Maxillary Expansion

Abstract

Maxillary transverse discrepancy usually requires expansion of the palate by a combination of orthopedic and orthodontic tooth movements. Three expansion treatment modalities are used today: rapid maxillary expansion, slow maxillary expansion and surgically assisted maxillary expansion.This article aims to review the maxillary expansion by all the three modalities and a brief on commonly used appliances.

Palatal Expansion and its Effects in Orthodontics

“…These modalities can be categorized by three primary types of expansion: rapid maxillary expansion, slow maxillary expansion, and surgically assisted maxillary expansion [5]. Furthermore, four types of expanders exist when categorized by activation protocol.…”

“…Indications for rapid palatal expansion include transverse discrepancies of greater than 4mm with dental compensation via buccally tipped maxillary molars, disruption of sutures to aid Class III correction, and moderate maxillary crowding. RPE is contraindicated when there is recession of the alveolar bone on maxillary molars or premolars, presence of anterior open bite, high mandibular plane angle, convex profile and doubtful patient compliance [5]. Furthermore, RPE is contraindicated in mature patients beyond the growth spurts, however many practitioners may still choose this treatment modality on older patients.…”

“…Clinically, patients are instructed to turn the expander once in the morning and once in the evening, or only once a day, commonly for a period of two to three weeks followed by a retention period of at least three months. This rapid rate of activation and relatively large force application is thought to maximize orthopedic skeletal expansion while minimizing dental movements [5]. RPEs can be designed as banded or bonded appliances, and can be tooth-borne, tissueborne, or tooth and tissue borne.…”

“…RPEs can be designed as banded or bonded appliances, and can be tooth-borne, tissueborne, or tooth and tissue borne. Some examples of rapid palatal expanders are the Hyrax expander, Issacson expander, and Haas expander [5].…”

Rapid Maxillary Expansion and Appliance

“…Wires are tagged and soldered onto the palatal aspect of the band. Those wires tags are inserted into a splitpalatal acrylic plate, incorporating a screw at its centre 5,8,9 .…”