• Maxillofacial Plastic and Reconstructive Surgery
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• v.37
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• pp.11.1-11.5
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• 2015

Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.

• The korean journal of orthodontics
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• v.25 no.6 s.53
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• pp.733-746
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• 1995

In narrow maxillary arch, midpalatal suture can be readily opened in growing children with maxillary palatal expansion. In adult patients, narrow maxilla is generally treated surgically because their growth are deemed completed due to their age. However, in patients under 25, midpalatal suture may not be closed. In addition, maxillary expansion may depend upon the closure of other maxillary sutures, which generally remain open at this stage. The present study attempted suture openings with palatal expansion on 5 female patients in their early 20's. The opening was successful in 4 patients, while only one patient showed no suture opening. In all 4 subjects, no discomfort or pain was present during s\expansion, and the successful suture opening was confirmed on occlusal x-rays. Therefore, for those patients with narrow maxilla in their early 20's, rapid palatal expansion or slow palatal expansion may offer a simple and less complicated option which, if successful, may preclude the need for surgery and thereby circumvent the psychological and financial burdens for the patients.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.375-381
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• 1999

The purpose of this study was to evaluate whether the basal bone of maxilla was expanded transversely by rapid palatal expansion through the posteroanterior cephalome- tric analysis. Thirty patients with the maxillary deficiency were utilized in this study. The posteroanterior cephalometric X-ray film were taken twice, before and after rapid palatal expansion. logram The obtained results were as follows; 1. There was a significant increase of the maxillary width by rapid palatal expansion in male and female. (P<0.001) 2. There was no significant difference between the male and female in the expansion of the maxillary width by rapid palatal expansion. 3. There was a significant increase of the maxillary width by rapid palatal expansion in the both of before and after the puberty. 4. There was no significant difference between before and after the puberty in the expansion of the maxillary width by rapid palatal expansion.

• The korean journal of orthodontics
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• v.48 no.5
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• pp.304-315
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• 2018

Objective: The purpose of this study was to analyze initial displacement and stress distribution of the maxillofacial complex during dentoskeletal maxillary protraction with various appliance designs placed on the palatal region by using three-dimensional finite element analysis. Methods: Six models of maxillary protraction were developed: conventional facemask (Type A), facemask with dentoskeletal hybrid anchorage (Type B), facemask with a palatal plate (Type C), intraoral traction using a Class III palatal plate (Type D), facemask with a palatal plate combined with rapid maxillary expansion (RME; Type E), and Class III palatal plate intraoral traction with RME (Type F). In Types A, B, C, and D, maxillary protraction alone was performed, whereas in Types E and F, transverse expansion was performed simultaneously with maxillary protraction. Results: Type C displayed the greatest amount of anterior dentoskeletal displacement in the sagittal plane. Types A and B resulted in similar amounts of anterior displacement of all the maxillofacial landmarks. Type D showed little movement, but Type E with expansion and the palatal plate displayed a larger range of movement of the maxillofacial landmarks in all directions. Conclusions: The palatal plate served as an effective skeletal anchor for use with the facemask in maxillary protraction. In contrast, the intraoral use of Class III palatal plates showed minimal skeletal and dental effects in maxillary protraction. In addition, palatal expansion with the protraction force showed minimal effect on the forward movement of the maxillary complex.

• The korean journal of orthodontics
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• v.49 no.3
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• pp.150-160
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• 2019

Objective: This study aimed to analyze the effect of changing various parameters of the bone-borne rapid palatal expander (RPE) using the finite element method (FEM). Methods: In eight experimental groups, we investigated the effect of the number, position, and length of miniscrews; positional changes of the expander; and changes in the hook length on maxillary expansion. In finite element analysis, we compared the magnitude and distribution of stress, and the displacement changes following expansion of the bone-borne RPE. Results: When we compared the number and position of miniscrews, placing miniscrews in the anterior and posterior sides was advantageous for maxillary expansion in terms of stress distribution and displacement changes. Miniscrew length did not significantly affect stress distribution and displacement changes. Furthermore, anteroposterior displacement of the expander did not significantly affect transverse maxillary expansion but had various effects on vertical changes of the maxilla. The maxilla rotated clockwise when the miniscrews were placed in the anterior region. The hook length of the expander did not show consistent results in terms of changes in stress distribution and magnitude or in displacement changes. Conclusions: The findings of this study suggest that changes in the location and length of the miniscrews and displacement of the bone-borne RPE could affect the pattern of the maxillary expansion, depending on the combination of these factors.

• The korean journal of orthodontics
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• v.48 no.2
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• pp.98-106
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• 2018

Objective: This study aimed to explore the usefulness of adjunctive buccal and palatal corticotomy for adult maxillary expansion in an animal model using cone-beam computed tomography (CBCT). Methods: Twelve adult sheep were randomly divided into two groups (each n = 6): a control group, where no treatment was administered, and a treatment group, where buccal and palatal corticotomy-assisted maxillary expansion was performed. CBCT scans were taken before (T1) and after (T2) treatment. Differences in all transverse dental and alveolar dimensions, alveolar width at crest level, hard palate level, horizontal bone loss, interdental cusp width and inter-root apex were assessed using Wilcoxon signed-rank and Mann-Whitney U-tests. Kruskal-Wallis tests and pairwise comparisons were used to detect the significance of differences among the inter-premolar and inter-molar widths. Results: CBCT data revealed significant changes in all transverse dental and alveolar dimensions. The mean interpremolar alveolar width showed an increase of 2.29 to 3.62 mm at the hard palate level, 3.89 to 4.38 mm at the alveolar crest level, and 9.17 to 10.42 mm at the buccal cusp level. Dental changes in the vertical dimension were not significant. Conclusions: Our findings based on an adult animal model suggest that adjunctive buccal and palatal corticotomy can allow for both skeletal and dental expansion, with the amount of dental expansion exceeding that of skeletal expansion at alveolar crest and hard palate levels by two and three folds, respectively. Therefore, this treatment modality is potential to enhance the outcomes of maxillary expansion in adults.

• The korean journal of orthodontics
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• v.15 no.1
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• pp.43-54
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• 1985

Recently, rapid palatal expansion technique is widely used for the correction of the skeletal imbalance in Cl III malocclusion patients. There were many studies about the cephalometric changes to rapid palatal expansion but quantitative analysis were small. The purpose of this study was to analysis the stresses and displacement of the maxilla in human dry skull to rapid palatal expansion. The results were as follows: 1. The anterior portion of palate show more lateral and inferior displacement than the posterior portion. But the posterior portion show more anterior displacement. 2. In transpalatal suture area, the medial portion show more anterior and inferior displacement than the lateral portion. But the lateral portion show more lateral displacement than the medial portion. 3. In mid-sagittal plane, the lower portion (palatal area) of maxilla show more anterior, lateral, inferior displacement than the upper portion (frontamaxillary stuture area). 4. In zygomatic arch, the adjacent area to maxilla show tonsil. stresses and the adjacent area to frontal bone show compressive stresses. 5. The sequence of stress bearing area to R.P.E. is upper retromolar area, upper 1st molar, 1st premolar, 2nd premolar, anterior segment of teeth.

• Journal of the korean academy of Pediatric Dentistry
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• v.37 no.4
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• pp.473-481
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• 2010

Maxillary canine impaction is an anomaly often encountered in children. Although it has been reported that the incidence of palatally impacted canines is higher than that of labially impacted ones, it has been found that labial impaction of canines is more common than palatal impaction in Asian populations. In the cases presented here, maxillary canines were guided normally after rapid palatal expansion, followed by modification of root angulation of neighboring lateral incisors in 8-10-year-old children who had maxillary canines suspected of labial impaction. Consequently, the method of modifying the root angulation of the maxillary lateral incisor, combined with rapid palatal expansion, is effective in preventing impaction of an ectopically erupting maxillary canine without resorting to surgical methods.

• The korean journal of orthodontics
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• v.21 no.3
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• pp.657-670
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• 1991

It was said that early rapid palatal expansion was the treatment of choice in case of maxillary constriction with posterior crossbite. The author tried to assess dimensional changes of nasal and oral cavity before rapid palatal expansion and over 4 months of retention by use of three coronal tomograms through the incisal, molar, and maxillary tuberosity areas. The subjects of this study were consisted of 9 boys and 11 girls ranging from 11 to 13 years old. The results were as follows: 1. A mean change in maxillary first molar width was 3.68mm and a mean change in nasal cavity width was 2.26mm after 6.70mm expansion by Hyrax-type screw and over 4 months of retention tomographically in molar cut. 2. A change in nasal cavity width tomographically showed in order of molar cut, incisal cut, maxillary tuberosity cut respectively. 3. There was no correlation between changes in oral cavity width and nasal cavity width.

• The korean journal of orthodontics
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• v.51 no.3
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• pp.217-227
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• 2021

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.