Articles de revues : « MARPE, surgically assisted rapid palatal expansion (SARPE) »

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Vaghela, Vijay. « Surgically Assisted Rapid Palatal Expansion and Mini-screw Assisted Rapid Palatal Expansion - A review ». Academic Journal of Research and Scientific Publishing 3, n^o 30 (5 octobre 2021) : 21–29. http://dx.doi.org/10.52132/ajrsp.e.2021.302.

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This review was undertaken to compare the effects of surgically assisted rapid palatal expansion (SARPE) and mini-screw assisted rapid palatal expansion (MARPE). Discrepancies in the transverse relation between maxillary and mandibular dentition can result in the development of posterior cross bite. For the correction of posterior cross bite, maxillary expansion is frequently undertaken. The conventional approach for maxillary expansion includes expansion screw being anchored to the maxillary teeth and is known and rapid palatal expansion (RPE) appliance. However, RPE can only be applied in growing individuals and is not as effective in late adolescents and adults. In such patients, surgically assisted rapid palatal expansion (SARPE) technique is used to expand the maxillary arch. As this procedure involves surgery, it deters many patients from choosing SARPE as a treatment option. Recently a non-surgical technique of expansion of maxillary arch has been introduced that can be applied to late adolescents and adults using palatal mini-screws. This technique is known as mini-screw assisted rapid palatal expansion (MARPE). In this review, the studies in the current literature regarding the SARPE and MARPE expansion techniques as compared to conventional RPE were included. It was observed that both SARPE and MARPE are effective methods for achieving maxillary expansion. With both techniques being effective, the advantage of MARPE over SARPE is the non-surgical approach which leads to higher patient acceptance and lower rate of complications.

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Chuang, Yun-Hsuan, Jen-Hsuan Chen, Kwok-Hing Ho, Kai-Long Wang, Shun-Chu Hsieh et Heng-Ming Chang. « The role of micro-implant-assisted rapid palatal expansion (MARPE) in clinical orthodontics — a literature review ». Australasian Orthodontic Journal 37, n^o 2 (1 janvier 2021) : 206–16. http://dx.doi.org/10.21307/aoj-2021.018.

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Abstract A maxillary transverse deficiency is a common craniofacial problem. Rapid palatal expansion (RPE) has been traditionally considered for the treatment of children and young adolescents, but this is not applicable in late adolescents or adults due to the ossification of facial sutures. A surgically assisted rapid palatal expansion (SARPE) was initially advocated for this group of patients, but the surgical procedure is associated with morbidity. As temporary anchorage devices (TADs) have been recently and popularly applied in clinical orthodontics, micro-implant-assisted rapid palatal expansion (MARPE) has been employed to facilitate maxillary expansion in skeletally mature patients. There have been various proposed MARPE designs and the outcomes appear promising. The aim of the present article is to discuss the role of MARPE in clinical orthodontics by reviewing its background, design, indications, treatment effects, stability, and limitations in the current literature. The treatment effects of two types of MARPE, bone-borne and tooth-bone-borne (hybrid), will be individually assessed.

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Brunetto, Daniel Paludo, Eduardo Franzzotti Sant’Anna, Andre Wilson Machado et Won Moon. « Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE) ». Dental Press Journal of Orthodontics 22, n^o 1 (février 2017) : 110–25. http://dx.doi.org/10.1590/2177-6709.22.1.110-125.sar.

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ABSTRACT Introduction: Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). Objective: The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA). Methods: All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained. Conclusion: It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

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Ventura, Vanda, João Botelho, Vanessa Machado, Paulo Mascarenhas, François Durand Pereira, José João Mendes, Ana Sintra Delgado et Pedro Mariano Pereira. « Miniscrew-Assisted Rapid Palatal Expansion (MARPE) : An Umbrella Review ». Journal of Clinical Medicine 11, n^o 5 (26 février 2022) : 1287. http://dx.doi.org/10.3390/jcm11051287.

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In postpubertal patients, maxillary transverse discrepancy is a common condition often requiring surgical approaches. To overcome the excess morbidity and discomfort, maxillary expansion through miniscrew-assisted rapid palatal expansion (MARPE) was proposed and studied in the last few years. This umbrella review aims to critically appraise the quality of evidence and the main clinical outcomes of available systematic reviews (SRs) on MARPE. An extensive search was carried out in five electronic databases (PubMed-Medline, Cochrane Database of SRs, Scielo, Web of Science, and LILACS) until December 2021. The methodological quality was appraised using the A Measurement Tool to Assess SRs criteria 2 (AMSTAR2). The primary outcome was the methodological quality of SRs. Overall, four SRs were included and analyzed, one of high methodological quality, one of low and two of critically low. Despite the verified methodological constraints, MARPE seems to present significant clinical changes when compared to conventional RPE, SARPE or controls and less adverse clinical outcomes. The quality of evidence produced by the available SRs was not favorable. Future high standard SRs and well-designed clinical trials are warranted to better clarify the clinical protocols and outcomes success of MARPE.

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S, Dr Manimala, et Dr Vimal Parmar. « A Review on Changes in Condylar Position after Palatal Expansion ». Scholars Journal of Dental Sciences 8, n^o 11 (10 décembre 2021) : 318–21. http://dx.doi.org/10.36347/sjds.2021.v08i11.002.

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Introduction: The effects of rapid palatal expansion on condylar response is not described very well. The purpose of this review is to describe whether rapid palatal expansion has an influence on the condylar position. Methods: This review article describes the three main types of expanders namely Rapid palatal expansion (RPE), mini-screw assisted rapid palatal expansion (MARPE), and surgically assisted rapid palatal expansion (SARPE) and their effects on condylar position from the current literature. Results: The palatal expanders can have an effect on the Class II malocclusion patients in helping to decrease the overjet in some patients. It also helps in the lowering the nasal resistance and increases the airway volume. The palatal expanders can lead to molar extrusion which results in increased joint spaces in the temporomandibular joint and an alteration of condylar position. Conclusions: The design of expanders can influence the effects on dentition such as molar extrusion, the joint space, and the condylar position. Dentists and orthodontists can have a better discernment of effects of expanders and condylar position by understanding in detail the effects of the palatal expanders on occlusal alterations and condylar position.

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Goddard, R., et H. Witherow. « Surgically assisted rapid palatal expansion (SARPE) ». British Journal of Oral and Maxillofacial Surgery 49, n^o 1 (janvier 2011) : 65–66. http://dx.doi.org/10.1016/j.bjoms.2009.11.013.

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Madhavarajan, Satish, Nigel Taylor et Paul Johnson. « Surgically assisted Rapid Palatal Expansion (SARPE) ». British Journal of Oral and Maxillofacial Surgery 52, n^o 8 (octobre 2014) : e59-e60. http://dx.doi.org/10.1016/j.bjoms.2014.07.056.

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Kumar Shetty, Sharath, Neeraj N. S, Mahesh Kumar Y et Vijayananda K. Madhur. « Surgically Assisted Rapid Palatal Expansion (SARPE) : A Literature Review ». Scholars Journal of Dental Sciences 8, n^o 1 (9 janvier 2021) : 25–40. http://dx.doi.org/10.36347/sjds.2021.v08i01.005.

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Rasool, Insha, Merry, Sanjay Mittal, Isha Aggarwal et Tanzin Palkir. « Slow expansion in orthodontics -A review article ». International Dental Journal of Student's Research 10, n^o 3 (15 septembre 2022) : 85–91. http://dx.doi.org/10.18231/j.idjsr.2022.019.

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One of the most common problems faced by an orthodontist while treating young as well as adult patients is the constricted maxillary arch. Expansion of the maxillary arch has been a topic of debate since centuries. The commonly used methods for constricted arch include slow maxillary expansion, rapid maxillary expansion and surgically assisted rapid palatal expansion (SARPE). Slow palatal expansion is a procedure to expand the maxillary arch in transverse dimension to correct the constricted maxillary arch with light forces. The following review article provides detailed information of various slow maxillary expansion appliances with their implications in orthodontics.

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Vogiatzis, Fotis, Petros Roussos, Ioannis Doulis, Georgia Palikaraki, Panagiotis Christopoulos et Iosif Sifakakis. « Effects of Surgically Assisted Rapid Palatal Expansion on Facial Soft Tissues : A Systematic Review ». Applied Sciences 12, n^o 22 (21 novembre 2022) : 11859. http://dx.doi.org/10.3390/app122211859.

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Surgically assisted rapid palatal expansion (SARPE) is a successful method for treating transverse discrepancies in adult patients. The relocation of maxillary segments may induce changes at the surrounding soft tissues as well. The aim of this systematic review was to examine the possible effects that SARPE may have in the soft tissues of the face. Our search strategy included electronic databases (Pubmed, Scopus, ProQuest, Google Scholar, Cochrane Library) and a hand search of the reference list of found reviews. A priori definition of inclusion and exclusion criteria was made. Finally, 15 articles were included in qualitative synthesis. Risk of bias was generally high among the included studies. Study outcomes included nasal, labial, nasolabial and other facial soft tissue measurements. The evaluation of the changes was two-dimensional in six studies, and three-dimensional in nine studies. Meta-analysis was unfeasible due to lack of standardization, important methodological limitations, and shortcomings of the studies. A post-surgical increase in the dimensions of the alar width and the alar base width was commonly reported among the included studies. However, the above should be considered with caution due to the high risk of bias and the inability for quantitative synthesis.

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Behnia, Hossein, Hossein Mohammad-Rahimi et Mohammad Behnaz. « Treatment of an Adult Skeletal Class III Patient with Surgically Assisted Rapid Palatal Expansion and Facemask ». Case Reports in Dentistry 2019 (31 décembre 2019) : 1–6. http://dx.doi.org/10.1155/2019/8251903.

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This case report presents the treatment of a 21-year-old male patient with class III skeletal malocclusion, an open bite, and vertical growth pattern. He was managed with surgically assisted rapid palatal expansion (SARPE) along with an orthopedic facemask. The duration of treatment was 16 months. Significant improvement and favourable outcome were observed concerning both facial appearance and paraclinical parameters after completion of treatment.

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Graham, M. Elise, Duane Yamashiro et Jonathan R. Skirko. « Management of midnasal stenosis with infant surgically assisted rapid palatal expansion (i SARPE ) ». Laryngoscope 129, n^o 5 (16 octobre 2018) : 1211–14. http://dx.doi.org/10.1002/lary.27199.

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Farronato, Marco, Davide Farronato, Aldo Bruno Giannì, Francesco Inchingolo, Ludovica Nucci, Gianluca Martino Tartaglia et Cinzia Maspero. « Effects on Muscular Activity after Surgically Assisted Rapid Palatal Expansion : A Prospective Observational Study ». Bioengineering 9, n^o 8 (3 août 2022) : 361. http://dx.doi.org/10.3390/bioengineering9080361.

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The study aims to investigate the modifications in the temporalis and the masseter activity in adult patients before and after SARPE (Surgically Assisted Rapid Palatal Expansion) by measuring electromyographic and electrokinesographic activity. 24 adult patients with unilateral posterior crossbite on the right side were selected from the Orthodontic Department of the University of Milan. Three electromyographic and electrokinesographic surface readings were taken respectively before surgery (T0) and 8 months after surgery (T1). The electromyographic data of both right and left masseter and anterior temporalis muscles were recorded during multiple tests: standardized maximum voluntary contraction (MVC)s, after transcutaneous electrical nerve stimulation (TENS) and at rest. T0 and T1 values were compared with paired Student’s t-test (p < 0.05). Results: Significant differences were found in the activity of right masseter (p = 0.03) and right temporalis (p = 0.02) during clench, in the evaluation of right masseter at rest (p = 0.03), also the muscular activity of masseters at rest after TENS from T0 to T1 (pr = 0.04, pl = 0.04). No significant differences were found in the activity of left masseter (p = 0.41) and left temporalis (p = 0.39) during clench and MVC, in the evaluation of left masseter at rest (p = 0.57) and in the activity during MVC of right masseter (p = 0.41), left masseter (p = 0.34), right temporalis (p = 0.51) and left temporalis (p = 0.77). Results showed that the activity of the masseter and temporalis muscles increased significantly after SARPE during rest and clenching on the side where the cross-bite was treated.

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Silva, Alessandro. « Poster 008 : A Retrospective Survey of Complications With Surgically Assisted Rapid Palatal Expansion (SARPE) ». Journal of Oral and Maxillofacial Surgery 66, n^o 8 (août 2008) : 72–73. http://dx.doi.org/10.1016/j.joms.2008.05.163.

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Bridle, C., et N. Ali. « P84 Modified Surgically Assisted Rapid Palatal Expansion (SARPE) : pre-tensioning of orthodontic appliance prior to palatal split ». British Journal of Oral and Maxillofacial Surgery 48 (mai 2010) : S46. http://dx.doi.org/10.1016/s0266-4356(10)60175-1.

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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, n^o 1 (16 janvier 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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Harzer, Winfried, Matthias Schneider, Tomasz Gedrange et Eve Tausche. « Direct Bone Placement of the Hyrax Fixation Screw for Surgically Assisted Rapid Palatal Expansion (SARPE) ». Journal of Oral and Maxillofacial Surgery 64, n^o 8 (août 2006) : 1313–17. http://dx.doi.org/10.1016/j.joms.2005.11.061.

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Schmid, Jonas Q., Elena Gerberding, Ariane Hohoff, Johannes Kleinheinz, Thomas Stamm et Claudius Middelberg. « Non-Surgical Transversal Dentoalveolar Compensation with Completely Customized Lingual Appliances versus Surgically Assisted Rapid Palatal Expansion in Adults—The Amount of Posterior Crossbite Correction ». Journal of Personalized Medicine 12, n^o 11 (11 novembre 2022) : 1893. http://dx.doi.org/10.3390/jpm12111893.

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The aim of this study was to compare the crossbite correction of a group (n = 43; f/m 19/24; mean age 27.6 ± 9.5 years) with surgically assisted rapid palatal expansion (SARPE) versus a non-surgical transversal dentoalveolar compensation (DC) group (n = 38; f/m 25/13; mean age 30.4 ± 12.9 years) with completely customized lingual appliances (CCLA). Arch width was measured on digital models at the canines (C), second premolars (P2), first molars (M1) and second molars (M2). Measurements were obtained before treatment (T0) and at the end of lingual treatment (T1) or after orthodontic alignment prior to a second surgical intervention for three-dimensional bite correction. There was no statistically significant difference (p > 0.05) in the amount of total crossbite correction between the SARPE and DC-CCLA group at C, P2, M1 and M2. Maxillary expansion was greater in the SARPE group and mandibular compression was greater in the DC-CCLA group. Crossbite correction in the DC-CCLA group was mainly a combination of maxillary expansion and mandibular compression. Dentoalveolar compensation with CCLAs as a combination of maxillary expansion and mandibular compression seems to be a clinically effective procedure to correct a transverse maxillo-mandibular discrepancy without the need for surgical assistance.

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Lee, K. C., J. C. Chou, J. Yang, J. A. Shariff et M. A. Perrino. « Soft Tissue Alar Base Width Changes in Patients Submitted to Surgically Assisted Rapid Palatal Expansion (SARPE) : A Meta-Analysis ». Journal of Oral and Maxillofacial Surgery 74, n^o 9 (septembre 2016) : e67-e68. http://dx.doi.org/10.1016/j.joms.2016.06.122.

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ISOGAI, YUKAKO, AYAKA OKA, HIDETAKA SHIMIZU, MASAKAZU HAMADA, NARIKAZU UZAWA et TAKASHI YAMASHIRO. « A Case of Mandibular Prognathism with Narrow Maxilla Treated by Surgically Assisted Rapid Palatal Expansion （SARPE） and Two-jaw Osteotomy ». Japanese Journal of Jaw Deformities 29, n^o 3 (2019) : 253–62. http://dx.doi.org/10.5927/jjjd.29.253.

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Hoque, Tamanna, Dilip Srinivasan, Sangeetha Morekonda Gnaneswar, Sushil Chakravarthi et Krishnaraj Rajaram. « Microimplant Assisted Rapid Palatal Expansion : A Comprehensive Review ». JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021. http://dx.doi.org/10.7860/jcdr/2021/49911.15316.

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

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ROMANO, Fábio Lourenço, Cássio Edward SVERZUT, Alexandre Elias TRIVELLATO, Maria Conceição Pereira SARAIVA et Tung Tahan NGUYEN. « Alveolar defects before and after surgically assisted rapid palatal expansion (SARPE) : a CBCT assessment ». Dental Press Journal of Orthodontics 27, n^o 2 (2022). http://dx.doi.org/10.1590/2177-6709.27.2.e2219299.oar.

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ABSTRACT Introduction: Surgically Assisted Rapid Palatal Expansion (SARPE) promote maxillary expansion in skeletally mature patients. This technique is effective; however, some side effects are still unknown. Objectives: evaluate the presence of alveolar defects (dehiscences and fenestrations) in patients submitted to the SARPE. The null hypothesis tested was: SARPE does not influence the number of dehiscences and fenestrationss. Methods: A retrospective quasi-experiment study of a convenience sample of 279 maxillary teeth, in 29 patients evaluated with Cone Beam Computed Tomography (CBCT) at T1 (before SARPE), T2 (after expansion) and T3 (after retention), was performed. The examined teeth were: canines, first and second premolars, first and second molars. in axial, coronal, and cross-sectional views. The evaluations involved viewing slices from mesial to distal of the buccal roots. Results: All statistical analyses were performed using SAS 9.3 and SUDAAN softwares. Alpha used in the study was 0.05. Alveolar defects increased statistically from T1 (69.0%) to T2 (96.5%) and T3 (100%). Dehiscences increased 195% (Relative Risk 2.95) at the end of expansion (T2). After retention (T3), individuals were on average 4.34 times more likely to develop dehiscences (334% increase). Fenestrations did not increase from T1 to T2 (p = 0.0162, 7.9%) and decreased from T2 to T3 (p = 0.0259, 4.3%). Presence of fenestrations at T1 was a significant predictor for the development of dehiscences in T2 and T3. Dehiscences increased significantly in all teeth, except second molars. Conclusion: The null hypothesis was rejected. After SARPE the number of dehiscences increased and fenestrations decreased. Previous alveolar defects were predictor for dehiscences after SARPE.

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Romano, Fábio, Cássio Edvard Sverzut, Alexandre Elias Trivellato, Maria Conceição Pereira Saraiva et Tung T. Nguyen. « Surgically assisted rapid palatal expansion (SARPE) : three-dimensional superimposition on cranial base ». Clinical Oral Investigations, 10 janvier 2022. http://dx.doi.org/10.1007/s00784-021-04355-z.

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Venkateshwaran, K., Sukhpal Kaur et Shaon. « Slow maxillary expansion ». International journal of health sciences, 31 décembre 2021, 303–14. http://dx.doi.org/10.53730/ijhs.v5ns2.5776.

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Constricted maxillary arch is one of the most common problems faced by an Orthodontist while treating young as well as adult patients. Maxillary expansion occupies a unique niche in dentofacial therapy and it has been a topic of debate since centuries. Slow maxillary expansion, rapid maxillary expansion and surgically assisted rapid palatal expansion (SARPE) are the commonly used methods for maxillary expansion. Slow maxillary expansion is a procedure to expand the maxillary arch in transverse dimension to correct the constricted maxillary arch with light forces. This review article provides detailed information about various slow maxillary expansion appliances with their implications in orthodontics.

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Johnson, Ellen Louise, et Gavin Power. « The ‘Powerbite’ and surgical rapid expansion ». Journal of Orthodontics, 4 décembre 2022, 146531252211385. http://dx.doi.org/10.1177/14653125221138585.

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Adults presenting with transverse maxillomandibular discrepancies in Class III skeletal patterns, asymmetries and anterior open bite can be challenging to treatment plan and manage. Therefore, they often necessitate a multidisciplinary approach, with surgical input from the oral and maxillofacial team. It can be difficult to assess how much the maxilla needs to be expanded after surgery in these patients, as the upper and lower teeth cannot be brought into occlusion. We aim to discuss the use of a device we have come to call the ‘Powerbite’, which is used intra-orally to assess the expansion of the maxilla after surgically assisted rapid palatal expansion (SARPE) and establish when expansion is sufficient to accommodate the mandibular arch. This device is not novel, last described in 1986 in the Journal of Orthodontics.

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Heldmaier, Wiebke, Daniel Lonic et Denys J. Loeffelbein. « Three-Dimensional Analyses of Postoperative Effects of Surgically Assisted Rapid Palatal Expansion (SARPE) on the Soft Tissue of the Midface Region and the Upper Airway Space Using Stereophotogrammetry and Cone Beam Computed Tomography (CBCT) ». American Surgeon, 9 janvier 2023, 000313482211483. http://dx.doi.org/10.1177/00031348221148349.

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Background Surgically assisted rapid palatal expansion (SARPE) is an established method to treat transverse maxillary hypoplasia in skeletally mature adult patients. SARPE affects the surrounding soft tissue. In addition, effects on the airway and breathing have been described. Aim of this study was to assess the effects of SARPE on the nasal soft tissue and the upper airway by means of three-dimensional stereophotogrammetry and cone beam computed tomography (CBCT). Methods This retrospective study used preoperative and postoperative cone beam computed tomography (CBCT) scans and three-dimensional stereophotogrammetry. Ten skeletally adult patients (4 male, 6 female; mean age 27.68 years) with transverse maxillary hypoplasia were included. Patients had undergone SARPE procedure, performed by the same surgical team using the same technique. Nasal soft tissue changes were analyzed, using three-dimensional stereophotogrammetry records taken preoperatively (t0) and at the postoperative checkup appointment (t1). The upper airway was assessed using CBCT scans for surgical planning (t0) and the first scan taken after SARPE (t1). Results In stereophotogrammetry, it was shown that only a few soft tissue nasal parameters increased significantly and SARPE leads to mainly clinically irrelevant changes in nasal soft tissue. In CBCT, only a significant increase in nasopharyngeal airway volume was found. Discussion Results were in alignment with literature. The effects of SARPE on the nasal soft tissue are mostly statistically insignificant and clinically irrelevant. Airway volume significantly increased in the nasopharyngeal area. Further research on SARPE effects should be conducted to reinforce SARPE as a treatment option for sleep apnea patients.

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Almaqrami, Bushra Sufyan, Peter Ngan, Maged Sultan Alhammadi, Majedh Abdo Ali Al-Somairi, Hui Xiong et H. Hong. « Three-dimensional craniofacial changes with maxillary expansion in young adult patients with different craniofacial morphology ». APOS Trends in Orthodontics, 21 février 2022, 1–15. http://dx.doi.org/10.25259/apos_177_2021.

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Objectives: Skeletally mature patients with transverse deficiency are best treated with surgically assisted rapid palatal expansion (RPE) procedure. Recent studies have shown that microimplant-assisted RPE (MARPE) appliances can be effective in achieving skeletal expansion in young adults. This retrospective study aimed to evaluate the skeletal and dental alveolar changes in response to treatment with MARPE appliances in three types of anteroposterior skeletal malocclusions using cone-beam computed tomography (CBCT) scans. Material and Methods: Seventy-eight subjects diagnosed with maxillary transverse deficiency and treated with the MARPE appliance (mean age of 22.9 ± 4.2 years) were divided into skeletal Class I, II, and III malocclusions with 26 subjects in each group. Pre- and post-treatment CBCT scans were used for superimposition to examine the skeletal and dentoalveolar changes following maxillary expansion treatment. Results: Significant lateral separation of the maxilla was found at the levels of the nasal floor, interzygomatic bones, and the inferior palatine margin of the alveolar process (P < 0.05) in the whole sample. Most of the sagittal and vertical variables change significantly in the whole sample and each studied group separately. Intergroup comparisons revealed no significant differences among the three skeletal classes except for the left frontozygomatic angle, left maxillary inclination angle, and torque in the first and second premolars. In Class III patients, the maxilla moved forward significantly in most of the cases (eight of 26 cases) (0.88°, P < 0.05) and the mandible moved downward and backward improving the anteroposterior skeletal relationship. Significant differences were also found in the vertical measurements (N-Me, MMP, and MP/SN, P < 0.05) in all three types of anteroposterior malocclusions. Conclusion: Maxillary expansion with the MARPE appliance in young adult patients induced different skeletal and dentoalveolar changes in the anteroposterior and vertical dimensions in each skeletal malocclusion with no significant difference among the three skeletal classes.

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