4.3 Article

Comparison of skeletal maxillary transverse deficiency treated by microimplant-assisted rapid palatal expansion and tooth-borne expansion during the post-pubertal growth spurt stage: A prospective cone beam computed tomography study

Journal

ANGLE ORTHODONTIST
Volume 91, Issue 1, Pages 36-45

Publisher

E H ANGLE EDUCATION RESEARCH FOUNDATION, INC
DOI: 10.2319/041920-332.1

Keywords

Maxillary transverse deficiency; Microimplant-assisted rapid palatal expansion; Tooth-borne expansion; Post-pubertal growth spurt stage

Funding

  1. Scientific Research Common Program of Beijing Municipal Commission of Education [KM201610025022]
  2. Beijing Municipal Science & Technology Commission [Z161100000516202]

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The study demonstrated that MARPE is more effective in treating skeletal maxillary discrepancies during the post-pubertal growth spurt stage, achieving greater skeletal expansion and less buccal tipping and alveolar height loss on anchorage teeth compared to traditional Hyrax expanders.
Objective: To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. Materials and Methods: Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 +/- 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 +/- 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. Results: The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P < .01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P < .01). Conclusions: MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage.

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