In the presence of a continuous cleft in the jaw and palate area, orthodontic forces (quadhelix) are apparently already sufficient to allow a skeletal expansion of the maxilla. Maxillary expansion using the quadhelix appliance represents a reasonable alternative to using conventional rapid maxillary expansion appliances among cleft patients.

For patients with prior periodontal disease or loosened teeth, a debonding procedure by compression of the bracket wings is recommended, since here the load for the periodontal structures of the tooth is lowest.

In clinical situations requiring major orthodontic forces, it is better to choose an indirect anchorage in order to minimize the risk of losing the miniscrew.

Our FEM results reveal relatively high loads on the dental anchorage when using indirect miniscrew anchorage. This may carry an increased risk of anchorage loss during mandibular molar protraction; however, further studies are necessary to confirm this.

No abstract