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Abstract
ObjectiveRapid maxillary expansion (RME) is an established and frequently used procedure to overcome maxillary constriction. In-depth studies about morphological changes of the alveolar process and its immediate surroundings are missing. Therefore, the aim of the present study was to examine the treatment effects of a dentally anchored, rapid maxillary expander at different dentition stages upon palatal width, height and shape.Material and methodsThe dental casts of 114 patients—taken immediately before and after RME—were three-dimensionally analysed. Depending on the dentition stage, the patients were divided into two groups (each n = 57, group 1, early mixed dentition; group 2, late mixed or permanent dentition).ResultsThe width increases were highly significant, both in the overall and in the individual groups (p < 0.001). While the width increase was greater in the posterior area than anteriorly in the early group, the widening in the late group happened significantly greater anteriorly than posteriorly. Palatal height increased anteriorly and posteriorly in both groups to a significant extent (p < 0.001). The height increase was more pronounced in the anterior region than in the posterior region in the late group. The palatine index according to Kim revealed a change in palatal morphology both anteriorly and posteriorly in the early group but only anteriorly in the late group.ConclusionsMaxillary expansion occurs more parallel in early treatment compared to V-shaped opening in the later treatment approach.Clinical relevanceRME is more advantageous in an early dentition.
Highlights
The forced skeletal expansion of the maxilla, commonly known as “rapid maxillary expansion (RME)” or “rapid palatal expansion (RPE)”, was first described by the American dentist Angell [1] and remains an inherent part of orthodontic treatment measures until today
One hundred fourteen (67 female, 47 male) out of 167 patients who received a rapid maxillary expansion between 2010 and 2020 with an Rapid maxillary expansion (RME) appliance including a Hyrax screw anchored to four teeth were included in the study, using the following inclusion criteria: Treatment exclusively by the same orthodontist, no prior orthodontic treatment, Caucasian origin, transverse maxillary arch deficiency, uni- or bilateral crossbite, corresponding high-quality dental casts prior to treatment and immediately after RME removal and the number of Hyrax screw activations had to be almost equal in both groups
The width increase is greater in the early group patients at all measurement levels compared with the late group
Summary
The forced skeletal expansion of the maxilla, commonly known as “rapid maxillary expansion (RME)” or “rapid palatal expansion (RPE)”, was first described by the American dentist Angell [1] and remains an inherent part of orthodontic treatment measures until today. According to a survey by Korbmacher et al [2], it is used in patients showing a pronounced skeletal maxillary constriction, The principle of forced skeletal expansion of the maxilla is based on the application of a defined force upon skeletal structures to separate the palatine processes and the horizontal laminae of the palatine bone in order to obtain basal expansion. The forced skeletal expansion of the maxilla affects both the median palatine suture and its surrounding sutures. Many studies have concluded that the force peaks on the surrounding structures increase with decreasing distance from the median palatine suture. Greater changes are described for sutures directly connected to the maxilla than in those with an indirect connection [16, 19]
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