• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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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.

• 대한치과교정학회지
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• 제25권6호
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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.

• 대한치과교정학회지
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• 제29권3호
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• pp.375-381
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• 1999

본 연구는 상악궁이 양측성으로 협소하여 구치부 교차 교합을 보이는 환자 30 명에서 정중구개봉합 급속 확장술을 시행한 후, 정모두부방사선 규격 사진을 이용하여 상악골 기저부의 횡적 확장 여부를 확인하고, 그 양을 정량적으로 계측하여 상하악골 횡적 부조화의 개선 정도를 평가하여 다음과 같은 결과를 얻었다. 1. 정중구개봉합 급속 확장술을 시행한 경우 남녀 모두 각각 상악골 기저부의 유의성 있는 증가를 보였다. (P<0.001) 2. 정중구개봉합 급속 확장술을 시행한 후 확장량에 있어서 남녀간 유의성 있는 차이를 보이지 않았다. 3. 정중구개봉합 급속 확장술을 시행한 경우 사춘기 이전과 사춘기 이후 모두 각각 상악골 기저부의 유의성 있는 증가를 보였다. (P<0.001) 4. 정중구개봉합 급속 확장술을 시행한 후 확장량에 있어서 사춘기 이전과 이후 간에 유의성 있는 차이를 보이지 않았다.

• 대한치과교정학회지
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• 제48권5호
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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.

• 대한치과교정학회지
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• 제49권3호
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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.

• 대한치과교정학회지
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• 제48권2호
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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.

• 대한치과교정학회지
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• 제15권1호
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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.

• 대한소아치과학회지
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• 제37권4호
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• pp.473-481
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• 2010

상악 견치 매복은 소아 청소년기 환자들에게서 흔하게 발견되는 문제이다. 일반적으로 구개측 매복이 순측 매복 보다 더 흔한 것으로 알려져 있지만 서양에서는 오히려 순측 매복이 더 많은 것으로 보고되고 있다. 본 보고에서는 파노라마 방사선 사진상 상악 견치의 순측매복이 의심되는 8-10세의 혼합치열기 아동을 대상으로 급속 구개확장(rapid palatal expansion)을 시행하였으며, 이를 통하여 상악 측절치의 근원심 치근각도를 조절하여 매복 가능성이 있는 견치의 정상맹출을 유도할 수 있었기에 보고하는 바이다.

• 대한치과교정학회지
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• 제21권3호
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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.

• 대한치과교정학회지
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• 제51권3호
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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.