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...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2021-08-01
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| Series: | Journal of Clinical and Diagnostic Research |
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| Online Access: | https://jcdr.net/articles/PDF/15316/49911_CE[Ra1]_F[SK]_PF1(JY_RK)_PFA(SL).pdf |
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| author | Tamanna Hoque Dilip Srinivasan Sangeetha Morekonda Gnaneswar Sushil Chakravarthi Krishnaraj Rajaram |
| author_facet | Tamanna Hoque Dilip Srinivasan Sangeetha Morekonda Gnaneswar Sushil Chakravarthi Krishnaraj Rajaram |
| author_sort | Tamanna Hoque |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-21T06:11:39Z |
| format | Article |
| id | doaj.art-1362011a8cb0422a8c5fe66a19fc9529 |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-21T06:11:39Z |
| publishDate | 2021-08-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-1362011a8cb0422a8c5fe66a19fc95292022-12-21T19:13:31ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2021-08-01158ZE11ZE1510.7860/JCDR/2021/49911.15316Microimplant Assisted Rapid Palatal Expansion: A Comprehensive ReviewTamanna Hoque0Dilip Srinivasan1Sangeetha Morekonda Gnaneswar2Sushil Chakravarthi3Krishnaraj Rajaram4Postgraduate Student, Department of Orthodontics and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.Professor, Department of Orthodontics and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.Senior Lecturer, Department of Orthodontics and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.Reader, Department of Orthodontics and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.Professor, Department of Orthodontics and Dentofacial Orthopaedics, SRM Dental College, Ramapuram, Chennai, Tamil Nadu, India.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.https://jcdr.net/articles/PDF/15316/49911_CE[Ra1]_F[SK]_PF1(JY_RK)_PFA(SL).pdfbone-anchored maxillary expansionhybrid hyraxmaxillary skeletal expandermaxillary transverse deficiencymini-implant |
| spellingShingle | Tamanna Hoque Dilip Srinivasan Sangeetha Morekonda Gnaneswar Sushil Chakravarthi Krishnaraj Rajaram Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review Journal of Clinical and Diagnostic Research bone-anchored maxillary expansion hybrid hyrax maxillary skeletal expander maxillary transverse deficiency mini-implant |
| title | Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review |
| title_full | Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review |
| title_fullStr | Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review |
| title_full_unstemmed | Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review |
| title_short | Microimplant Assisted Rapid Palatal Expansion: A Comprehensive Review |
| title_sort | microimplant assisted rapid palatal expansion a comprehensive review |
| topic | bone-anchored maxillary expansion hybrid hyrax maxillary skeletal expander maxillary transverse deficiency mini-implant |
| url | https://jcdr.net/articles/PDF/15316/49911_CE[Ra1]_F[SK]_PF1(JY_RK)_PFA(SL).pdf |
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