During maxillary expansion, the main resistance forces occur at the zygomatico-maxillary sutures, and not in the median palatal suture, which is the basic principle on which this method is based. The use of maxillary expanders has the effect of distancing the maxillary bones at the level of the median palatal suture. The miniscrew-assisted rapid palatal expansion (MARPE) was first introduced in clinical practice in 2010. Although occlusal modifications occur after palatal split, especially in unilateral cross-bite cases, these changes can be treated with the help of fixed orthodontic appliances. No cases of necrosis of the palatal mucosa were observed. Swelling at the mid-palatal suture after split was observed in all cases and was caused by the resultant force. Six patients 22.22% showed hypertrophy/hyperplasia of the palatal mucosa associated with ulcerations, erythema, itching, and discomfort in the area. Maxillary canines tended to show symmetric buccal inclinations relative to the maxillary basal bone. Changes of the occlusal planes were observed in 10 cases (37%). The mid-palatal suture was separated in 88.88% of cases, buccal bone height of the alveolar crest had decreased at first molar both at oral and palatal level by approximately 2.07 mm in 40.7% of cases whilst the remaining 59.3% showed insignificant bone loss, with canines exhibiting buccal tipping of 4.10° in 62.5% of cases. Skeletal and dentoalveolar changes were evaluated using cone beam computed tomography (CBCT) images acquired before and after expansion. The study included 27 patients with maxillary transverse deficiency and unilateral or bilateral cross-bite. In this observational study, we evaluated possible complications at the skeletal and dentoalveolar level after palatal split using miniscrew-assisted rapid palatal expansion (MARPE) associated or not with corticopuncture (CP) therapy.
0 Comments
Leave a Reply. |