Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient

Abstract

Introduction: Etiology of dental crowding may be related to arch constriction in diverse dimensions, and an appropriate manipulation of arch perimeter by intervening in basal bone discrepancies cases, may be a key for crowding relief, especially when incisors movement is limited due to underlying pathology, periodontal issues or restrictions related to soft tissue profile. Objectives: This case report illustrates a 24-year old woman, with maxillary transverse deficiency, upper and lower arches crowding, Class II, division 1, subdivision right relationship, previous upper incisors traumatic episode and straight profile. A non-surgical and non-extraction treatment approach was feasible due to the miniscrew-assisted rapid palatal expansion technique (MARPE). Methods: The MARPE appliance consisted of a conventional Hyrax expander supported by four orthodontic miniscrews. A slow expansion protocol was adopted, with an overall of 40 days of activation and a 3-month retention period. Intrusive traction miniscrew-anchored mechanics were used for correcting the Class II subdivision relationship, managing lower arch perimeter and midline deviation before including the upper central incisors. Results: Post-treatment records show an intermolar width increase of 5 mm, bilateral Class I molar and canine relationships, upper and lower crowding resolution, coincident dental midlines and proper intercuspation. Conclusions: The MARPE is an effective treatment approach for managing arch-perimeter deficiencies related to maxillary transverse discrepancies in adult patients.

Quantitative evaluation of midpalatal suture opening and its relation with zygomaticomaxillary suture status in patients aged 7–25 years using cone beam computed tomography images: In an Iranian population

“…[ 18 19 ] Miniscrew-assisted rapid palatal expansion (MARPE) as a nonsurgical technique could be considered an alternative method to correct transverse discrepancy and expand maxilla to increase upper arch length for crowding correction. [ 20 21 ] Thus, the results of this study confirmed that the evaluation of MPS based on CBCT finding is helpful to choose the best treatment planning.…”

Transverse maxillary deficiency: treatment alternatives in face of early skeletal maturation

“…18,19 MARPE is a less invasive option than SARME, has a skeletal effect, fewer dentoalveolar effects, no surgical risks and reasonably stable results, in addition to being more affordable financially. 20,21 Thus, the objective of this study was to analyze and discuss different treatment approaches for the correction of maxillary deficiencies in patients with advanced skeletal maturation, and describe the treatment of a female patient (14 years and 4 months old) presenting Class II skeletal malocclusion, transverse maxillary hypoplasia and unilateral functional unilateral posterior crossbite -this case was submitted to the Brazilian Board of Orthodontics (BBO).…”

“…The activation protocol recommended for MARPE is ¼ of a turn every day, 4 so that the tissues adapt to the forces applied and patient discomfort is minimized, considering the increase in the rigidity of the midpalatal suture with age. 21…”

Uso da expansão rápida palatal assistida por mini-implantes (MARPE) em tratamentos ortopédicos maxilares – revisão de literatura e relato de caso

“…Cantarella et al (19) avaliaram quinze pacientes, com idade média de 17,2 anos, após o uso de um expansor esquelético. Observou-se uma abertura da sutura palatina mediana de 4,8mm e 4,3mm na espinha nasal anterior e espinha nasal posterior, respectivamente.…”