Maxillary Expansion in Skeletally Mature Patients with TADs

Moon, Won

doi:10.1002/9781119513636.ch24

Cited by 4 publications

(6 citation statements)

References 13 publications

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“…The overall displacement color map indicated that the location of the miniscrews most likely contributed to the suture separation, in addition to the different degrees of ossification the midpalatal suture encountered along its entire length. 17 According to previous studies, 6,12,23 center of resistance and center of rotation of the zygomaticomaxillary complex are present during palatal expansion. The unavoidable V pattern of maxillary halves displacement in frontal view was consistent with previous FEA studies.…”

Section: Discussionmentioning

confidence: 96%

“…13 Adult patient skeletal expansion has been demonstrated to be successful when using bone-borne palatal expanders with a variety of appliance designs. 7,8,23 According to available scientific studies, 3,6,10 palatal slope bone-borne expanders had superior advantages over other types of B-RPE because of their versatility in allowing the positioning of anchor screws in a variety of positions, ease of fabrication and adjustment, and less stress accumulation at the area around anchored miniscrews compared to other designs. Expanders can be employed for the purpose of retention once the expansion process has been completed and simply offer direct or indirect absolute anchorage.…”

Section: Discussionmentioning

confidence: 99%

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Analysis of Stress Distribution and Displacement Based on the Miniscrew Positions of the Palatal Slope Bone-borne Expander: A Finite Element Study

Leeisaramas,

Chantarapanich,

Inglam

et al. 2024

Eur J Dent

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Objectives This study aimed to investigate the stress distribution pattern of the palatal slope bone-borne expander on the maxillary area according to a different anteroposterior position of anchored miniscrews using finite element analysis. Materials and Methods Nasomaxillary stereolithography files with three different anteroposterior anchored miniscrew positions of the palatal slope bone-borne expander were determined as model A, B, and C. Each model consists of four supported miniscrews. Model A: two anterior miniscrews were located between the maxillary canine and the first premolar, and two posteriors between the second premolar and the first molar. Model B: two anteriors were between the lateral incisor and the canine, and two posteriors were the same as in model A. Model C: two anteriors were the same as in model A, and two posteriors were distal to the first molar. One turn of expander screws was applied. Maximum principal stress, equivalent elastic strain, equivalent von Mises stress, and transverse displacement were evaluated. Results The maximum principal stress was mostly found at the bone-miniscrew interface. Model A exhibited an intersecting area of stress between the supported miniscrews. The highest value of principal stress was in model B, while model C showed a uniform distribution pattern. The elastic strain pattern was similar to the principal stress in all models. The highest value of equivalent von Mises stress was located on the expander screw. The largest amount of transverse displacement of teeth was in model A, while model C exhibited a more consistent transverse displacement than other models. Vertical displacement of posterior teeth was also noticed. Conclusion Based on the result, it revealed that the various anteroposterior miniscrew placements of the palatal slope bone-borne expander had various patterns of stress distribution and resulted in various outcomes. It may be inferred that model A's miniscrew location was advantageous for obtaining expansion quantities, but model C's miniscrew position was advantageous for maintaining consistent biomechanics.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Analysis of Stress Distribution and Displacement Based on the Miniscrew Positions of the Palatal Slope Bone-borne Expander: A Finite Element Study

Leeisaramas,

Chantarapanich,

Inglam

et al. 2024

Eur J Dent

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“…Through the use of four bicortical placed mini‐implants (both palatal and nasal) situated proximate to the midpalatal suture, the potential for direct force application onto this structure, the pterygopalatine suture, and the zygomatic buttress is considerable. This interaction could contribute to a more uniformly distributed force application 2,19,20 …”

Section: Discussionmentioning

confidence: 99%

“…This interaction could contribute to a more uniformly distributed force application. 2,19,20 A significant difference in mean age was observed between the two groups, with patients in the MISMARPE group being older (37.7 ± 10.8 years) than those in the SARPE. The MISMARPE technique thus appears to be a good alternative for skeletally mature patients, with successful outcomes in treating maxillary atresia even past the fifth decade of life.…”

Section: F I G U R E 1 Surgical Access and Device Used For Mismarpe (...mentioning

confidence: 93%

Effects of SARPE and MISMARPE on correction of transverse maxillary deficiency: A preliminary comparative evaluation

da Silva,

da Rosa,

Matje

et al. 2023

Orthod Craniofacial Res

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AimThe present study was designed to compare, on cone‐beam computed tomography imaging, the skeletal and dental effects of the SARPE (Surgically assisted rapid palatal expansion) and MISMARPE (Minimally Invasive Surgical and Miniscrew‐Assisted Rapid Palatal Expansion) techniques.Materials and methodsThe sample of adult patients with transverse maxillary deficiency (TMD) was divided into two groups, and scans were obtained preoperatively (T0) and immediately after completion of expansion (T1). The posterior and anterior linear transverse distances of the maxilla and the angulation of the maxillary first molars were evaluated. The data were entered into a generalized estimating equations model to verify the postoperative effects of the different techniques.ResultsNone of the techniques caused any appreciable change in the angulation of the molars. The skeletal changes were similar, with significantly greater gains in the nasal fossa and intermaxillary distance when using the MISMARPE.ConclusionThe technique can be an effective and lower morbidity alternative to SARPE.

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“…The present case describes, to the best of our knowledge, nonsurgical palatal expansion in the oldest patient reported in the literature. 24 The general consensus has been that orthopedic palatal expansion by nonsurgical means is feasible only until adolescence. 10 , 25 The mechanical resistance resulting from increasing interdigitation of the facial sutures is commonly believed to limit orthopedic expansion in mature patients.…”

Section: Discussionmentioning

confidence: 99%

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding

Kim

Park

et al. 2021

Korean J Orthod

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Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

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Maxillary Expansion in Skeletally Mature Patients with TADs

Cited by 4 publications

References 13 publications

Analysis of Stress Distribution and Displacement Based on the Miniscrew Positions of the Palatal Slope Bone-borne Expander: A Finite Element Study

Analysis of Stress Distribution and Displacement Based on the Miniscrew Positions of the Palatal Slope Bone-borne Expander: A Finite Element Study

Effects of SARPE and MISMARPE on correction of transverse maxillary deficiency: A preliminary comparative evaluation

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding

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