The Effects of Mini-Implant Assisted Rapid Palatal Expansion on Intrabony Canals in The Anterior Maxilla

Year 2025, Volume: 15 Issue: 3, 584 - 590, 30.09.2025

Emre Köse , Özge Ünlüoğlu , Yazgı Ay Ünüvar

https://doi.org/10.33808/clinexphealthsci.1629809

Abstract

Objective: This study aims to evaluate the impact of mini-implant assisted rapid maxillary expansion (MARPE) on intrabony canals in the anterior maxilla.
Methods: The cone beam computed tomography (CBCT) scans obtained before and after treatment from 24 patients who underwent mini-implant assisted rapid maxillary expansion (MARPE) were analyzed retrospectively. In the sagittal plane, three levels of the incisive foramen (lower, middle, and upper) were assessed. Mediolateral and buccolingual widths were measured on axial sections, and the widest diameter of the canalis sinuosus was measured in the coronal section. Pre-treatment and post-treatment measurements were statistically compared.
Results: The mediolateral width of the incisive foramen showed a statistically significant increase at the lower and middle levels during the T1 stage compared with the T0 stage (p=.0001). In the buccolingual width of the incisive foramen, measurements at the lower level in the T1 stage also exhibited a statistically significant increase compared to the T0 stage (p=.0049). However, no statistically significant difference was found in the measurements at the middle level (p=.365) (Table 3). Additionally, the measurements on the right side of the canalis sinuosus demonstrated a statistically significant increase in the T1 stage compared to the T0 stage (p=.0004) (Table 4).
Conclusion: MARPE causes expansion of the intrabony canals in the anterior maxilla. The expansion of these canals may be attributed to the need for increased vascularization and innervation accompanying the increased bone volume.

Keywords

Mini-implant assisted rapid maxillary expansion , Incisive canal , Canalis sinousus , cone beam computed tomography , maxillary expansion

References

• Moyers R. Handbook of Orthodontics. USA: Year Book Medical Publishers Inc.; 1980. 123–125 p.
• Lagravère MO, Heo G, Major PW, Flores-Mir C. Meta-analysis of immediate changes with rapid maxillary expansion treatment. The Journal of the American Dental Association. 2006;137(1):44–53. https://doi.org/10.14219/jada.archieve.2006.0020
• Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the haas expander. Angle Orthod. 2000;70(2):129–144.
• Mundstock KS, Barreto G, Meloti AF, Araújo MA, dos Santos-Pinto A, Raveli DB. Rapid maxillary expansion with the hyrax appliance: an occlusal radiographic evaluation study. World J Orthod. 2007;8(3):277–284.
• Fishman LS. Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod. 1982;52(2):88–112.
• Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg. 1995;10(2):75–96.
• Suri L, Taneja P. Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop. 2008;133(2):290–302. https://doi.org/10.1016/j.ajodo.2007.01.021
• Lee KJ, Park YC, Park JY, Hwang WS. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. American Journal of Orthodontics and Dentofacial Orthopedics. 2010;137(6):830–839. https://doi.org/10.1016/j.ajodo.2007.10.065
• Zong C, Tang B, Hua F, He H, Ngan P. Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances. Semin Orthod. 2019;25(1):46–59. https://doi.org/10.1053/j.sodo.2019.02.006
• Liao YC, Ho KH, Wang CW, Wang KL, Hsieh SC, Chang HM. Skeletal and dental changes after microimplant-assisted rapid palatal expansion (MARPE) – a cephalometric and cone-Beam computed tomography (CBCT) study. Clinical and Investigative Orthodontics. 2022;81(2):84–92. https://doi.org/10.1080/27705781.2022.2051120
• Vaghela V. Surgically assisted rapid palatal expansion and mini-screw assisted rapid palatal expansion-a review. Academic Journal of Research and Scientific Publishing. 2021;3(30):21–29. https://doi.org/10.52132/Ajrsp.e.2021.302
• Murphy J, Helman J, Edwards S, Ward B. Advanced palatomaxillary cancer. In: Oral, Head and Neck Oncology and Reconstructive Surgery. 2018.571–585 p.
• de Oliveira-Santos C, Rubira-Bullen IRF, Monteiro SAC, León JE, Jacobs R. Neurovascular anatomical variations in the anterior palate observed on CBCT images. Clin Oral Implants Res. 2013;24(9):1044–1048. https://doi.org/10.1111/j.1600-0501.2012.02497.x
• MacGinnis M, Chu H, Youssef G, Wu KW, Machado AW, Moon W. The effects of micro-implant assisted rapid palatal expansion (MARPE) on the nasomaxillary complex--a finite element method (FEM) analysis. Prog Orthod. 2014;15(1):52. https://doi.org/10.1186/s40510-014-0052-y
• Kohavi D. Demonstration of unusually wide artery in the maxillary alveolar bone using a reformatting program of computed tomography: A case report. International Journal of Oral and Maxillofacial Implants. 1994;9(4):1–7.
• Temmerman A, Hertelé S, Teughels W, Dekeyser C, Jacobs R, Quirynen M. Are panoramic images reliable in planning sinus augmentation procedures? Clin Oral Implants Res. 2011;22(2):189–194. https://doi.org/10.1111/j.1600-0501.2010.02000.x
• Choi SK, Kim YR, Park JH, Kang KH, Chang NY, Chae JM. Effects of mini-implant-assisted rapid palatal expansion on incisive canal morphology and tooth–canal relationship. Applied Sciences. 2022;12(20):10470. https://doi.org/10.3390/app122010470
• McMullen C, Al Turkestani NN, Ruellas ACO, Massaro C, Rego MVNN, Yatabe MS, Kim-Berman H, McNamara JA, Angelieri F, Franchi L, Ngan P, He H, Cevidanes LHS. Three-dimensional evaluation of skeletal and dental effects of treatment with maxillary skeletal expansion. American Journal of Orthodontics and Dentofacial Orthopedics. 2022;161(5):666–678. https://doi.org/10.1016/j.ajodo.2020.12.026
• Baccetti T, Franchi L, McNamara JA. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod. 2002;72(4):316–323.
• Song KT, Park JH, Moon W, Chae JM, Kang KH. Three-dimensional changes of the zygomaticomaxillary complex after mini-implant assisted rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2019;156(5):653–662. https://doi.org/10.1016/j.ajodo.2018.11.019
• Suri L, Taneja P. Surgically assisted rapid palatal expansion: A literature review. American Journal of Orthodontics and Dentofacial Orthopedics. 2008;133(2):290–302. https://doi.org/10.1016/j.ajodo.2007.01.021
• Marshall S, Southard K, Southard T. Early transverse treatment. Seminars in Orthodontics .2005;11:130–139. https://doi.org/10.1053/j.sodo.2005.04.006
• Betts NJ, Vanarsdall RL, Barber HD, Higgins-Barber K, Fonseca RJ. Diagnosis and treatment of transverse maxillary deficiency. Int J Adult Orthodon Orthognath Surg. 1995;10(2):75–96.
• Vanarsdall RL. Transverse dimension and long-term stability. Semin Orthod. 1999;5(3):171–180. https://doi.org/10.1016/s1073-8746(99)80008-5
• Major PW, Johnson DE, Hesse KL, Glover KE. Landmark identification error in posterior anterior cephalometrics. Angle Orthod. 1994;64(6):447–454.
• Jafari A, Shetty KS, Kumar M. Study of stress distribution and displacement of various craniofacial structures following application of transverse orthopedic forces-a three-dimensional FEM study. Angle Orthod. 2003;73(1):12–20.
• Provatidis C, Georgiopoulos B, Kotinas A, McDonald JP. On the FEM modeling of craniofacial changes during rapid maxillary expansion. Med Eng Phys. 2007;29(5):566–579. https://doi.org/10.1016/j.medengphy.2006.03.007
• Suter VGA, Warnakulasuriya S, Reichart PA, Bornstein MM. Radiographic volume analysis as a novel tool to determine nasopalatine duct cyst dimensions and its association with presenting symptoms and postoperative complications. Clin Oral Investig. 2015;19(7):1611–1618. https://doi.org/10.1007/s00784-014-1391-2
• Kang SR, Bok SC, Choi SC, Lee SS, Heo MS, Huh KH, Kim TI, Yi WJ. The relationship between dental implant stability and trabecular bone structure using cone-beam computed tomography. J Periodontal Implant Sci. 2016;46(2):116–127. https://doi.org/10.5051/jpis.2016.46.2.116
• Cunha AC da, Lee H, Nojima LI, Nojima M da CG, Lee KJ. Miniscrew-assisted rapid palatal expansion for managing arch perimeter in an adult patient. Dental Press J Orthod. 2017;22(3):97–108. https://doi.org/10.1590/2177-6709.22.3.097-108.oar
• Abedini S, Elkenawy I, Kim E, Moon W. Three-dimensional soft tissue analysis of the face following micro-implant-supported maxillary skeletal expansion. Prog Orthod. 2018;19(1):46. https://doi.org/10.1186/s40510-018-0243-z