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      Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults with the Dutch Maxillary Expansion Device: a prospective clinical cohort study

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          Abstract

          Objectives

          To provide a higher degree of evidence on the efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults, thereby applying the Dutch Maxillary Expansion Device (D-MED).

          Materials and methods

          D-MED was developed as an individualized, 3D-designed, and fabricated MARPE appliance supported by 4 palatal miniscrews. Patients from the age of 16 onwards with transverse maxillary deficiency were enrolled consecutively. Pre-expansion and immediate post-expansion CBCTs and intra-oral scans were acquired and measurements of skeletal, alveolar, and dental expansion as well as dental and periodontal side-effects were performed.

          Results

          Thirty-four patients were enrolled (8 men, 26 women) with mean age 27.0 ± 9.4 years. A success rate of 94.1% was achieved (32/34 patients). The mean expansion duration, or mean observation time, was 31.7 ± 8.0 days. The mean expansion at the maxillary first molars (M1) and first premolars (P1) was 6.56 ± 1.70 mm and 4.19 ± 1.29 mm, respectively. The expansion was 60.4 ± 20.1% skeletal, 8.1 ± 27.6% alveolar, and 31.6 ± 20.1% dental at M1 and 92.2 ± 14.5% skeletal, 0.0 ± 18.6% alveolar, and 7.8 ± 17.7% dental at P1, which was both statistically ( p < 0.001) and clinically significant. Buccal dental tipping (3.88 ± 3.92° M1; 2.29 ± 3.89° P1), clinical crown height increase (0.12 ± 0.31 mm M1; 0.04 ± 0.22 mm P1), and buccal bone thinning (− 0.31 ± 0.49 mm M1; − 0.01 ± 0.45 mm P1) were observed, while root resorption could not be evaluated.

          Conclusions

          MARPE by application of D-MED manifested its efficacy in a prospective clinical setting, delivering a high amount of skeletal expansion with limited side-effects in late adolescents and adults.

          Clinical relevance

          Higher quality evidence is supportive of MARPE as a safe and successful non-surgical treatment option for transverse maxillary deficiency.

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          The Cervical Vertebral Maturation (CVM) Method for the Assessment of Optimal Treatment Timing in Dentofacial Orthopedics

          Tiziano Baccetti, Lorenzo Franchi, James McNamara Jr. (2005)
          Article 0 comments Cited 161 times – based on 0 reviews     Review now
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            Treatment timing for rapid maxillary expansion.

            Rosannah C Cameron, T Baccetti, Lorenzo Franchi … (2001)
            The aim of this study was to evaluate the short-term and long-term treatment effects of rapid maxillary expansion in 2 groups of subjects treated with the Haas appliance. Treatment outcomes were evaluated before and after the peak in skeletal maturation, as assessed by the cervical vertebral maturation (CVM) method, in a sample of 42 patients compared to a control sample of 20 subjects. Posteroanterior cephalograms were analyzed for the treated subjects at T1 (pretreatment), T2 (immediate post-expansion) and T3 (long-term observation), and were available at T1 and at T3 for the controls. The mean age (years: months) at T1 was 11:10 for both the treated and the control groups. The mean ages at T3 also were comparable (20:6 for the treated group and 17:8 for the controls). Following expansion and retention (2 months on average), fixed standard edgewise appliances were placed. The study included transverse measurements on dentoalveolar structures, maxillary and mandibular bases and other craniofacial regions (nasal, zygomatic, orbital, and cranial). Treated and control samples were divided into 2 groups according to individual skeletal maturation. The early-treated and early-control groups had not reached the pubertal peak in skeletal growth velocity at T1 (CVM 1 to 3), whereas the late-treated and late-control groups were during or slightly after the peak at T1 (CVM 4 to 6). The group treated before the pubertal peak showed significantly greater short-term increases in the width of the nasal cavities. In the long-term, maxillary skeletal width, maxillary intermolar width, lateronasal width, and lateroorbitale width were significantly greater in the early-treated group. The late-treated group exhibited significant increases in lateronasal width and in maxillary and mandibular intermolar widths. Rapid Maxillary Expansion treatment before the peak in skeletal growth velocity is able to induce more pronounced transverse craniofacial changes at the skeletal level.
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              Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation.

              José Henriques, Daniela Garib, Roberto De Masi … (2006)
              The force delivered during rapid maxillary expansion (RME) produces areas of compression on the periodontal ligament of the supporting teeth. The resulting alveolar bone resorption can lead to unwanted tooth movement in the same direction. The purpose of this study was to evaluate periodontal changes by means of computed tomography after RME with tooth-tissue-borne and tooth-borne expanders. The sample comprised 8 girls, 11 to 14 years old, with Class I or II malocclusions with unilateral or bilateral posterior crossbites Four girls were treated with tooth-tissue-borne Haas-type expanders, and 4 were treated with tooth-borne Hyrax expanders. The appliances were activated up to the full 7-mm capacity of the expansion screw. Spiral CT scans were taken before expansion and after the 3-month retention period when the expander was removed. One-millimeter thick axial sections were exposed parallel to the palatal plane, comprising the dentoalveolar area and the base of the maxilla up to the inferior third of the nasal cavity. Multiplanar reconstruction was used to measure buccal and lingual bone plate thickness and buccal alveolar bone crest level by means of the computerized method. RME reduced the buccal bone plate thickness of supporting teeth 0.6 to 0.9 mm and increased the lingual bone plate thickness 0.8 to 1.3 mm. The increase in lingual bone plate thickness of the maxillary posterior teeth was greater in the tooth-borne expansion group than in the tooth-tissue-borne group. RME induced bone dehiscences on the anchorage teeth's buccal aspect (7.1 +/- 4.6 mm at the first premolars and 3.8 +/- 4.4 mm at the mesiobuccal area of the first molars), especially in subjects with thinner buccal bone plates. The tooth-borne expander produced greater reduction of first premolar buccal alveolar bone crest level than did the tooth-tissue-borne expander.
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                Author and article information

                Contributors
                Aldin Kapetanović:
                ORCID: http://orcid.org/0000-0002-9114-8873
                orthodontie@radboudumc.nl
                Journal
                Journal ID (nlm-ta): Clin Oral Investig
                Journal ID (iso-abbrev): Clin Oral Investig
                Title: Clinical Oral Investigations
                Publisher: Springer Berlin Heidelberg (Berlin/Heidelberg )
                ISSN (Print): 1432-6981
                ISSN (Electronic): 1436-3771
                Publication date (Electronic): 22 June 2022
                Publication date PMC-release: 22 June 2022
                Publication date (Print): 2022
                Volume: 26
                Issue: 10
                Pages: 6253-6263
                Affiliations
                [1 ]GRID grid.10417.33, ISNI 0000 0004 0444 9382, Department of Dentistry - Orthodontics and Craniofacial Biology, , Radboud Institute for Health Sciences, Radboud University Medical Center, Radboudumc, ; Dentistry 309, PO Box 9101, 6500 HB Nijmegen, the Netherlands
                [2 ]Private Orthodontic Practice, Rotterdam, the Netherlands
                [3 ]GRID grid.10417.33, ISNI 0000 0004 0444 9382, Radboudumc 3D Lab, Radboud Institute for Health Sciences, Radboud University Medical Center, ; PO Box 9101, 6500 HB Nijmegen, the Netherlands
                [4 ]GRID grid.10417.33, ISNI 0000 0004 0444 9382, Department of Oral and Maxillofacial Surgery, , Radboud Institute for Health Sciences, Radboud University Medical Center, ; PO Box 9101, 6500 HB Nijmegen, the Netherlands
                Author information
                http://orcid.org/0000-0002-9114-8873
                http://orcid.org/0000-0002-3626-656X
                http://orcid.org/0000-0002-4452-4389
                http://orcid.org/0000-0002-9142-9253
                Article
                Publisher ID: 4577
                DOI: 10.1007/s00784-022-04577-9
                PMC ID: 9525423
                PubMed ID: 35731323
                SO-VID: a7c91880-3935-43fc-8fe0-f1033ddeb88d
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

                History
                Date received : 28 February 2022
                Date accepted : 7 June 2022
                Categories
                Subject: Original Article
                Custom metadata
                issue-copyright-statement © Springer-Verlag GmbH Germany, part of Springer Nature 2022

                ScienceOpen disciplines: Dentistry
                Keywords: miniscrew-assisted rapid palatal expansion (marpe),transverse maxillary deficiency,midpalatal suture expansion,maxillary expansion technique,non-surgical expansion technique,cbct
                Data availability:
                ScienceOpen disciplines: Dentistry
                Keywords: miniscrew-assisted rapid palatal expansion (marpe), transverse maxillary deficiency, midpalatal suture expansion, maxillary expansion technique, non-surgical expansion technique, cbct

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