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Ponna P, Tarraf NE, Dalci K, Wilmes B, Darendeliler MA, Dalci O. Dentoskeletal effects of mini-screw assisted, non-surgical palatal expansion in adults using a modified force-controlled polycyclic protocol: a single-centre retrospective study. Eur J Orthod 2024; 46:cjad080. [PMID: 38315572 PMCID: PMC10841106 DOI: 10.1093/ejo/cjad080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
OBJECTIVES This study assessed the dental and skeletal effects of pure bone-borne, non-surgical maxillary expansion, using a modified force-controlled polycyclic protocol. METHODS Records of 17 adult patients, mean age 24.1 years; range 18-39 years, who had undergone maxillary expansion using a bone-borne Quad-expander (with 4 mini-screws), were analysed. In all patients, 0.17 mm/day of expansion was completed for 1 week, followed by a cyclic protocol of expansion of forward and backward turns until the force needed to turn the expander was below 400 cN, assessed weekly. After this, expansion continued at a rate of 0.17 mm/day until the desired amount of expansion was achieved. Cone beam computer tomography scans were taken pre- and post-expansion. RESULTS The mid-palatal suture was successfully opened in 100% of patients included in this study. Axially, the amount of skeletal opening at the posterior nasal spine was 61% of the anterior nasal spine. Expansion was pyramidal in the coronal plane. Significant increases at the dental and skeletal levels were achieved, with changes at the skeletal level reaching 73%. The alveolar bone angle increased more than the angular changes at the molars and premolars. LIMITATIONS This is a retrospective study with short-term results. CONCLUSION The Quad-expander, with a force-controlled polycyclic expansion protocol, effectively produced a significant increase in maxillary width in skeletally mature subjects in the short term.
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Affiliation(s)
- Priyanka Ponna
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
| | - Nour Eldin Tarraf
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
| | - Kerem Dalci
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
| | - Benedict Wilmes
- Department of Orthodontics, University of Düsseldorf, Düsseldorf, 40225, Germany
| | - Mehmet Ali Darendeliler
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
| | - Oyku Dalci
- Discipline of Orthodontics and Paediatric Dentistry, School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2010, Australia
- Department of Orthodontics, Sydney Dental Hospital, Sydney Local Health District, Surry Hills, NSW, 2010, Australia
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Cremonini F, Ansaloni MC, Cremonini A, Maino BG, Paoletto E, Pellitteri F, Lombardo L. Severe transverse discrepancy in adult Class III patient: Parallel rapid palatal expansion with a bone-borne tandem expansion screws (TSE) followed by lingual fixed appliance for a non-surgical treatment: A case report. Int Orthod 2021; 20:100599. [PMID: 34872832 DOI: 10.1016/j.ortho.2021.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/03/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Midpalatal suture opening in young adults is often difficult to achieve, depending on the suture maturation stage. It has been suggested that it is possible to avoid surgery and still achieve a successful pure skeletal expansion if a bone-borne Miniscrew-Assisted Rapid Palatal Expander is chosen (MARPE). CASE PRESENTATION The following case report describes the use of a pure bone-borne miniscrew-assisted rapid palatal expander followed by lingual fixed appliance to correct a severe transversal discrepancy in an adult patient characterized by a hyperdivergent mandibular skeletal pattern. MANAGEMENT AND OUTCOMES All treatment phases were digitally planned, starting with the miniscrews' insertion with a three-dimensionally printed surgical guided (Miniscrew Assisted Palatal Application: MAPA system) and Tandem Skeletal Expander (TSE) appliance, to the lingual indirect bonding. The final outcomes confirmed that this orthodontic approach represented a valid alternative to orthognathic surgery, with a significant improvement of the patient's occlusion and facial appearance. DISCUSSION The Tandem Skeletal Expander (TSE) design and the expansion protocol applied allowed to obtain a significant and stable skeletal increase of transversal diameters by digital planning of the insertion of miniscrews, with lower risks and costs than other surgical approaches.
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Affiliation(s)
- Francesca Cremonini
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy.
| | | | | | - Bartolo Giuliano Maino
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
| | | | - Federica Pellitteri
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
| | - Luca Lombardo
- Postgraduate School of Orthodontics, University of Ferrara, Via Luigi Borsari 46, 44121 Ferrara, Italy
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