Evaluation of factors related to the success of miniscrew-assisted rapid palatal expansion

Oliveira, Cibele Braga de; Ayub, Priscila Vaz; Angelieri, Fernanda; Murata, Wilson Humio; Suzuki, Selly Sayuri; Ravelli, Dirceu Barnabé; Santos-Pinto, Ary dos

doi:10.2319/051420-436.1

Cited by 32 publications

(28 citation statements)

References 14 publications

(22 reference statements)

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“…The success rate of non-surgical expansion in adults using MAPE with the FCPC protocol was almost 84.4%, and is similar to those obtained in the recent literature [ 10 , 21 – 23 ]. In contrast to the literature, the mean age of the patients in the present study was higher (29.1 years) than similar studies using MARPE for non-surgical expansion of mostly young adult patients (mean age from 17.1 to 23.3 years) [ 8 , 10 , 16 , 24 – 27 ] or include subjects younger than 18 years old [ 8 , 16 , 24 , 25 , 28 ].…”

Section: Discussionsupporting

confidence: 87%

Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

Winsauer¹,

Walter

Katsaros

et al. 2021

Head Face Med

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Introduction Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC). Methods This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others. Results Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects’ complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019). Conclusions 1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%. 2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed. 3. Complications were significantly associated with age. 4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients. Trial registration Consecutive cohort study, Review Board No. EK-2-2014/0016.

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Section: Discussionsupporting

confidence: 87%

Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

Winsauer¹,

Walter

Katsaros

et al. 2021

Head Face Med

View full text Add to dashboard Cite

show abstract

“…The success rate of non-surgical expansion in adults using MAPE with the FCPC protocol was almost 84.4%, and is similar to those obtained in the recent literature [9,[19][20][21]. In contrast to the literature, the mean age of the patients in the present study was higher (29.1 years) than similar studies using MARPE for non-surgical expansion of mostly young adult patients (mean age from 17.1 to 23.3 years) [7,9,15,[22][23][24][25] or include subjects younger than 18 years old [7,15,22,23,26].…”

Section: Discussionsupporting

confidence: 87%

“…This evidence suggests that non-surgical palatal expansion, assisted by miniscrews or implants, is achievable even for older patients. This can be explained by various predictors for midpalatal suture expansion, such as patient´s individual anatomy, midpalatal suture maturation stage or density ratio [27], design, stability and location of the expansion appliance used, and the activation protocol applied for the expansion process [7,19,21,25,28]. In order to evaluate the success of non-surgical expansion, some studies have stated that the ossi cation of the midpalatal suture of each individual should be assessed by CBCT prior to treatment [27,28].…”

Section: Discussionmentioning

confidence: 99%

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Success And Complication Rate of Miniscrew Assisted Non-Surgical Palatal Expansion In Adults - A Consecutive Study Using A Novel Force-Controlled Polycyclic Activation Protocol

Winsauer

Walter

Katsaros

et al. 2021

Preprint

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Introduction: Bone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC).Methods: This consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others.Results: Successful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects' complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019).Conclusions:1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%.2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed.3. Complications were significantly associated with age.4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients.Trial registration: consecutive cohort study, Review Board No. EK-2-2014/0016

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“…Alternative surgically assisted palatal expansion has been indicated in postpubertal and mature patients [5]. Recently, the combined use of bone-borne miniscrews connected to hyrax expanders has resulted in successful non-surgical orthopedic expansion in adults of various ages, including those in their 20 s and 30 s [6][7][8][9]. The rationale for the incorporation of miniscrews includes a possible increase in the success rate and/or safety during and after expansion to protect the buccal plate of the anchor teeth against the pressure from the hyrax expander [10].…”

Section: Introductionmentioning

confidence: 99%

The success and effectiveness of miniscrew-assisted rapid palatal expansion are age- and sex-dependent

et al. 2021

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Objectives This study aimed to assess the success rate and the amount of suture separation after the miniscrew-assisted rapid palatal expansion (MARPE) procedure in relation to the chronological age and sex of the patients. Materials and methods The periapical radiographs of 215 subjects (95 male; 120 female; range, 6–60 years) who had undergone MARPE treatment were retrospectively analyzed. The success of suture separation was determined and, in suture-separated subjects, the amount of suture separation was evaluated by suture separation ratio calculated from the periapical radiograph obtained after active expansion. Association tests were performed using linear-by-linear association, the Jonckheere-Terpstra test, Fisher’s exact test, and the Mann–Whitney U test, and linear regression models were also developed. Results The success rate of suture separation was 61.05% in male, 94.17% in female, and 79.53% in both sexes. There was a statistically significant association between older age and suture nonseparation in male (p < 0.001), but not in female (p = 0.221). In suture-separated subjects, there was a statistically significant trend toward a low amount of suture separation with older age subgroups in both sexes (p < 0.001); however, there was no statistically significant difference in the amount of suture separation between male and female in all age subgroups. Conclusions Older patients treated with MARPE, particularly in male, may have a reduced likelihood of both success in suture separation and sufficient basal bone expansion. Clinical relevance This study demonstrates that clinicians should consider that the success rate of MARPE and the amount of suture separation may depend on chronological age and sex.

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Evaluation of factors related to the success of miniscrew-assisted rapid palatal expansion

Cited by 32 publications

References 14 publications

Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

Success And Complication Rate of Miniscrew Assisted Non-Surgical Palatal Expansion In Adults - A Consecutive Study Using A Novel Force-Controlled Polycyclic Activation Protocol

The success and effectiveness of miniscrew-assisted rapid palatal expansion are age- and sex-dependent

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