Skeletal Transversal Expansion Using Modified RME Appliance in Adult Patient

Year 2024, Volume: 34 Issue: 4, 306 - 309, 15.10.2024

Serdar Çik Ali Kiki

https://doi.org/10.17567/currresdentsci.1555964

Abstract

Objective: In this study, rapid maxillary expansion without corticotomy with the use of a miniscrew-supported appliance in an adult patient is presented.
Case: As a result of the clinical examination of an 18-year-old Caucasian female patient, she had a bilateral posterior crossbite. The upper midline was coincident with the facial midline, whereas there was a deviation to the right in the lower midline. Angle's Class II molar relationship on the right and Angle's Class I on the left were observed. Arch-length deficiency values were -2 mm in the upper and -3 mm in the lower. Overjet was 7.5 mm and overbite was 0 mm. It was determined by the hand-wrist radiograph that the patient's growth was ceased. It was planned to expand maxilla non-surgically prior to any other orthodontic interventions. After 55 quarter-turns of activation the appliance was left in mouth passively for 3 months. Her fixed treatment is continuing.
Results: With RME SNB angle did not change and SNA angle increased by approximately 1 degree. 1-SN decreased by approximately 6 and IMPA by 1 degrees. Inclinations of the upper first molar teeth were not significantly changed as confirmed by postero-anterior radiograph. Overjet increased from 7.5 to 9 mm while the amount of overbite remained as 0 mm. It was determined by the model analysis that the increase in intermolar was 6.18 mm and intercanine widths was 5.21 mm. There was no significant change in lower teeth in model measurements.
Conclusions: It is seen that the presented appliance can achieve sutural expansion without any corticotomy in adult patients.
Key Words: Modified RME, Appliance, Adult patient, Corticotomy, MARPE

Keywords

Modified RME, Appliance, Adult patient, Corticotomy, MARPE

References

• 1. McNamaraa JA. Maxillary transverse deficiency. Am J Orthod Dentofac Orthoped. 2000;117(5):567-570.
• 2. Davidovitch M, Efstathiou S, Sarne O, Vardimon AD. Skeletal and dental response to rapid maxillary expansion with 2-versus 4-band appliances. Am J Orthodontics Dentofac Orthoped. 2005;127(4):483-492.
• 3. Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. Angle Orthodontist. 1961;31(2):73-90.
• 4. Wertz RA. Skeletal and dental changes accompanying rapid midpalatal suture opening. Am J Orthod. 1970;58(1):41-66.
• 5. Garib DG, Henriques JFC, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofac Orthoped. 2006;129(6):749-758.
• 6. Baysal A, Karadede I, Hekimoglu S, et al. Evaluation of root resorption following rapid maxillary expansion using cone-beam computed tomography. Angle Orthod. 2011;82(3):488-494.
• 7. Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofac Orthoped. 2008;134(1):8. e1-8. e11.
• 8. Alpern MC, Yurosko JJ. Rapid palatal expansion in adults: with and without surgery. Angle Orthod. 1987;57(3):245-263.
• 9. Lines PA. Adult rapid maxillary expansion with corticotomy. Am J Orthod Dentofacl Orthoped. 1975;67(1):44-56.
• 10. Mommaerts M. Transpalatal distraction as a method of maxillary expansion. Brit J Oral Maxillofaci Surg. 1999;37(4):268-272.
• 11. Çeken G. Kemik destekli ve hibrit apareylerle yapilan hizli üst çene genişletmesinin konik işinli bilgisayarli tomografi ile karşilaştirilmasi. Doktora tezi. Atatürk Üniversitesi Diş Hekimliği Fakültesi; 2013.
• 12. Bucci R, D'antò V, Rongo R, Valletta R, Martina R, Michelotti A. Dental and skeletal effects of palatal expansion techniques: a systematic review of the current evidence from systematic reviews and meta‐analyses. J Oral Rehabil. 2016;43(7):543-564.
• 13. Kılıç N, Kiki A, Oktay H. A comparison of dentoalveolar inclination treated by two palatal expanders. Eur J Orthod. 2008;30(1):67-72.
• 14. Basciftci F, Karaman A. Effects of a modified acrylic bonded rapid maxillary expansion appliance and vertical chin cap on dentofacial structures. Angle Orthod. 2002;72(1):61-71.
• 15. Odenrick L, Karlander OD, Eva Lilja, Pierce OD, Angela, FRACDS OD, Kretschmar U. Surface resorption following two forms of rapid maxillary expansion. Eur J Orthod. 1991;13(4):264-270.