Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults

Abstract

Objective: To evaluate the stability of nonsurgical miniscrew-assisted rapid maxillary expansion (MARME) in young adults with a transverse maxillary deficiency. Materials and Methods: From a total of 69 adult patients who underwent MARME followed by orthodontic treatment with a straight-wire appliance, 20 patients (mean age, 20.9 6 2.9 years) with follow-up records (mean, 30.2 6 13.2 months) after debonding were selected. Posteroanterior cephalometric records and dental casts were obtained at the initial examination (T0), immediately after MARME removal (T1), immediately after debonding (T2), and at posttreatment follow-up (T3). Results: Suture separation was observed in 86.96% of subjects (60/69). An increase in the maxillary width (J-J; 1.92 mm) accounted for 43.34% of the total expansion with regard to the intermolar width (IMW) increase (4.43 mm; P , .001) at T2. The amounts of J-J and IMW posttreatment changes were 20.07 mm (P . .05) and 20.42 mm (P 5 .01), respectively, during retention. The postexpansion change in middle alveolus width increased with age (P , .05). The postexpansion change of interpremolar width (IPMW) was positively correlated with the amount of IPMW expansion (P , .05) but not with IMW. The changes of the clinical crown heights in the maxillary canines, first premolars, and first molars were not significant at each time point. Conclusions: Nonsurgical MARME can be a clinically acceptable and stable treatment modality for young adults with a transverse maxillary deficiency. (Angle Orthod. 2016;86:713-720.)

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

“…, 27 , 30 A clinical study that followed up 69 young adults that underwent MARPE did not find any clinically significant side effects 25 . Other studies of conventional palatal expansion in young adults without MI have warned about the risk of side effects 23 …”

Bilateral or Unilateral Cross-Bite Treatment with Nickel Titanium Palatal Expander (NPE-2) in Young Adults

“…The treatment options of the posterior cross bite in young adults are: rapid maxillary expansion [26,27], rapid maxillary expansion with miniscrew [15] and Surgical Assisted Rapid Maxillary Expansion (SARME) [28].…”

“…In the last years the SARME method has been frequenly used to overcome the mentioned limitation of RME. Another treatment option was to use in association with the RME appliance mini screws in palatal bone (MARME: miniscrew assisted RME) [15]. This type of treatment had greater orthopedic effects in adolescents than young adults where the midpalatale suture is closed [32,33].…”

“…This type of treatment had greater orthopedic effects in adolescents than young adults where the midpalatale suture is closed [32,33]. The above mentioned technique (SARME and MARME) require a surgical procedures and sometimes patients refuse this type of approach [15]. Other type of fixed oral appliance used in adults treatment are the quad helix [29].…”

“…Many studies evaluate the possible effect of RME on adults [14]. The treatment protocol, on young adults, provide the use of miniscrew in palatal side [15] or a Surgical Assisted Rapid Maxillary Expansion (SARME) [16].…”