Maxillary Intermolar Width Research Articles

Sexual dimorphism in permanent maxillary and mandibular canines and intermolar arch width: Endemic study

Aims and Objectives: The purpose of this study was to investigate whether dimorphism of permanent mandibular and maxillary canine teeth as well as intercanine and intermolar distance plays a role in establishing sex identity. Materials and Methods: Four hundred volunteers comprising 200 males and 200 females, with age ranging from 18 to 50 years, were selected. The greatest mesiodistal width of the canine teeth and the distance between the tips of canines of both arches and intermolar arch width were measured using vernier caliper with 0.02 mm resolution. All data were tabulated and analysis done by t test. Results: The widths of the mandibular and maxillary right and left canine teeth were almost bilaterally symmetrical in females and males. The mean values for left and right mandibular and maxillary canine widths were less in females than in males and the differences were statistically significant. The mean values for mandibular and maxillary intercanine and intermolar distances were less in females than in males and the differences were statistically significant (P

An evaluation of the dentoskeletal effects of slow maxillary expansion from the mixed to the permanent dentition

Abstract Introduction The aim of this study was to evaluate the dentoskeletal effects of a modified slow maxillary expansion appliance (MSMEA) during the transition from the mixed to the permanent dentition. Methods Forty subjects presenting with posterior crossbites were divided into two groups. Twenty-three subjects were assigned to a treatment group (mean age: 9.45 years) and 17 subjects assigned to a control group (mean age: 9.25 years). An MSMEA with acrylic occlusal coverage limited to the palatal cusps was used to provide maxillary expansion. The mean slow expansion treatment period was 7.8 months, while the mean observation period continued for 14.8 months of a 22.6-month total study period. Results Substantial dental and skeletal effects were observed following treatment with the MSMEA. Most maxillary inter-molar and deciduous inter-second molar width increases were maintained in the permanent dentition (91% and 97%, respectively). Skeletal maxillary transverse dimensions, which increased by 2 mm after active expansion, were significantly greater (p< 0.001) when compared with the controls. Conclusion The findings suggested that an MSMEA provided orthopaedic and dental effects as a result of posterior crossbite correction. The effects of the appliance seen during the mixed dentition were maintained in the permanent dentition.

Erratum: Sexual dimorphism in permanent maxillary and mandibular canines and intermolar arch width: Endemic study

Erratum: Sexual dimorphism in permanent maxillary and mandibular canines and intermolar arch width: Endemic study

Comparison of Dental arch widths, arch forms in different types of malocclusions in Chennai population- a 3D laser scanner study

The aim of the study was to compare the arch widths and arch forms in different types of malocclusions in Chennai population using 3D Laser scanning system. The study was conducted on 90 subjects at Department of Orthodontics Tamil Nadu Government Dental College amp Hospital Chennai. The subjects had no previous history of orthodontic treatment and aged between 16-23 years. The three groups class-I class-II division 1 and class-III consisted of 30 samples per group with 15 males and 15 females each.The results showed that both the maxillary and mandibular arch width was significantly lower in class-II division 1 groupsplt0.05. However mandibular intercanine and interpremolar width were notstatistically different among all groupspgt0.05.The maxillary intermolar width showed highly significantly difference between class-III and class-II division 1groups and mandibular intermolar width are highly significant at 1 level between class-II and class-III groups and 5 level between class-Iand class-IIIgroups.The arch widths of males were higher than females except the mandibular intercanine width in class-III and class-II division 1 groups. Arch form results revealed that the ovoid type was frequently distributed in class-I and class-III groups and tapered type in class-II division 1groups. No gender dimorphism was observed in arch form distribution.

Orthodontics problems in pediatric and growing subjects

Results The presence of posterior crossbite was significantly greater in growing subjects with oral breathing thus confirming the influence of these factors on skeletal development with constriction of the whole palate. Unilateral posterior crossbite is often associated with mandibular lateral displacement that is clinically characterized by deviation of the chin, facial asymmetry, dental midline discrepancy, and high prevalence of internal derangement of the temporomandibular joint. Children with anterior openbite presented with a greater prevalence rate of sucking habits. Hyperdivergency is a risk factors for negative overbite in mixed dentition subjects. The test group had significantly smaller maxillary intermolar and intercanine widths and greater posterior transverse discrepancy. Class III malocclusion is a complex clinical entity that entail the contraction of the maxilla and a narrowing of the base of the nose in addition to an increased mandibular total length. Conclusions Treatment of orthodontic problems that do not improve with age may be started earlier to avoid worsening of the condition in permanent dentition. The objective of any treatment in pediatric subjects before eruption of all permanent teeth are to correct the skeletal discrepancy between the jaws and improve function and facial esthetics by allowing them to develop normally, to create an ideal overbite and overjet relationship, to align the anterior permanent teeth and reduce the chance of trauma to these teeth, to improve the width of the dental arches and to reduce the risk for extraction of permanent teeth and for surgery in severe cases. Morphologic and functional characteristics of unilateral posterior crossbite with mandibular lateral deviation should be clarified to correct and prevent this malocclusion. Children with mouth-breathing pattern and sucking habits showed a significant constriction of the maxillary arch and an increased palatal height when compared with control group. Early treatment of Class III malocclusion is able to produce significant and favorable longterm skeletal shape changes characterized by an anterior morphogenetic rotation of the mandible.

Avaliação do dimorfismo sexual e da relação entre as características craniofaciais, dos arcos dentários e do músculo masseter na fase de dentição mista

Objetivo avaliar o dimorfismo sexual e a relação entre as características morfológicas craniofaciais, dos arcos dentários e do músculo masseter na fase de dentição mista. Métodos 32 crianças, com idade entre 6-10 anos (14♀/18♂) com oclusão normal, compuseram a amostra. Características morfológicas craniofaciais, dos arcos dentários e espessura do masseter foram avaliadas por meio de radiografia cefalométrica posteroanterior, modelos em gesso e ultrassonografia, respectivamente. Os resultados foram analisados utilizando testes Shapiro-Wilk, Mann-Whitney/teste “t” e regressão linear múltipla para avaliar a relação entre a largura da face e idade, gênero, índice de massa corporal, espessura do masseter, distâncias intermolares e intercaninos (entre cúspides e pontos cervicais) e larguras nasal, maxilar, mandibular e intermolar. Resultados a espessura do masseter não diferiu significativamente entre os lados esquerdo e direito. A comparação entre os gêneros mostrou diferença significativa apenas na largura da face (maior em meninos). O modelo de regressão mostrou que a largura da face relacionou-se positivamente com o índice de massa corporal, espessura do masseter, distâncias intermolares (cúspides) e intercaninos (cervicais) inferiores e largura intermolar maxilar; e negativamente com a distância intermolares superiores (cúspides) e inferiores (cervicais) e intercaninos inferiores (cervicais). Ou seja, quando as demais variáveis foram adicionadas ao modelo, a variável explanatória gênero não alcançou valor significativo. Conclusão na amostra avaliada, a espessura do masseter e dimensões dos arcos dentários não diferiram entre gêneros; além disso, a largura da face mostrou relação significativa com o índice de massa corporal, espessura do masseter e dimensões dos arcos dentários, mas o gênero não contribuiu significativamente para sua variação.

Residents' journal review

Residents' journal review

An assessment of conventional and self-ligating brackets in Class I maxillary constriction patients

To evaluate two different treatment systems with regard to incisor position, transverse dimension changes in maxillary arch, changes in maxillary molar inclinations, clinical periodontal parameters, and pain intensity in patients with a Class I malocclusion. Seventeen patients (with a mean age of 14.5 years) underwent orthodontic treatment with the Roth prescribed edgewise bracket systems after expanding the maxillary arch with a quad-helix appliance, and 16 patients (with a mean age of 14.8 years) underwent orthodontic treatment with the Damon 3MX bracket system. Each subject's lateral cephalometric and posteroanterior radiographs and dental casts were obtained at the beginning of the treatment and after debonding. In addition to these, the periodontal index and pain scores were taken. Cephalometric data showed that in both treatment systems, overjet value decreased and maxillary and mandibular incisors proclined. Posteroanterior measurements demonstrated a greater increase in the maxillary molar inclination in the Damon group. Significant increase of maxillary intercanine, interpremolar, and intermolar widths was shown in both systems. Periodontal index and pain score changes between different observation periods were the same. The conventional and Damon systems were found similar with regard to the incisor position, transverse dimension changes in maxillary arch, clinical periodontal parameters, and pain intensity. The only significant difference was that the Damon system inclined the maxillary molars more buccally than the conventional group.

Skeletal and dental characteristics in subjects with ankyloglossia

BackgroundThe role of ankyloglossia in etiology of malocclusion is not much discussed over the years. The aim of the present study was to assess the skeletal and dental characteristics in subjects with ankyloglossia.MethodsFifty-seven subjects diagnosed with ankyloglossia (group 1) were compared with 60 subjects (group 2) without ankyloglossia, who had class I skeletal base. Ankyloglossia was diagnosed and graded (mild, moderate, severe and very severe) using Kortlow's method. SNA, SNB, ANB, Go-Gn-SN angle, FMA, maxillary and mandibular intercanine widths and intermolar widths, tooth size-arch length discrepancy in maxillary and mandibular arches and overbite were measured. Independent t test was used to compare the mean parameters between the two groups. Analysis of variance and Tukey honestly significant difference were used to compare mean parameters among various grades of ankyloglossia.ResultsMajority of group 1 subjects belonged to class I skeletal base followed by class II and class III skeletal bases. Moderate ankyloglossia was most common in group 1. The mean maxillary and mandibular intercanine widths and maxillary intermolar width were statistically significant in independent t test (P < 0.01) and reduced in group 1. In ANOVA followed by Tukey HS, the Go-Gn-SN angle and overbite were statistically significant among different grades of ankyloglossia (P < 0.05).ConclusionsSubjects with ankyloglossia had reduced maxillary and mandibular intercanine widths and reduced maxillary intermolar width. The mandibular plane angle and overbite were altered with severity of ankyloglossia.

The impact of spur therapy in dentoalveolar open bite

Abstract Aim: A longitudinal case-control study, designed to analyse the isolated effect of attached palatal spurs in patients displaying a dentoalveolar anterior open bite, is presented. Methods: Thirty-one patients (mean age of 13.3 years ± 3.17 years) underwent a standardised treatment protocol with fixed anterior spurs for 8.3 months. Lateral cephalograms and plaster casts were analysed before (T1) and after spur therapy (T2). The data were tested using paired t-tests with a significance level of p &lt; 0.05. Results: The cephalometric analysis showed significant elongation of the height of the maxillary (mean +1.22 mm) and the mandibular (mean +1.39 mm) alveolar processes, as well as uprighting of the lower anterior teeth. The plaster cast analysis showed an increase in maxillary intermolar width (mean +0.98 mm) and a decrease in intercanine distance (mean -0.96 mm). The mandibular anterior width and dental arch length reduced. Overall, spur therapy resulted in a significant increase in overjet and overbite. Conclusion: The use of spurs produced a resolution of the open bite in all patients. Therefore, spurs could be considered an effective mechanism for the management of anterior open bite in selected adolescent patients.

The effectiveness of non-surgical maxillary expansion: a meta-analysis

To evaluate and compare the effectiveness of rapid maxillary expansion (RME) and slow maxillary expansion (SME). PubMed, Embase, Web of Science, CENTRAL, ProQuest Dissertations & Theses, ClinicalTrial.gov, and SIGLE were searched from January 1980 to October 2012 for randomized or non-randomized controlled trials. The processes of study search, selection, and quality assessment were conducted independently and in duplicate. Original outcome data underwent statistical pooling through Review Manager 5. Fourteen eligible studies were finally included and two interventions (RME and SME) studied. Four outcomes (maxillary intermolar width, maxillary intercanine width, maxillary interpremolar width, and mandibular intermolar width) during three time periods (expansion, retention, and net change) were statistically pooled. The sensitivity analysis revealed that the results from the meta-analysis were generally robust. Egger's test and Begg's test detected no publication bias except for maxillary intercanine width in expansion period for SME versus control. SME is effective in expanding maxillary arch, while we cannot determine its effectiveness in mandibular arch expansion. RME is effective in expanding both maxillary and mandibular arches. Furthermore, SME is superior to RME in expanding molar region of maxillary arch, while similar with RME in mandibular arch expansion. However, we cannot compare their effectiveness in maxillary anterior region.

Intra-arch widths: A meta-analysis

To determine and compare the mean values of various intra-arch distances in Class I, Class II division 1 and Class II division 2 patients. The search engines PubMed, Embrace and Cochrane were employed to select articles for further study, and the sample thereby selected comprised adult subjects with full permanent dentition, without missing teeth, malformations or previous orthodontic treatment. Only subjects from articles published during the last 10 years were included in the study. The search located a total of 628 articles regarding arch form. However, only eight articles were chosen for the study. We observed that: the distance between mandibular canines is smaller in Class I than in Class II division 1; mandibular inter-molar distance is similar in Class I and Class II division 1; maxillary inter-canine distance is similar in Class I, Class II division 2 and Class II division 1; maxillary inter-premolar width is greater in Class I than in Class II division 1; and that maxillary inter-molar width is similar in Class I and Class II division 2. No statistically significant differences in arch width were found between the different classes analysed (there are only slightly differences between classes), except in the case of mandibular inter-canine width (L3), which was smaller in Class I than in Class II,1, and maxillary inter-premolar width (U4), which was smaller in Class II-I than in Class I.

Different manifestations of Class II Division 2 incisor retroclination: A morphologic study

The aims of this study were to investigate whether there is a different transverse morphologic pattern of dental arches among patients with different manifestations of Class II Division 2 incisor retroclination and to evaluate to what extent the pattern of smaller-than-average teeth in Class II Division 2 malocclusion is common to all groups studied. This information might clarify whether different Class II Division 2 phenotypes represent a single etiology or multiple etiologies. The sample comprised 108 subjects with Class II Division 2 malocclusions, divided into 2 groups according to the type of incisor retroclination: group I included 43 Class II Division 2 subjects with retroclination exclusively of the maxillary central incisors, and group II included 65 Class II Division 2 subjects with retroclination of the 4 maxillary incisors. Maxillary and mandibular intercanine and intermolar widths as well as mesiodistal crown dimensions of the 4 maxillary and mandibular incisors were determined from the patients' initial study models. Mean values of all variables were compared between the 2 groups by sex with analysis of variance. From the comparison between these 2 groups, no statistically significant differences were found for all transverse measurements (P>0.05). For all mesiodistal measurements analyzed, statistically significant differences between the groups were only found for the mean value of both maxillary lateral incisors' mesiodistal dimensions in both sexes (P<0.05). It is not possible to attribute a characteristic pattern of dental arch-width and incisor mesiodistal dimensions to the different manifestations of incisor retroclination in Class II Division 2 malocclusion.

Dental consequences of mouth breathing in the pediatric age group

Background: The presence of mouth breathing (MB) in pediatric patients is a relatively common fact and may result in a series of changes characteristic of occlusal features. In the presence of unbalanced muscular activity, dental inter-arch relationship is the important parameter to understand the patient's occlusion. Therefore, it is important to assess the occurrence of occlusal disorders among MB children. Aim: The present study is undertaken to verify the dental occlusal characteristics with extent of MB and nasal breathing in a pediatric patient. Materials and Methods: A cross-sectional study was performed to assess the association of changed mode of respiration with occlusal variables from dental cast. Ninety-two subjects, of whom 40 were mouth breathers and 52 were nasal breathers, of 7-11 years of age were submitted to clinical examination and dental cast analysis. Results: Mouth breathers demonstrated considerable increase in palatal height and increased overjet, and statistically significant narrowing of the upper arch at the level of the molar. Conclusion: Changed mode of respiration during critical growth periods in children has a higher tendency for increased palatal height and overjet, reduced overbite and maxillary intermolar width.

The influence of sucking habits on occlusion development in the first 36 months

OBJECTIVE: The objective of this study was to identify the influence of sucking habits on the occlusal characteristics of the deciduous dentition. METHODS: The initial sample consisted of 86 infants, aged 0 to 3 months. Seven home visits were performed, when and information on breastfeeding practice, nutritive and non-nutritive sucking habits, mouth breathing and dentition development was collected. From the first sample, impressions of the dental arches were obtained from 58 children at the age of 36 months (+2.51SD). Dental casts were obtained and two examiners, trained and calibrated by the Kappa and Pearson Correlation tests, measured several parameters of dental occlusion, such as arch length, depth, and width. RESULTS: The results showed that bottle feeding before 6 months was associated to an increased mandibular intermolar width (p=0.01). Pacifier use before 6 months was statistically associated to a reduction of the maxillary intercanine (p=0.03) and intermolar (p=0.03) width. In addition to these findings, the increased molar depth of the maxillary arch was associated to loss of lip closure before the age of 12 months (p= 0.03). CONCLUSION: According to these results, it could be concluded that sucking habits interfere with the determination of some deciduous occlusal characteristics: pacifier sucking limits lateral-lateral maxillary growth, bottle feeding favors lateral-lateral mandibular growth and open bite development, and the lack of lip closure favors the anteroposterior maxillary growth.

Vertical facial and dental arch dimensional changes in extraction vs. non-extraction orthodontic treatment.

To compare the vertical facial and dental arch dimensional changes occurring with extraction and nonextraction orthodontic treatments. Cross-sectional comparative study. The Aga Khan University Hospital, Karachi during the period 2003 to 2005. Data were collected using records of patients who visited the study setting during the study period. Pre- and post-treatment lateral cephalographs and study casts of 81 orthodontic patients (41=non-extraction and 40=premolar extractions) were taken. Variables used for evaluating vertical dimension were Frankfort mandibular plane angle (FMA), facial height (N-Me), facial height ratio (N-ANS/ANS-Me), soft tissue facial height (G' to Me'), soft tissue facial height ratio (G'-Sn'/zn'-Me'), upper first molar to palatal plane and lower first molar to mandibular plane distance, posterior facial height to anterior facial height ratio (PFH/AFH) and Y-axis. Intercanine, interpremolar and intermolar widths and arch depths were also measured. To evaluate the pre-treatment and posttreatment comparison within each group, paired t-tests were used. For pre- and posttreatment comparisons between the extraction and non-extraction groups, independent sample t-tests were used. The mean age was 15.8+/-1.5 years for non-extraction and 15.4+/-1.2 years for the extraction group. There was no significant difference in the vertical dimensional changes between extraction and non-extraction treatments as it increased in both groups. When comparing posttreatment arch dimensions, there was an increase in the maxillary intermolar width in the non-extraction group while the intermolar widths and arch depths decreased in the extraction group in both arches. Vertical dimensional changes showed no significant difference between extraction and non-extraction groups. Intermolar widths and arch depths decreased in both arches in the extraction group while the maxillary intermolar width increased in the non-extraction group.

Evaluation of transverse changes in the dental arches according to growth pattern: a longitudinal study

OBJECTIVE: To evaluate changes in intercanine (LICW and UICW) and intermolar (LIMW and UIMW) widths on the dental arches of subjects with normal occlusion and Angle Class I malocclusion during the transition to permanent dentition, and evaluate whether or not facial pattern influences on the normal development of the dentition and occlusion. METHODS: Nineteen Caucasian Brazilian children were selected, with ages ranging from 6 to 8.6 years at T1 and from 10.10 to 14.2 years at T2. Their second records consisted of study dental casts and a lateral cephalometric radiograph. To obtain intermolar and intercanine widths a three-dimensional scanner unit (digitizer MicroScribe 3DX) was used connected to a microcomputer. To analyze changes at T1 and T2 Student's paired t-test was applied, whereas Spearman's correlation analysis was used to assess the relationship between measurements obtained at T1 and T2 and the facial pattern, both at 95% level of confidence. RESULTS: The mean values found on each assessment time (T1 and T2) were statistically different (p=0.000 for LICW, p=0.001 for UICW, p=0.000 for UIMW, and p=0.046 for LIMW), regardless of the facial pattern. The anterior dimensions, UICW and LICW, increased by 3.21 mm and 1.52 mm, respectively. And the posterior dimensions, UIMW and LIMW, increased by 2.16 mm and 0.50 mm, respectively. Only UIMW showed a significant correlation with the facial pattern (p<0.01). CONCLUSION: There was an increase in dental arch width during the transition period from primary or mixed dentition to permanent dentition irrespective of facial pattern. Only the changes observed in the maxillary intermolar width were associated with the facial pattern.

Maxillary expansion with the memory screw: a preliminary investigation

ObjectiveThe purpose of this study was to investigate the effects of a newly developed rapid maxillary expansion screw-the memory screw-over 6 months.MethodsFive subjects, aged between 11.7 and 13.75 years, were enrolled in this study. All subjects underwent placement of a maxillary expansion appliance containing superelastic nickel-titanium open-coil springs in its screw bed. The parents of the patients and/or the patients themselves were instructed to activate the expansion screw by 2 quarter-turns 3 times a day (morning, midday, and evening; 6 quarter-turns a day). The mean expansion period was 7.52 ± 1.04 days. Dentoskeletal effects of the procedure, including dentoalveolar inclination, were evaluated. Measurements of all the parameters were repeated after 6 months of retention in order to check for relapse.ResultsSella-Nasion-A point (SNA) and Sella-Nasion/Gonion-Menton angles increased, and Sella-Nasion-B point (SNB) angle decreased in all the subjects during the expansion phase. However, they approximated to the initial values at the end of 6 months. On the other hand, the increments in maxillary apical base (Mxr-Mxl) and intermolar widths was quite stable. As expected, some amount of dentoalveolar tipping was observed.ConclusionsThe newly developed memory expansion screw offers advantages of both rapid and slow expansion procedures. It widens the midpalatal suture and expands the maxilla with relatively lighter forces and within a short time. In addition, the resultant increments in the maxillary apical base and intermolar width remained quite stable even after 6 months of retention.

Outcome analysis of palatoplasty in various types of cleft palate

Aims:To analyse the factors affecting clinical and functional outcome of Veau-Wardill-Kilner palatoplasty in various types of cleft palate.Materials and Methods:Demographic data were retrieved from case records and a detailed speech, language and hearing and an orthodontic analysis were carried out prospectively.Results:Mean age at operation was 2.7 years; whereas mean age at the time of evaluation was 6 years. Most of the patients (43.3%, 13/30) had a bilateral cleft lip and palate. The postoperative fistula had developed in 31% (4/13) of the patients with bilateral clefts and in 17% (1/6) and 9% (1/11) of the patients with left unilateral and isolated cleft palate respectively (P<0.05). Eight per cent (2/24) of the patients operated before 2 years of age developed a fistula as compared to 66.6% (4/6) of the patients who had undergone a repair after 2 years of age (P<0.01). Severe speech abnormality was seen in 33.4% of the patients having postoperative fistula as compared to 16.6% of non-fistula patients (P<0.05). Derangement of speech was found in 66.6% of the patients who had undergone surgery after the age of 2 years as compared to the patients (13%, 3/24) undergoing correction before 2 years of age (P<0.05). Hearing loss was seen most commonly in patients with bilateral cleft palate as compared to the other varieties (P>0.05). Tympanic membrane (TM) abnormalities were also more common in bilateral cleft patients (P<0.05). Mean maxillary arch length, arch circumference and maxillary inter-canine and inter-molar width were significantly reduced as compared to the control group (P<0.001).Conclusions:Socially acceptable quality of speech can be achieved in more than 85% of the patients. The postoperative fistula is associated with poor speech; bilateral cleft and older age being the risk factors for fistula formation. Many patients require audiological surveillance even when asymptomatic. Maxillary growth is impaired in all the patients despite early surgery.

Efficacy of Nickel-Titanium Palatal Expanders

Objective: Timely treatment of narrow maxilla by means of maxillary expansion during the primary or transitional dentition is recommended to reestablish optimal function in order to normalize dental, skeletal and neuromuscular growth. The aim of this study was to assess the amount of orthodontic and orthopedic expansion achieved in the maxilla and to evaluate cephalometrically the various postural changes in the maxilla and mandible with the use of nickel-titanium palatal expander. Materials and methods: A total of ten subjects, five males and five females were selected from a survey conducted on 2000 children in age range of 7 to 15 years, belonging to various schools. Their study cast, cephalograms and occlusal radiographs were used for the study. Maxillary intermolar width, maxillary intercanine width and mandibular intermolar width were measured on study cast using Vernier caliper. Certain measurements were done on the cephalogram and occlusal radiograph. The data obtained out of various measurements made on study casts, frontal, lateral cephalograms and occlusal radiographs at the pretreatment, postexpansion and postretention stages were statistically analyzed. All the observations were made by two observers. The interexaminer variability was calculated using t-test. The mean and standard deviations were calculated and student's t-test (paired) was applied to determine the amount of change, variability of change and significance of change, respectively. Results: A constant force exerted by nickel-titanium palatal expander had orthopedic effects in growing age group indicated by statistically increase in the maxillary width. The ratio of relative orthodontic to orthopedic effect with this appliance was 6:1. Consequent to maxillary expansion, there occurred a significant downward movement of the maxillae and downward and backward rotation of the mandible. There was opening of midpalatal suture during active phase followed by suture remineralization during the retention period. Conclusion: To conclude, a Ni-Ti expander brings about expansion by a combination of orthodontic and orthopedic effects by an increase in maxillary intermolar, maxillary intercanine and mandibular intercanine widths as also the opening of the midpalatal suture.