Korean J Orthod.  2017 Mar;47(2):77-86. 10.4041/kjod.2017.47.2.77.

Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: A cone-beam computed tomography study

• Park JJ
• Park YC
• Lee KJ
• Cha JY
• Tahk JH
• Choi YJ

• KMID: 2400385
• DOI: http://doi.org/10.4041/kjod.2017.47.2.77

Abstract

OBJECTIVE
The aim of this study was to evaluate the skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion (MARPE) in young adults by cone-beam computed tomography (CBCT).
METHODS
This retrospective study included 14 patients (mean age, 20.1 years; range, 16-26 years) with maxillary transverse deficiency treated with MARPE. Skeletal and dentoalveolar changes were evaluated using CBCT images acquired before and after expansion. Statistical analyses were performed using paired t-test or Wilcoxon signed-rank test according to normality of the data.
RESULTS
The midpalatal suture was separated, and the maxilla exhibited statistically significant lateral movement (p < 0.05) after MARPE. Some of the landmarks had shifted forwards or upwards by a clinically irrelevant distance of less than 1 mm. The amount of expansion decreased in the superior direction, with values of 5.5, 3.2, 2.0, and 0.8 mm at the crown, cementoenamel junction, maxillary basal bone, and zygomatic arch levels, respectively (p < 0.05). The buccal bone thickness and height of the alveolar crest had decreased by 0.6-1.1 mm and 1.7-2.2 mm, respectively, with the premolars and molars exhibiting buccal tipping of 1.1°-2.9°.
CONCLUSIONS
Our results indicate that MARPE is an effective method for the correction of maxillary transverse deficiency without surgery in young adults.

Keyword

Cone-beam computed tomography; Miniscrew-assisted rapid palatal expansion; Adults; Expansion

MeSH Terms

Adult
Bicuspid
Cone-Beam Computed Tomography*
Crowns
Humans
Maxilla
Methods
Molar
Retrospective Studies
Sutures
Tooth Cervix
Young Adult*
Zygoma

Figure

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  Figure 1 Clinical application of miniscrew-assisted rapid palatal expansion.

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  Figure 2 Three-dimensional tooth models used for the cone-beam computed tomography assessment of interpremolar and intermolar widths after miniscrew-assisted rapid palatal expansion. Solid arrow, interpremolar width; dashed arrow, intermolar width.

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  Figure 3 Two-dimensional posteroanterior cephalogram reconstructed from a three-dimensional skull model. Refer to Table 1 for the definitions of abbreviations.

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  Figure 4 Superimposition of three-dimensional cone-beam computed tomography images acquired before (white) and after (blue) miniscrew-assisted rapid palatal expansion. 1 and 2, alare, right and left; 3 and 4, A-point, right and left; 5 and 6, prosthion, right and left; 7 and 8, ectocanine, right and left; 9 and 10, ectomolare, right and left; 11 and 12, processus zygomaticus, right and left.

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  Figure 5 Coronal cone-beam computed tomography images acquired before expansion at furcations of the first premolar (left) and first molar (right). a, buccal bone thickness; b, buccal alveolar height. Buccal bone thickness and alveolar height were measured on the right and left sides, and the mean value of the two measurements was calculated.

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