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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. [ABSTRACT FROM AUTHOR]

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.

Maxillary deficiency is one of the common problems in orthodontic patients and is usually associated with bilateral or unilateral posterior crossbite, narrow nasal cavity, and crowding. Maxillary expansion is the best possible treatment to correct maxillary deficiency. The aim of the study was to quantitatively assess the different types of expansion devices used and also to study the association between the type of appliances used and age distribution. This was a retrospective cross sectional study conducted in the Department of Orthodontics, Saveetha Dental College, Chennai. Records of patients who underwent maxillary expansion over a period of 10 months from June 2019 to March 2020 were analysed and the type of appliance used for expansion was noted and grouped accordingly. Total of 13 records were selected based on the selection criteria. Percentage calculation for each type of appliance used was calculated using SPSS software version 20.0 for Windows. Quad helix was the most common appliance used with a percentage of about 30.77%. HYRAX was used for 23.06% of patients who required expansion. Removable appliances with Jack screw, Jockey archwire expansion, MARPE and SARPE were used for 15.38%, 15.38%, 7.69% and & 7.69% respectively. The appliances were selected based on the pre-treatment condition, age of the patient, risk benefit ratio and technical skills of the clinician. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the following null hypothesis: the skeletal and dentoalveolar expansion patterns in the coronal and axial planes are not different with two different types of microimplant-assisted rapid palatal expansion (MARPE) systems., Methods: Pretreatment (T0) and post-MARPE (T1) cone-beam computed tomography (CBCT) images of 32 patients (14 males and 18 females; mean age, 19.37) were analyzed. We compared two different MARPE systems. One MARPE system included the maxillary first premolars, maxillary first molars, and four microimplants as anchors (U46 type, n = 16), while the other included only the maxillary first molars and microimplants as anchors (U6 type, n = 16)., Results: In the molar region of the U6 and U46 groups, the transverse expansion at the midnasal, basal, alveolar, and dental levels was 2.64, 3.52, 4.46, and 6.32 mm and 2.17, 2.56, 2.73, and 5.71 mm, respectively. A significant difference was observed in the posterior alveolar-level expansion ( p = 0.036) and posterior basal-bone-level expansion ( p = 0.043) between the groups, with greater posterior skeletal and alveolar expansion in the U6 group., Conclusions: Compared with the U46 group, the U6 group showed greater posterior expansion at the alveolar and basal-bone levels, with an almost parallel split. Both groups showed a pyramidal expansion pattern in the coronal view.

The maxillary permanent canine acts as the corner stone of occlusion and plays a key role in smile design. Any morphological defect or eruption anomaly, affecting the maxillary permanent canine has a negative impact on the smile and facial esthetics of the person. The etiology of impacted maxillary permanent canine is multifactorial. Maxillary transverse discrepancies have been reported in 7 - 23% of the population. The objective of this study was to assess the association between maxillary transverse discrepancy and impacted permanent maxillary canines. The study was carried out at the Armed Forces Institute of Dentistry. After obtaining informed written consent from all patients, 60 casts of skeletal class I patients with complete permanent dentition except third molars were selected from the records of the Orthodontics department; 30 with impacted maxillary canines for the experimental group and 30 without any impacted teeth for the control group. The maxillary arch width was measured as the distance between the mesiopalatal cusp tips of the first permanent molars. The mandibular arch width was measured as the distance between the central fossae of the mandibular first permanent molars. The difference between the two measurements was calculated to determine maxillary transverse discrepancy. A positive ( r = 0.341) and highly significant (p < 0.01) association was observed between maxillary transverse discrepancy and impacted maxillary permanent canines. Early correction of maxillary transverse discrepancy may reduce the chances of maxillary permanent canine impaction. [ABSTRACT FROM AUTHOR]

Aim: The purpose of this study was to evaluate the effects of the rapid palatal expansion (RPE) on posture and gait analysis in subjects with maxillary transverse discrepancies., Material and Methods: Forty-one patients between 6 and 12 years were divided into 3 groups: 10 control subjects (Cs), 16 patients with unilateral posterior crossbite (CbMono), 15 patients with maxillary transverse discrepancy and no crossbite (Nocb). Every subject underwent gait analysis and posturographic examination in order to evaluate the presence of balance alterations before (T0) and after (T4) RPE application. The examinations were performed through a six-cameras stereophotogrammetric system (60-120Hz, BTS S.p.A.) synchronized with two force plates (FP4060, Bertec Corp.). Romberg test was performed on a force plate, and the statokinesiogram and joint kinematics were evaluated. One-way Anova was performed among the variables after evidence of normal distribution (Levene's test for equality of variances) and Kruskal-Wallis test (P<0.05), in order to compare the three groups of subjects. While paired t-test was performed, or Kruskal-Wallis test, instead when comparing pre- and post-RPE application within the same group of subjects (P<0.05). Tamane T2 or Bonferroni correction was applied where needed., Results: The posturographic analysis reveal significant differences across the 3 population: 95% power frequency in medio-lateral and antero-posterior direction in T0, median frequency in medio-lateral direction in T0, mean power frequency in medio-lateral direction in T0. Significant differences were also registered in the three-dimensional joints kinematics variables, mainly between Cs and Cbmono in T0 and T4 and between Cbmono and Nocb in T4., Conclusions: A detectable correlation between dental occlusion and body posture is shown in this study that confirms another benefit of the RPE. This was mainly revealed in the dynamic posture where modifications at the mandibular level affect the whole body., (Copyright © 2018. Published by Elsevier Masson SAS.)