Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review
Maxillary transverse deficiency routinely requires expansion of the palate. In prepubertal patients, Rapid Maxillary Expansion (RME) is a reliable treatment modality. However, in skeletally mature patients due to progressively interdigitated mid palatal suture, decreased elasticity of bone and inc...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2021-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15316/49911_CE[Ra1]_F[SK]_PF1(JY_RK)_PFA(SL).pdf |
| Summary: | Maxillary transverse deficiency routinely requires expansion of the palate. In prepubertal patients, Rapid Maxillary Expansion
(RME) is a reliable treatment modality. However, in skeletally mature patients due to progressively interdigitated mid palatal suture,
decreased elasticity of bone and increased stiffness of the osseous articulations of the maxilla with the adjoining bones, palatal
expansion becomes challenging. Patients are frequently suggested to opt for more invasive procedures, like the Surgically Assisted
Rapid Palatal Expansion (SARPE). The quest for minimally invasive expansion appliances with pure orthopaedic movement
led researchers to incorporate mini-implants with conventional RME. Microimplant Assisted Rapid Palatal Expansion (MARPE)
maximises skeletal expansion and minimises dentoalveolar undesirable effects and obviates the need for orthognathic surgery.
This comprehensive review aims to discuss MARPE as an effective, non surgical, minimally invasive treatment modality for
skeletally mature patients with maxillary transverse insufficiency. Furthermore, various designs of MARPE with different placement
sites, lengths, and numbers of miniscrews along with the latest technological advancements to improve diagnosis and treatment
planning using CBCT and intraoral scan, as well as the use of Computer-Aided Design/Computer-Aided Manufacturing (CAD-CAM)
technology to custom fabricate three dimensional (3D) miniscrew insertion surgical guide, 3D laser-printed metallic mini-implant
to enhance implant placement accuracy and comfort were discussed along with the clinical significance and limitations of the
MARPE. Maxillary Skeletal Expander (MSE) is a unique lineage of MARPE when combined with facemask results in distraction
osteogenesis like movement of midface and forms a promising basis for non surgical orthopaedic treatment modality for skeletal
class III mature patients. Bone-anchored maxillary expansion appliances provide better vertical control, especially beneficial for
hyperdivergent skeletal pattern patients. MARPE significantly increases transverse widths of the nasal floor, nasopharyngeal volume
and significantly lowers mean nasal airway resistance thereby facilitating nasal breathing. MARPE results in greater orthopaedic
expansion and safety, with fewer undesirable effects and high success rates. |
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| ISSN: | 2249-782X 0973-709X |