What are the limits of microimplant-assisted palatal expanders?

Winsauer, Heinz; Walter, A.; Scherfler, Maria; Ploder, Oliver

doi:10.1016/j.ajodo.2016.09.011

Cited by 12 publications

(10 citation statements)

References 3 publications

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“…The gap between the screw (1.5 mm in diameter) and holes (2.0 mm in diameter) allows the initial activation of the expander to loading of the anchor teeth primarily, although the suture is not open. 15,23,24 This could be a reason for the tipping of anchorage teeth that was observed. However, some patients in the MSE group skipped 1 day of activation when the stress was too excessive (there was a risk that the turning instrument would break).…”

Section: Discussionmentioning

confidence: 95%

Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study

Moon¹,

Kim²,

Ahn³

et al. 2019

The Angle Orthodontist

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Objective: To evaluate the molar inclination and skeletal and alveolar bone changes when comparing tooth bone-borne (MSE) and tissue bone-borne type maxillary expanders (C-expander) using cone-beam computed tomography (CBCT) in late adolescence. Materials and Methods: A sample of 48 late-adolescent patients were divided into two groups according to the type of expander: MSE group (n = 24, age = 19.2 ± 5.9 years) and C-expander group (n = 24, age = 18.1 ± 4.5 years). CBCT scans were taken before treatment and 3 months after expansion. Transverse skeletal and dental expansion, alveolar inclination, tooth axis, buccal alveolar bone height, thickness, dehiscence, and fenestration were evaluated on the maxillary first molar. Paired t-test, independent t-test, Pearson's chi-square test, and Spearman correlation analysis were performed. Results: The MSE group produced greater dental expansion (P < .05), whereas skeletal expansion was similar in both groups (P = .859). The C expander group had more alveolar bone inclination change (P < .01), and the MSE group had more buccal tipping of the anchorage teeth (P < .01 or .001). Buccal alveolar bone height loss and thickness changes were greater in the MSE group (P < .01 or <.001). Formation of dehiscences was more frequent in the MSE group (P < .001), whereas for fenestrations, there were no significant differences between the two groups. Buccal bone height loss in the MSE group had a negative correlation with initial buccal bone thickness. Conclusions: The incorporation of teeth into bone-borne expanders resulted in an increase in the severity of side effects. For patients in late adolescence, tissue bone-borne expanders offer comparable skeletal effects to tooth bone-borne expanders, with fewer dentoalveolar side effects.

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Section: Discussionmentioning

confidence: 95%

Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study

Moon¹,

Kim²,

Ahn³

et al. 2019

The Angle Orthodontist

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show abstract

“… 21 MARPE has the advantage of minimizing these side effects, although the procedure has been questioned in terms of real preservation of the side effects in the molars. 22 ,22 In a clinical study with anchorage of only two mini-implants, a reduction in the buccal cortical surface was observed. 23 It is possible that the design of the appliance, the quality of the steel and welding, the dimensions of the mini-implants involved, the mono- or bicortical anchorage, the quantity of expansion activations, the age of the patient and the degree of maturation of the midpalatal suture influence reduction of the buccal cortical surface and undesirable vestibular inclination of the molars.…”

Section: Discussionmentioning

confidence: 99%

Stress and displacement of mini-implants and appliance in Mini-implant Assisted Rapid Palatal Expansion: analysis by finite element method

Oliveira

Soares

Andrade

et al. 2021

Dental Press J. Orthod.

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Objective: In this study, simulations were performed by the finite element method (FEM) to determine the tension and displacement in mini-implants and in expander appliance during rapid maxillary expansion, by varying the number and location of the mini-implants. Methods: For the computational simulation, a three-dimensional mesh was used for the maxilla, mini-implants and expander appliance. Comparisons were made on six different Mini-implant Assisted Rapid Palatal Expander (MARPE) configurations, by varying the amount and location of mini-implants. A closed suture was design and received two activations of 0.25 mm, and an open suture had a 0.5-mm aperture that received 20 activations, also of 0.25 mm. Results: For the closed suture, the maximum displacement values in the mini-implants were between 0.253 and 0.280 mm, and stress was between 1,348.9 and 2,948.2 MPa; in the expander appliance, the displacement values were between 0.256 and 0.281 mm, and stress was between 738.52 and 1,207.6 MPa. For the open suture, the maximum displacement values in the mini-implants were between 2.57 and 2.79 mm, and stress was between 5,765.3 and 10,366 MPa; in the appliance, the maximum displacements was between 2.53 and 2.89 mm, and stress was between 4,859.7 and 9,157.4 MPa. Conclusions: There were higher stress concentrations in the mini-implant than in the expander arm. In the simulations with a configuration of three mini-implants, stress overload was observed in the isolated mini-implant. Displacements of the mini-implants and arms of the appliance were similar in all simulations.

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“…Screening resulted in exclusion of 504 records, and full texts of the remaining 10 articles were retrieved and analyzed according to the eligibility criteria. Nine articles were excluded for the following reasons: One study was a letter to the editor (27), two studies were retrospective (28,29), three studies were reviews (30)(31)(32), and three studies examined only one type of miniscrew-supported palatal expander (33)(34)(35).…”

Section: Study Selectionmentioning

confidence: 99%

Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review

et al. 2021

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The aim of this review was to evaluate the current evidence regarding post-treatment effects of tooth-bone-borne vs. bone-borne expanders. A search was conducted in MEDLINE via PubMed, Web of Science, Scopus, Cochrane Library, Google Scholar, and Open Gray; in addition to a hand search in reference lists of selected articles and creating a search alert in electronic databases. Selection criteria included randomized and prospective clinical trials comparing post-expansion skeletal and/or dento-alveolar effects of tooth-bone-borne expanders to those of bone-borne expanders. Following study retrieval and selection, relevant data was extracted, and risk of bias was assessed using the revised RoB 2 tool for randomized clinical trials. After examining 10 full text articles, one randomized clinical trial was finally included. The study compared the dento-alveolar effects of tooth-bone-borne and bone-borne expanders, following expansion and after 6 months, using digital dental casts. Using the RoB 2 tool, the study was judged overall to show some concerns. A definitive conclusion could not be drawn from this systematic review due to the scarcity of clinical trials tackling the research question. A need for future well-conducted research was highlighted in this review.

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What are the limits of microimplant-assisted palatal expanders?

Cited by 12 publications

References 3 publications

Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study

Molar Inclination and Surrounding Alveolar Bone Change Relative To the Design of Bone-borne Maxillary Expanders: A Cbct study

Stress and displacement of mini-implants and appliance in Mini-implant Assisted Rapid Palatal Expansion: analysis by finite element method

Tooth-Bone-Borne Vs. Bone-Borne Palatal Expanders: A Systematic Review

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