Skeletal effects of mini-implant assisted rapid palatal expansion (MARPE) on the sagittal dimensions of the maxilla an in-vivo cone-beam computed tomography (CBCT) study

DR Shymal vairagi; 2	DR ASHWITH HEGDE; 3	DR AJIT KALIA; 4	DR SALIL NENE; DR AMIT RAJA

doi:10.5937/sejodr8-24870

DR Shymal vairagi MDS IN ORTHODONTICS MA Rangoonwala dental college,pune
2 DR ASHWITH HEGDE M.D.S (professor) MA Rangoonwala dental college,pune
3 DR AJIT KALIA M.D.S(professor and HOD) MA Rangoonwala dental college,pune
4 DR SALIL NENE M.D.S (professor) MA Rangoonwala dental college,pune
DR AMIT RAJA MDS IN ORTHODONTICS

DOI: https://doi.org/10.5937/sejodr8-24870

Abstract

Introduction -Transverse discrepancies of the maxilla are one of the most prevalent skeletal problems. Due to drawbacks of conventional RPE and invasive surgical expansion methods alternative methods were developed such as Mini Implant-supported rapid maxillary expansion (MARPE).Haas¹⁷ , Davis and Kronman^18,Akkaya et al¹⁹ and many other studies have reported the maxillary response after MARPE on the sagittal dimensions, but their results were inconclusive.

Aim - This study analyzed the effects on the maxilla in the sagittal dimension after Mini Implant assisted rapid palatal expansion (MARPE) in adolescents using CBCT.

Material and method -A pretreatment CBCT image (T1) was taken as a standard initial record for all patients and post treatment CBCT (T2) was taken after three months in retention. The parameters SNA angle, Frankfort horizontal plane to NA angle, A-N perpendicular, ANS –PNS were measured and calculated for evaluation of the sagittal maxillary changes. Comparisons were then made between the two treatment groups (T1, T2).

Result -There was a positive increase in both angular and linear measurements from pretreatment to post treatment measurements showing significant skeletal changes in sagittal dimension.

Conclusion -The study concludes that there was statistically significant forward displacement of maxilla after transverse skeletal expansion in patients with transverse problems achieved through MARPE in adolescent patients.

References

McNamaraa JA. Maxillary transverse deficiency. American Journal of Orthodontics and Dentofacial Orthopedics. 2000 May 1;117(5):567-70.

Malandris M, Mahoney EK. Aetiology, diagnosis and treatment of posterior cross‐bites in the primary dentition. International journal of paediatric dentistry. 2004 May 1;14(3):155-66.

Belluzzo RH, Faltin Junior K, Lascala CE, Vianna LB. Maxillary constriction: Are there differences between anterior and posterior regions?. Dental Press Journal of Orthodontics. 2012 Aug;17(4):1-6.

Habeeb M, Boucher N, Chung CH. Effects of rapid palatal expansion on the sagittal and vertical dimensions of the maxilla: a study on cephalograms derived from cone-beam computed tomography. American Journal of Orthodontics and Dentofacial Orthopedics. 2013 Sep 1;144(3):398-403.

Wilmes B, Nienkemper M, Drescher D. Application and effectiveness of a mini-implant- and tooth-borne rapid palatal expansion device: the hybrid hyrax. World J Orthod. 2010;11(4):323–30

Lee K-J, Park Y-C, Park J-Y, Hwang W-S. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop. 2010 Jun;137(6):830–9.

Haas AJ. Rapid expansion of the maxillary dental arch and nasal cavity by opening the midpalatal suture. The Angle Orthodontist. 1961 Apr;31(2):73-90.

Davis WM, Kronman JH. Anatomical changes induced by splitting of the midpalatal suture. The Angle Orthodontist. 1969 Apr;39(2):126-32.

Akkaya S, Lorenzon S, Üçem TT. A comparison of sagittal and vertical effects between bonded rapid and slow maxillary expansion procedures. The European Journal of Orthodontics. 1999 Apr 1;21(2):175-80.

Angelieri F, Cevidanes LH, Franchi L, Gonçalves JR, Benavides E, McNamara Jr JA. Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. American Journal of Orthodontics and Dentofacial Orthopedics. 2013 Nov 1;144(5):759-69.

Garret 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 Dentofacial Orthop. 2008;134(1):8-9.

Bernard Rosner. Fundamentals of Biostatistics, 2000, 5th Edition, Duxbury, page 80-240.

Robert H Riffenburg. Statistics in Medicine 2005, 2nd Edition, Academic press. 85-125.

Sunder Rao P, Richard J, An Introduction to Biostatistics, A manual for students in health sciences, New Delhi: Prentice hall of India. 2006; 4th Edition, 86-160.

Suzuki H, Moon W, Previdente LH, Suzuki SS, Garcez AS, Consolaro A. Miniscrew-assisted rapid palatal expander (MARPE): the quest for pure orthopedic movement. Dental press journal of orthodontics. 2016 Aug;21(4):17-23.

Podesser B, Williams S, Crismani AG, Bantleon HP. Evaluation of the effects of rapid maxillary expansion in growing children using computer tomography scanning: a pilot study. The European Journal of Orthodontics. 2007 Feb 1;29(1):37-44.

Baccetti T, Franchi L, Cameron CG, McNamara Jr JA. Treatment timing for rapid maxillary expansion. The Angle Orthodontist. 2001 Oct;71(5):343-50.

Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. American journal of orthodontics. 1977 Jul 1;72(1):42-52.

Ludwig B, Glasl B, Bowman SJ, Wilmes B, Kinzinger GS, Lisson JA. Anatomical guidelines for miniscrew insertion: palatal sites. Journal of clinical orthodontics: JCO. 2011 Aug;45(8):433-1

Park CS, Park JK, Kim H, Han SS, Jeong HG, Park H. Comparison of conventional lateral cephalograms with corresponding CBCT radiographs. Imaging science in dentistry. 2012 Dec 1;42(4):201-5.

Periago DR, Scarfe WC, Moshiri M, Scheetz JP, Silveira AM, Farman AG. Linear accuracy and reliability of cone beam CT derived 3-dimensional images constructed using an orthodontic volumetric rendering program. Angle Orthod 2008;78:387-95

Chung CH, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. American journal of orthodontics and dentofacial orthopedics. 2004 Nov 1;126(5):569-75.

Basciftci FA, Mutlu N, Karaman AI, Malkoc S, Küçükkolbasi H. Does the timing and method of rapid maxillary expansion have an effect on the changes in nasal dimensions?. The Angle Orthodontist. 2002 Apr;72(2):118-23.

Kim SY, Park YC, Lee KJ, Lintermann A, Han SS, Yu HS, Choi YJ. Assessment of changes in the nasal airway after nonsurgical miniscrew-assisted rapid maxillary expansion in young adults. The Angle Orthodontist. 2018 Mar 23;88(4):435-41.

Barros SE, Hoffelder L, Araújo F, Janson G, Chiqueto K, Ferreira E. Short-term impact of rapid maxillary expansion on ectopically and normally erupting canines. American Journal of Orthodontics and Dentofacial Orthopedics. 2018 Oct 1;154(4):524-34.

Kossack C, Jost-Brinkmann PG. Plaque and gingivitis reduction in patients undergoing orthodontic treatment with fixed appliances—comparison of toothbrushes and interdental cleaning aids. Journal of Orofacial Orthopedics/Fortschritte der Kieferorthopädie. 2005 Jan 1; 66(1):20-38.

Bock NC, Von Bremen J, Kraft M, Ruf S. Plaque control effectiveness and handling of interdental brushes during multibracket treatment—a randomized clinical trial. The European Journal of Orthodontics. 2009 Dec 3;32(4):408-13.