Mini-implant selection protocol applied to MARPE

Nojima, Lincoln Issamu; Nojima, Matilde da Cunha Gonçalves; Cunha, Amanda Carneiro da; Guss, Natan Oliveira; Sant’Anna, Eduardo Franzotti

doi:10.1590/2177-6709.23.5.093-101.sar

Cited by 30 publications

(23 citation statements)

References 24 publications

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“…However, thin palatine bone in the middle and rear parts also increased the risk of penetration of implant anchorage into nasal mucosa and could even penetrate the inferior turbinate (Fig.1 d), causing discomfort to patients, and even causing local infection and affecting the implant stability of screws. Therefore, the size of the MSE screw, especially the length of the rear two-implant screws, should be designed more accurately and individually according to the palatal bone shape and implant direction, and short implant anchorage should be considered for implantation when necessary [32]. Reference planes for measuring palatal bone thickness.…”

Section: Discussionmentioning

confidence: 99%

Palatal Bone Thickness of MSE Implantation area in Adult Patients with Skeletal Class Ⅲ Malocclusion: A Cone-beam Computed Tomographic Study

Chen¹,

Zhang²,

Li³

2021

Preprint

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Background: Analyze the palatal bone thickness of maxillary skeletal expander (MSE) implantation area in adult patients with skeletal class Ⅲ malocclusion based on Cone-beam computed tomography (CBCT) data, and to provide a reference for the implantation of the miniscrew.Methods: A total of 80 adult patients (40 M, 40 F) with an normal angle before treatment were divided into two groups; skeletal class Ⅲ malocclusion group and skeletal Ⅰ malocclusion group according to sagittal facial type, with 40 patients in each group, with a male to female ratio of 1: 1. CBCT scanner was used to obtain DICOM data from all patients.The palatal bone thickness was measured at 45 sites with MIMICS 21.0 and SPSS 22.0 was employed for statistical analysis. The bone thickness of different regions of the palate in the same group was analyzed by one-way analysis of variance (ANOVA) method; Fisher’s least significant difference (LSD)-t method was used for comparison in pairs, and an independent sample t-test was employed to test the difference of bone thickness in the same area between the two groups.Results: (1) There was no significant difference among the anterior, middle, and posterior regions of the midline area in patients with skeletal class Ⅲ malocclusion (P > 0.05). Palatal bone thickness decreased gradually from front to back in the middle and lateral areas in both groups (P < 0.001). (2) The bone thickness of the anterior, middle, and posterior regions of the two groups gradually decreased from the middle area to the parapalatine region. (3) The palatal bone were significant thinner in the area 9.0 mm before the transverse palatine suture in midline area, 9.0 mm before and after the transverse palatine suture in the middle area, and 9.0 mm after the transverse palatine suture in the lateral area.Conclusion: (1) The palatal bone of patients with class Ⅲ malocclusion was thinner in some areas, so the MSE implant anchorage position could be moved forward appropriately. (2) The thin palatal bone increased the risk of MSE anchorage screw penetrating nasal mucosa and even inferior turbinate. Patients should be given a more precise and personalized implantation scheme based on factors such as palatine bone thickness and palatal morphology.

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Section: Discussionmentioning

confidence: 99%

Palatal Bone Thickness of MSE Implantation area in Adult Patients with Skeletal Class Ⅲ Malocclusion: A Cone-beam Computed Tomographic Study

Chen¹,

Zhang²,

Li³

2021

Preprint

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“…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 [ 3 ]. By introducing the use of micro-screws at the level of the hard palate, an attempt was made to reduce the complications that appeared after traditional procedures of rapid maxillary expansion such as limited skeletal expansion, failure in expansion, pain, tissue swelling, buccal inclination of the supporting teeth, gingival retraction, bone resorption, and relapse [ 4 , 5 ] by shortening the duration of treatment, which is a goal in orthodontics [ 6 ]. The use of orthodontic micro-implants as auxiliary anchorage devices to optimize the application of mechanical forces to circum-maxillary sutures, makes it possible to avoid the otherwise indispensable osteotomies.…”

Section: Introductionmentioning

confidence: 99%

Observational Study Regarding Possible Side Effects of Miniscrew-Assisted Rapid Palatal Expander (MARPE) with or without the Use of Corticopuncture Therapy

Bud

Bică

Păcurar

et al. 2021

Biology

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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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“…A principal diferença é a incorporação de mini-implantes no palato, os quais garantem a expansão do osso basal subjacente, minimizando os efeitos dentoalveolares. O tratamento com esse disjuntor é eficaz e estável, porém requer conhecimento anatômico da região para um ideal planejamento e prognóstico (6,7).…”

Section: Introductionunclassified

Uso da expansão rápida palatal assistida por mini-implantes (MARPE) em tratamentos ortopédicos maxilares – revisão de literatura e relato de caso

Bacchi

Mueller

2020

JOI

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O objetivo desta revisão de literatura foi descrever as vantagens da disjunção maxilar, com a utilização do disjuntor de ancoragem esquelética MARPE (Mini-Implant Assisted Rapid Palatal Expander), e ilustrar a técnica por meio de um caso clínico. O procedimento consiste na instalação de mini-implantes em um disjuntor que fica em íntimo contato com o palato, tendo também ancoragem dentária. A disjunção com MARPE, apesar de não totalmente previsível, muitas vezes torna possível a disjunção da sutura palatina mediana após findado o período de crescimento, trazendo vantagens quando comparado à disjunção cirúrgica, como menor custo e morbidade. É apresentada no decorrer do trabalho uma disjunção com MARPE em uma paciente de trinta e seis anos de idade, sendo obtido resultado satisfatório. Mesmo em pacientes que ainda seria possível uma disjunção convencional, são observados resultados positivos com a utilização de MARPE, no que se refere a menores danos aos dentes e tecidos periodontais de suporte. Além disso, é notada estabilidade da disjunção, melhora no padrão respiratório e do sono dos pacientes tratados, sendo favorável principalmente para pacientes dolicofaciais e Padrão II, os quais teriam um agravamento no padrão vertical e no giro horário mandibular com a utilização de um disjuntor convencional.

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Mini-implant selection protocol applied to MARPE

Cited by 30 publications

References 24 publications

Palatal Bone Thickness of MSE Implantation area in Adult Patients with Skeletal Class Ⅲ Malocclusion: A Cone-beam Computed Tomographic Study

Palatal Bone Thickness of MSE Implantation area in Adult Patients with Skeletal Class Ⅲ Malocclusion: A Cone-beam Computed Tomographic Study

Observational Study Regarding Possible Side Effects of Miniscrew-Assisted Rapid Palatal Expander (MARPE) with or without the Use of Corticopuncture Therapy

Uso da expansão rápida palatal assistida por mini-implantes (MARPE) em tratamentos ortopédicos maxilares – revisão de literatura e relato de caso

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