comprised a control group. Posterior tongue tie was examined by the Kotlow tongue tie classification, tongue range of motion ratio (TRMR) and via a clinical assessment. The prevalence of posterior tongue tie was compared between the two groups. Results There was no significant difference in the level of the Kotlow classification grade between the two groups (p > 0.05) and the overall majority was diagnosed as normal. However, a higher proportion of posterior tongue tie was found in the MSE group than in the control group by clinical assessment (MSE group, 72.7%; control group, 42.9%; p = 0.005). The proportion of TRMR grade 2 was also higher in the MSE group than in the control group (p = 0.001). Of the subjects diagnosed with posterior tongue tie by clinical findings, approximately 94% showed TRMR grades 2 or 3. Conclusions A clinical assessment of posterior tongue tie was found to be simple and accurate, whereas a numerical assessment alone provided diagnostic difficulty. Considering the high prevalence of observed posterior tongue tie in the MSE group, there was a significant association between posterior tongue tie and transverse maxillary deficiency.

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Akin, Mehmet, Yasin Erdem Akgul, Zehra Ileri, and Faruk Ayhan Basciftci. "Three-dimensional evaluation of hybrid expander appliances: A pilot study." Angle Orthodontist 86, no. 1 (April 29, 2015): 81–86. http://dx.doi.org/10.2319/121214-902.1.

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ABSTRACT Objective: To evaluate transverse dimensional changes in dentoalveolar and skeletal structures caused by hybrid expander, using cone-beam computed tomography (CBCT). Materials and Methods: The CBCT records of nine patients (five boys and four girls) (mean age 13.61 ± 0.72 years) treated with hybrid expander were examined. CBCT images were taken at pretreatment and after the expansion. ELSA (point equidistant to both foramina spinosa) was determined as a reference point to compare the distances in all three dimensions. Nineteen transversal dimensions and four angles were measured for both right and left sides. Wilcoxon signed rank test was used for statistical comparison at P < .05 levels. Results: A V-shaped expansion of suture was successfully achieved in all patients without teeth support. The amount of opening was greater in anterior than posterior and in inferior than superior. An 8.75-mm screw expansion was achieved for all patients. Expansion effects reverberated to maxillary central incisor, canine, first premolar, and first molar at 70%, 75%, 92%, and 89%, respectively. The molar teeth tipped buccally (right 3.06° and left 3.24°) as did premolars (right 2.88° and left 3.02°). Conclusion: The hybrid expander, minimally invasive expansion appliance that protects teeth by including bone support, can be used easily for rapid maxillary expansion treatment.

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Cantarella, Daniele, Lorena Karanxha, Paolo Zanata, Christoph Moschik, Ana Torres, Gianpaolo Savio, Massimo Del Fabbro, and Won Moon. "Digital Planning and Manufacturing of Maxillary Skeletal Expander for Patients with Thin Palatal Bone." Medical Devices: Evidence and Research Volume 14 (October 2021): 299–311. http://dx.doi.org/10.2147/mder.s331127.

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Jia, Haichao, Li Zhuang, Nan Zhang, Yuanyuan Bian, and Song Li. "Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:." Angle Orthodontist 91, no. 1 (November 4, 2020): 36–45. http://dx.doi.org/10.2319/041920-332.1.

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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.

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Pereira, Juliana da S., Helder B. Jacob, Arno Locks, Mauricio Brunetto, and Gerson L. U. Ribeiro. "Evaluation of the rapid and slow maxillary expansion using cone-beam computed tomography: a randomized clinical trial." Dental Press Journal of Orthodontics 22, no. 2 (April 2017): 61–68. http://dx.doi.org/10.1590/2177-6709.22.2.061-068.oar.

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ABSTRACT OBJECTIVE: The aim of this randomized clinical trial was to evaluate the dental, dentoalveolar, and skeletal changes occurring right after the rapid maxillary expansion (RME) and slow maxillary expansion (SME) treatment using Haas-type expander. METHODS: All subjects performed cone-beam computed tomography (CBCT) before installation of expanders (T1) and right after screw stabilization (T2). Patients who did not follow the research parameters were excluded. The final sample resulted in 21 patients in RME group (mean age of 8.43 years) and 16 patients in SME group (mean age of 8.70 years). Based on the skewness and kurtosis statistics, the variables were judged to be normally distributed and paired t-test and student t-test were performed at significance level of 5%. RESULTS: Intermolar angle changed significantly due to treatment and RME showed greater buccal tipping than SME. RME showed significant changes in other four measurements due to treatment: maxilla moved forward and mandible showed backward rotation and, at transversal level both skeletal and dentoalveolar showed significant changes due to maxillary expansion. SME showed significant dentoalveolar changes due to maxillary expansion. CONCLUSIONS: Only intermolar angle showed significant difference between the two modalities of maxillary expansion with greater buccal tipping for RME. Also, RME produced skeletal maxillary expansion and SME did not. Both maxillary expansion modalities were efficient to promote transversal gain at dentoalveolar level. Sagittal and vertical measurements did not show differences between groups, but RME promoted a forward movement of the maxilla and backward rotation of the mandible.

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Bud, Eugen Silviu, Cristina Ioana Bică, Mariana Păcurar, Petru Vaida, Alexandru Vlasa, Krisztina Martha, and Anamaria Bud. "Observational Study Regarding Possible Side Effects of Miniscrew-Assisted Rapid Palatal Expander (MARPE) with or without the Use of Corticopuncture Therapy." Biology 10, no. 3 (March 3, 2021): 187. http://dx.doi.org/10.3390/biology10030187.

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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.

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El, Hakan, and Juan Martin Palomo. "Three-dimensional evaluation of upper airway following rapid maxillary expansion: A CBCT study." Angle Orthodontist 84, no. 2 (July 18, 2013): 265–73. http://dx.doi.org/10.2319/012313-71.1.

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ABSTRACT Objectives: To evaluate, by using cone beam computed tomography, the skeletal, dental, oropharyngeal (OP) airway volume, and nasal passage (NP) volume changes that occur after rapid maxillary expansion (RME). Materials and Methods: Two groups were selected, each with 35 patients (15 males, 20 females), an RME group (mean age, 14.02 ± 1.46 years) and a control group (mean age, 14.10 ± 1.44 years). The RME group consisted of patients with maxillary constriction who were treated with Hyrax palatal expanders, and the control group comprised age- and sex-matched patients who underwent comprehensive orthodontic treatment without the use of a rapid maxillary expander. Results: All of the transverse skeletal (medial orbital width, lateral nasal width, maxillary width, and mandibular width) and interdental (intermolar, interpremolar, and intercanine) parameters were significantly enlarged in the RME group. A statistically significant increase in airway variables was seen in both groups between pretreatment (T0) and final records (T1). The mean increase of NP airway volume for the RME group (1719.9 ± 1510.7 mm3) was twofold compared with the control group (813.6 ± 1006.7 mm3), and no intergroup significant difference was found for the OP volume. Conclusions: Rapid maxillary expansion creates a significant increase in nasal passage airway volume but no significant change in the oropharyngeal airway volume.

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Coloccia, Giovanni, Alessio Danilo Inchingolo, Angelo Michele Inchingolo, Giuseppina Malcangi, Valentina Montenegro, Assunta Patano, Grazia Marinelli, et al. "Effectiveness of Dental and Maxillary Transverse Changes in Tooth-Borne, Bone-Borne, and Hybrid Palatal Expansion through Cone-Beam Tomography: A Systematic Review of the Literature." Medicina 57, no. 3 (March 19, 2021): 288. http://dx.doi.org/10.3390/medicina57030288.

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Background and Objectives: Palatal expansion is a common orthodontic technique able to increase the transverse changes for subjects with constricted maxillary arches. The aim of the present investigation was to evaluate through a systematic review the tomography effectiveness of different palatal expander approaches. Materials and Methods: The database used to perform the screening and determine the eligibility of the clinical papers was PubMed (Medline). Results: The database search included a total of 284 results, while 271 articles were excluded. A total of 14 articles were included for the qualitative assessment. Conclusions: The effectiveness of the present studies reported that skeletal expansion was a useful approach to increase the transverse changes for subjects with constricted maxillary arches.

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Kongo, Elona. "Treatment of Maxillary Retrusion-Face Mask with or without RPE?" Balkan Journal of Dental Medicine 22, no. 2 (July 1, 2018): 93–97. http://dx.doi.org/10.2478/bjdm-2018-0016.

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SummaryBackground/Aim: Maxillary transverse deficiency often combines with retruded maxillary skeletal position causing a skeletal class III malocclusion. In these cases combination of rapid palatal expander and a facial mask to protract the maxilla is a very effective treatment protocol. When the maxilla is not deficient is it necessary to use palatal expansion before protracting? Should we use this combination because it has been proved to be effective? The aim of this paper is to show that maxillary protraction is also effective when applied without expanding the maxilla although there are some statistically significant changes.Material and Methods: Two groups of 20 patients each, were created for this study. The first group were treated with rapid palatal expansion and face mask. In the second group, patients were treated only with face mask.Results: Measurements made at T0 (prior to treatment) and those at T1 (after treatment) were statistically analyzed. At the end of the treatment patients of the 1st group showed significant difference for the values of SNA, SNB, ANB angles (p=0.000). Significant changes were observed also for the second group (SNA, SNB, ANB). The only differences between the two groups were observed regarding SNA angle (p=0.040) and maxillary incisor inclination (p=0.028).Conclusions: At the end of treatment, all patients showed skeletal class III correction and improved facial appearance. Significant changes of SNA angle were observed for each group. There were also significant changes in the position of the mandible. These changes contributed in skeletal class III correction but there was no significant difference between them.

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Ngan, Peter, Uyen Kelly Nguyen, Tung Nguyen, Timothy Tremont, and Chris Martin. "Skeletal, Dentoalveolar, and Periodontal Changes of Skeletally Matured Patients with Maxillary Deficiency Treated with Microimplant-assisted Rapid Palatal Expansion Appliances: A Pilot Study." APOS Trends in Orthodontics 8 (June 1, 2018): 71–85. http://dx.doi.org/10.4103/apos.apos_27_18.

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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.

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Lee, Hyub-Soo, Dong-Soon Choi, Insan Jang, and Bong-Kuen Cha. "Maxillary Protraction with Miniscrew Assisted Rapid Palatal Expander in Children with Skeletal Class III Malocclusions." Clinical Journal of Korean Association of Orthodontists 10, no. 1 (March 31, 2020): 34–44. http://dx.doi.org/10.33777/cjkao.2020.10.1.34.

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Suzuki, Hideo, Won Moon, Luiz Henrique Previdente, Selly Sayuri Suzuki, Aguinaldo Silva Garcez, and Alberto Consolaro. "Miniscrew-assisted rapid palatal expander (MARPE): the quest for pure orthopedic movement." Dental Press Journal of Orthodontics 21, no. 4 (August 2016): 17–23. http://dx.doi.org/10.1590/2177-6709.21.4.017-023.oin.

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ABSTRACT The midpalatal suture has bone margins with thick connective tissue interposed between them, and it does not represent the fusion of maxillary palatal processes only, but also the fusion of palatal processes of the jaws and horizontal osseous laminae of palatal bones. Changing it implies affecting neighboring areas. It has got three segments that should be considered by all clinical analyses, whether therapeutic or experimental: the anterior segment (before the incisive foramen, or intermaxillary segment), the middle segment (from the incisive foramen to the suture transversal to the palatal bone ) and the posterior segment (after the suture transversal to the palatal bone ). Rapid palatal expansion might be recommended for patients at the final pubertal growth stage, in addition to adult patients with maxillary constriction. It represents a treatment solution that can potentially avoid surgical intervention. When performed in association with rapid palatal expanders, it might enhance the skeletal effects of the latter. Of the various designs of expansion appliances, MARPE (miniscrew-assisted rapid palatal expander) has been modified in order to allow its operational advantages and outcomes to become familiar in the clinical practice.

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Seo, Yu-Jin, Kyu-Rhim Chung, Seong-Hun Kim, and Gerald Nelson. "Camouflage treatment of skeletal Class III malocclusion with asymmetry using a bone-borne rapid maxillary expander." Angle Orthodontist 85, no. 2 (March 2015): 322–34. http://dx.doi.org/10.2319/031314-189.1.

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Nam, Hye Jin, Silvia Gianoni-Capenakas, Paul W. Major, Giseon Heo, and Manuel O. Lagravère. "Comparison of Skeletal and Dental Changes Obtained from a Tooth-Borne Maxillary Expansion Appliance Compared to the Damon System Assessed through a Digital Volumetric Imaging: A Randomized Clinical Trial." Journal of Clinical Medicine 9, no. 10 (September 30, 2020): 3167. http://dx.doi.org/10.3390/jcm9103167.

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The purpose of this study was to evaluate and compare dental and skeletal changes associated with the Damon and Rapid Maxillary Expander (RME) expansion using Cone-Beam Computed Tomography (CBCT). Eighty-two patients, from The University of Alberta Orthodontic Clinic, were randomly allocated to either Group A or B. Patients in Group A received orthodontic treatment using the Damon brackets. Patients in Group B received treatment using the Hyrax (a type of RME) appliance. CBCT images were taken two times (baseline and after expansion). The AVIZO software was used to locate 18 landmarks (dental and skeletal) on sagittal, axial, and coronal slices of CBCT images. Comparison between two groups showed that transverse movement of maxillary first molars and premolars was much greater in the Hyrax group. The lateral movements of posterior teeth were associated with buccal tipping of crowns. No clinically significant difference in the vertical or anteroposterior direction between the two groups was noted. Alveolar bone next to root apex of maxillary first premolar and molar teeth showed clinically significant lateral movement in the Hyrax group only. The comparison between two groups showed significantly greater transverse expansion of the first molar and first premolars with buccal tipping in the RME group.

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Kayalar, Emre, Sonmez Fıratli, M. Ali Darendeliler, Kerem Dalci, and Oyku Dalci. "Skeletal, dentoalveolar, and buccal bone changes using hybrid and tooth-borne expanders for RME and SARME in different growth stages." Australasian Orthodontic Journal 38, no. 2 (January 1, 2022): 355–67. http://dx.doi.org/10.2478/aoj-2022.0036.

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Abstract Objective To compare the skeletal, dentoalveolar and buccal bone thickness of tooth–bone-borne (Hybrid-H) and tooth-borne (TB) maxillary expanders used for rapid maxillary expansion (RME) in early and late adolescents and for surgically-assisted RME (SARME) in young adults. Materials and methods: This two-centre clinical study included initial and 6 months post-retention CBCT records of 60 patients (27 males, 33 females; mean age 15.7 ± 3.75 years). The cohort was divided into two groups according to the expander type (H or TB) and subdivided into a further three groups determined by cervical vertebrae maturation stages: early adolescents (EA), late adolescents (LA), and young adults (A). EA and LA patients underwent RME and young adults received a SARME. Results: The hybrid-designed appliance increased the internal skeletal maxillary width and nasal width more than the TB-designed appliance anteriorly in EA and posteriorly in SARME young adults. The TB expanders tipped and expanded the first premolars more than the Hybrid SARME expanders in young adults and caused a greater reduction in buccal alveolar bone thickness at the level of the first premolars and molars at the three growth stages. Conclusion The hybrid expanders, with relatively greater skeletal and nasal widening potential and fewer dentoalveolar side effects, were a favourable alternative to tooth-borne expanders for RME in the early and late adolescents, and for SARME in young adults.

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Wu, Zuping, Xin Zhang, Zixuan Li, Yuyao Liu, Hairu Jin, Qian Chen, and Jie Guo. "A Bayesian network meta‐analysis of orthopaedic treatment in Class III malocclusion: Maxillary protraction with skeletal anchorage or a rapid maxillary expander." Orthodontics & Craniofacial Research 23, no. 1 (September 15, 2019): 1–15. http://dx.doi.org/10.1111/ocr.12339.

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Tanaka, Orlando Motohiro, Isabelle Adad Fornazari, Ariane Ximenes Graciano Parra, Bruno Borges de Castilhos, and Ademir Franco. "Complete Maxillary Crossbite Correction with a Rapid Palatal Expansion in Mixed Dentition Followed by a Corrective Orthodontic Treatment." Case Reports in Dentistry 2016 (2016): 1–6. http://dx.doi.org/10.1155/2016/8306397.

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This case report presents the interceptive orthodontic treatment of a boy, aged 8 years 4 months with a Class I malocclusion with severe transverse maxillary deficiency and complete maxillary crossbite and correction using Haas expansion and fixed appliance. The treatment goals were to correct the posterior crossbite and anterior crossbite and restore the normality of the dentition and occlusion. In phase I, the patient was treated with a modified Haas-type palatal expander, which provided a clinically significant palatal expansion and increased the maxillary arch perimeter with favorable conditions for orthodontic treatment with fixed appliances in phase II. The optimization of E-space and the use of intermaxillary Class III elastics helped to maintain the mandibular incisors upright. A removable wraparound type appliance and a bonded lingual canine-to-canine retainer were used as retention. Although the literature has reported a high rate of relapse after palatal expansion, after 2 years 9 months of posttreatment follow-up, the occlusal result was stable and no skeletal reversals could be detected.

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Taffarel, Ivan Pedro, Fernando Augusto Casagrande, Itamar Antonio Taffarel, Thiago Martins Meira, and Orlando Tanaka. "Classe II, divisão 1 – da dentição mista à permanente com aparelho ortopédico funcional e fixo." Orthodontic Science and Practice 14, no. 54 (2021): 62–72. http://dx.doi.org/10.24077/2021;1454-6272.

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Orthodontic treatment of Class II, division 1 malocclusion in one or two phases is still controversial in contemporary Orthodontics. The present clinical case presents the orthodontic treatment of a 6-year-old patient with aesthetic complaint regarding the smile and bullying, presenting skeletal Class II, Class II malocclusion, Angle division 1, overjet with exaggerated protrusion of the maxillary incisors, exaggerated overbite with the lower incisors touching the palatal mucosa, absence of lip sealing and concave inferior face profile. In Phase I, rapid maxillary expansion was performed with Hyrax-type expander together with the Herbst fixed functional orthopedic device for 11 months. In Phase II, the fixed orthodontic appliance associated with intermaxillary elastics was used for 13 months. The two-phase treatment of Class II malocclusion, division 1 showed to be effective after 24 months, establishing adequate occlusal and functional results and improving the aesthetics of the lower third of the face.

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Abate, Andrea, Davide Cavagnetto, Francesca Maria Emilia Rusconi, Paolo Cressoni, and Luca Esposito. "Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study." Children 8, no. 1 (January 7, 2021): 33. http://dx.doi.org/10.3390/children8010033.

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Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients. Methods: Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups. Results: All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients. Conclusions: Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion).

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Abate, Andrea, Davide Cavagnetto, Francesca Maria Emilia Rusconi, Paolo Cressoni, and Luca Esposito. "Safety and Effects of the Rapid Maxillary Expander on Temporomandibular Joint in Subjects Affected by Juvenile Idiopathic Arthritis: A Retrospective Study." Children 8, no. 1 (January 7, 2021): 33. http://dx.doi.org/10.3390/children8010033.

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Background: In Juvenile Idiopathic Arthritis (JIA) temporo-mandibular joints are often affected causing skeletal and dental malocclusions. The most frequent condition is mandibular hypoplasia, that may be associated with maxillary hypoplasia. The aim of this retrospective case control study is to investigate the effects and the safety of rapid maxillary expansion (RME) in growing patients affected by JIA. It was evaluated whether RME could be performed without complications on TMJs of JIA patients using DC/TMD protocol, and naso-maxillary transversal parameters were compared with the ones obtained on healthy patients. Methods: Twenty-five patients affected by JIA that ceased to manifest TMJ (Temporo-Mandibular Joint) symptoms in the previous year were treated with RME to solve the maxillary transverse hypoplasia. Postero-anterior cephalometric tracings were collected before and after treatment; linear measurements were obtained to study maxillary and nasal cavity modifications. Data were compared to those of a similar group of twenty-five healthy patients. Paired t-test and Independent t-test were used to evaluate changes before and after treatment in each group and to perform a comparison between the groups. Results: All patients demonstrated a statistically significant increase in nasal cavity width, maxillary width and upper and lower intermolar width. No patients presented a worsening of their TMJs condition. Intragroup comparisons revealed significant changes of cephalometric measurements, but no difference was found when comparing JIA and healthy patients. Conclusions: Growing patients with JIA that ceased to show signs of active TMJ involvement for at least one year could be safely treated with RME, expecting similar benefits to those of healthy patients. Dentists and rheumatologists should be informed of safety and potential benefits of palatal expansion in JIA patients in order to improve the outcome of orthodontic treatment and reduce the indication for more invasive procedures (i.e., Surgical Assisted Rapid Maxillary Expansion).

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Wang, Honghong, Jing Feng, Peijun Lu, and Gang Shen. "Correction of a skeletal Class II malocclusion with severe crowding by a specially designed rapid maxillary expander." American Journal of Orthodontics and Dentofacial Orthopedics 147, no. 2 (February 2015): 242–51. http://dx.doi.org/10.1016/j.ajodo.2013.12.032.

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Lee, Seung-Ryeol, Kyung-suk Cha, Jin-Woo Lee, Dong-Hwa Chung, and Sang-Min Lee. "Non-Extraction Orthodontic Camouflage Treatment Using Novel Maxillary Skeletal Expander Protocol for Skeletal Class III Patient with Severe Crowding and Facial Asymmetry." Clinical Journal of Korean Association of Orthodontists 10, no. 2 (June 30, 2020): 134–43. http://dx.doi.org/10.33777/cjkao.2020.10.2.134.

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Journal articles on the topic 'Maxillary Skeletal Expander (MSE)'

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