Proposal for a clinical diagnosis index in rapid palatal expansion (RPE) in childhood

Abstract

Rapid palatal expansion (RPE) in childhood is indicated in children and teenagers with transverse maxillary deficiencies, often with skeletal antero-posterior and vertical anomalies, and functional abnormalities. The procedure consists of separating the right and left maxillae over two or three weeks. Curiously, orthodontists are using expansion appliances without any real indication; they use little RPE although it is the only effective treatment of true transverse maxillary deficiencies. Using clinical and radiological observations of many patients it was possible to devise a diagnostic index specifying the indications for semi-rapid palatal expansion. This quick and easy index composed of 4 items takes into account all the information necessary to establish a medical indication for rapid palatal expansion. It also allows practitioners to evaluate the effectiveness of the index by comparing scores before and after treatment. At present, there is no other comparable diagnostic tool. The objective of the index is to specify the medical indication of RPE and to reduce differences in the use of this therapy.