Adult maxillary expansion

Aim: This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before...

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Detalles Bibliográficos
Autores: Walter, A.|||0000-0003-1124-8223, Winsauer, H., Crespo, E., Walter, D.|||0009-0002-7777-3442, Winsauer, C., Schwärzler, A.|||0000-0002-4640-5180, Mojal, Sergi|||0000-0003-0523-3869, Arcos, I., Puigdollers, A.
Tipo de recurso: artículo
Fecha de publicación:2024
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:310169
Acceso en línea:https://ddd.uab.cat/record/310169
https://dx.doi.org/urn:doi:10.1186/s13005-024-00474-6
Access Level:acceso abierto
Palabra clave:Cranial complications
Cranial sutures
MARPE
Mid-palatal suture
Mini screws in palate
Orthodontic mini-implants
Skeletal palatal expander
Slow expansion
Descripción
Sumario:Aim: This consecutive retrospective study compared Mini-implant Assisted Slow Palatal Expansion (MASPE) with rapid palatal expansion (MARPE) using a bone-borne skeletal expander in adults with a narrow maxilla. CBCT scans analyzed transverse changes and potential pterygoid process deformation before (T1) and after expansion (T2). Materials and methods: The Force Controlled PolyCyclic (FCPC) SLOW palatal expansion group (FCPC-MASPE-G) comprised 35 adults aged 18-54 years and received a skeletal expander limiting expansive force only allowing 500 cN at the activation wrench (force control). Discontinuous, polycyclic activations according to the FCPC-protocol were applied. The MARPE-group (n = 6) underwent continuous RAPID activation without FCPC until the desired width was reached. CBCT scans were taken pre and post-expansion. Inclusion criteria for both groups were successful outcomes without surgical assistance. Results: The maxilla opened transversally in both groups mildly V-shaped, with a pyramidal shape in the coronal plane, impacting the zygomatic bone. Width measurements at T2 indicated superior mechanical response in FCPC-MASPE-G. Response of zygomaticomaxillary sutures was similar in both groups (p < 0.001 to 0.025). Pterygoid process deformations were notably less in FCPC-MASPE-G (0.87-1.35 mm, p < 0.001) compared to MARPE-G (2.70-3.04 mm, p < 0.001 to 0.009). Dental measurements were similar (p < 0.001 to 0.023), but the ratio "Mid-palatal suture Opening Related to Expander opening" (M.O.R.E.-factor) was better with 84% in FCPC-MASPE-G than with 50% in MARPE-G. Conclusion: Slow expansion with FCPC protocol effectively widens the maxilla in adults, with significant impact on bones and sutures and less pterygoid process deformation compared to rapid expansion. Cranial complications were absent in both groups.