MARPE Guide: A Case Report

Abstract

Aim: This paper presents a prototyped surgical guide for placement of MARPE-mini-implant-assisted rapid palatal expander. Background: Investigations conducted in the last decades have increased the technological resources used in orthodontics. This scientific advance applies to several clinical procedures, including the planning of devices used in guided surgeries, using computed tomography images and intraoral scanning. Case description: This case report presents maxillary expansion in an adult patient (18 years and 5 months), using the MARPE technique, by virtual planning and fabrication of a surgical guide (laser-printed on a 3D printer MoonRay D225-SprintRay, 2014), after merging of 3 files: digital file of the expander (.stl), computed tomography of the suture, and intraoral scanning of the patient, using the planning software NemoStudio (version 20122, 16.50.0.56). Conclusion: Fabrication of a surgical guide for the MARPE technique provides an accurate transfer of the virtual planning to the surgical procedure. It allows three-dimensional orientation of the expander position and perforations of mini-implants, which are necessary to establish anchorage in areas with sufficient bone, assuring the system stability and a successful procedure. Clinical significance: The mini-implant assisted rapid palatal expansion (MARPE) has been investigated as a promising option for correction of malocclusion related with maxillary atresia in adult patients and is an option to orthognathic surgery. Digital treatment planning is fundamental to establish individual, reproducible, and accurate parameters, as in the present case, which evidenced significant benefits in both occlusal and respiratory aspects.

Digital workflow for mini-implant–assisted rapid palatal expander fabrication–a case report

“…The expander provides the line of force action, while the surgical stent aids in inserting the mini-implants in the desired location. To identify the best position for both parts, several digital workflows have been proposed by previous researchers using various expander designs [28][29][30]41]. Often these systems require a two-step process: mini-implant insertion by a digitally produced stent and retrofitting of MARPE onto the mini-implants by digital processing.…”

Die digital geplante Hybrid-GNE-Apparatur

“…Bei erwachsenen Patienten, bei denen der Knochen schon voll ständig entwickelt ist, kann eine rein dental getragene Oberkiefer dehnung zu einer Kippung der seitlichen Oberkieferzähne, bukka len Wurzelresorptionen, Fenestrationen, keiner Öffnung der Sutu ra palatina mediana und Instabilität der Expansion führen [3].Es wird untersucht, ob die MARPE eine vielversprechende Alternativ option gegenüber den chirurgischen Maßnahmen bei erwachse nen Patienten mit transversale Oberkieferenge darstellt. Eine digi tale Planung ist dabei essentiell [6].…”

Mechanical Properties, Fractal Dimension, and Texture Analysis of Selected 3D-Printed Resins Used in Dentistry That Underwent the Compression Test

“…The development of different types of resins led to the introduction of the stereolithography technique, which is based on the ultraviolet light photocuring of materials [ 10 ]. Therefore, this method can be applied to other branches of dentistry as well, such as surgery and orthodontics [ 11 , 12 , 13 ].…”