Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances

Zong, Chen; Tang, Bojun; Hua, Fang; He, Hong; Ngan, Peter

doi:10.1053/j.sodo.2019.02.006

Cited by 33 publications

(29 citation statements)

References 35 publications

(34 reference statements)

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“…33 Separation of the midpalatal suture in a parallel fashion enables sufficient separation of the posterior portion of the maxilla. 34 Consequently, the circumaxillary suture, which is close to the posterior portion of the maxilla, would be more directly affected, and this leads to a further increase in downward and forward movement of the maxilla. However, the soft tissue displacement tendency observed in the present study requires long-term follow-up evaluations for determining whether the change is merely temporary stretching of the soft tissue or an actual significant and permanent soft tissue displacement.…”

Section: Discussionmentioning

confidence: 99%

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study

et al. 2020

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The aim of this study was to evaluate changes in the nasal soft tissues, including movements of landmarks, changes in linear distances, and volumetric changes, using three-dimensional (3D) stereophotogrammetry after microimplant-assisted rapid palatal expansion (MARPE) in adult patients. Methods: Facial data were scanned using a white light scanner before and after MARPE in 30 patients. In total, 7 mm of expansion was achieved over a 4-week expansion period. We determined 10 soft tissue landmarks using reverse engineering software and measured 3D vector changes at those points. In addition, we calculated the distances between points to determine changes in the width of the nasal soft tissues. The volumetric change in the nose was also measured. Results: All landmarks except pronasale and subnasale showed statistically significant movement on the x-axis. Pronasale, subnasale, alar right, and alar left showed significant movement on the y-axis, while all landmarks except subnasale showed significant movement on the z-axis. The alar base width, alar width, and alar curvature width increased by 1.214, 0.932, and 0.987 mm, respectively. The average volumetric change was 993.33 mm 3 , and the amount of increase relative to the average initial volume was 2.96%. Conclusions: The majority of soft tissue landmarks around the nasal region show significant positional changes after MARPE in adults. The nose tends to widen and move forward and downward. The post-treatment nasal volume may also exhibit a significant increase relative to the initial volume. Clinicians should thoroughly explain the anticipated changes to patients before MARPE initiation.

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Section: Discussionmentioning

confidence: 99%

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study

et al. 2020

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“…A four-point microimplant-assisted rapid palatal expansion appliance (MARPE) has been used to treat skeletal maxillary transverse deficiency. 10,[15][16][17][18][19] Two retrospective studies 12,16 and one prospective study 14 revealed that a 4-point bone-borne expander produced greater skeletal expansion than a toothborne expander in adolescents. In the study of Lin et al in late adolescence, the older mean age (18.1 years) indicated that most patients had completed their growth.…”

Section: Introductionmentioning

confidence: 99%

Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:

Jia¹,

Li²,

Zhang³

et al. 2020

The Angle Orthodontist

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Objective To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. Materials and Methods Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. Results The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01). Conclusions MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.

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“…Model A was designed to perform RME in cases of severe atresia [ 11 ]. Model B was chosen because it has already shown satisfactory results in clinical studies [ 19 , 20 , 21 ]. Model C was chosen because it has open rings for insertion of mini-implants, which is advantageous in situations of mini-implant loss (it is possible to reposition another mini-implant with a different angulation from the original installation) [ 10 , 22 ].…”

Section: Discussionmentioning

confidence: 99%

Stress distribution and displacement of three different types of micro-implant assisted rapid maxillary expansion (MARME): a three-dimensional finite element study

André

Rino-Neto

Iared³

et al. 2021

Prog Orthod.

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Background/objective Until 2010, adults underwent surgical treatment for maxillary expansion; however, with the advent of micro-implant-assisted rapid maxillary expansion (MARME), the availability of less invasive treatment options has increased. Nevertheless, individuals with severe transverse maxillary deficiency do not benefit from this therapy. This has aroused interest in creating a new device that allows the benefit of maxillary expansion for these individuals. The aim of this study was to evaluate the efficacy of three MARME models according to tension points, force distribution, and areas of concentration in the craniofacial complex when transverse forces are applied using finite element analysis. Materials and methods Digital modeling of the three MARME models was performed. Model A comprised five components: one body screw expander and four adjustable arms with rings for mini-implant insertion. These arms have an individualized height adjustment that allows MARME positioning according to the patient’s palatal anatomy, thereby preventing body screw expander collision with the lateral mucosa in severe cases of maxillary deficiency. Model B was a maxillary expander with screw rings joined to the body, and model C was similar to model B, except that model C had open rings for the insertion of the mini-implants. Through the MEF (Ansys software), the stresses, distribution, and area of concentration of the stresses were evaluated when transverse forces of 7.85 N were applied. Results The three models maintained the following pattern: model C presented weak stress peaks with limited distribution and lower concentration area, model B obtained median stress peaks with better distribution when compared to that of model C, and model A showed better stress distribution and larger concentration area. In model A, tensions were located in the lateral lamina of the pterygoid process, which is an important site for maxillary expansion. The limitation of the present study was that it did not include the periodontal tissues and muscles in the finite element method evaluation. Conclusions Model A showed the best stress distribution conditions. In cases of severe atresia, model A seems to be an excellent option.

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Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances

Cited by 33 publications

References 35 publications

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study

Short-term impact of microimplant-assisted rapid palatal expansion on the nasal soft tissues in adults: A three-dimensional stereophotogrammetry study

Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage:

Stress distribution and displacement of three different types of micro-implant assisted rapid maxillary expansion (MARME): a three-dimensional finite element study

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