Korean J Orthod.  2023 Sep;53(5):289-297. 10.4041/kjod23.056.

Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

• Paredes N
• Gargoum A
• Dominguez-Mompell R
• Colak O
• Bui J
• Duong T
• Giannetti M
• Silva F
• Brooks K
• Moon W

• KMID: 2546549
• DOI: http://doi.org/10.4041/kjod23.056

Abstract

Objective
To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT).
Methods
Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared.
Results
The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs (P > 0.05). The posterior MI to hemiplate line was greater than that anteriorly (P < 0.05). The apical distance between the posterior MIs was greater than that anteriorly (P < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly (P > 0.01).
Conclusions
In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.

Keyword

Expansion; Microimplant-assisted rapid palatal expansion; Maxillary skeletal expander; Bone-anchored maxillary expander

Figure

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  Figure 1 Cone-beam computed tomography landmarks for MSE fabrication. A, The green line on the axial view is at the level of the greater extension of the zygomatic buttress (seen in the coronal view). B, The orange line on the axial view corresponds to the midpalatal suture. Planned MSE jackscrew position on the axial and sagittal views. C, Bone thickness measurements on the coronal and sagittal cuts at the level of insertion of the right anterior microimplant. MSE, maxillary skeletal expander.

• 

  Figure 2 MSE II device (Biomaterials Korea, Seoul, Korea). One MSE II expansion turn is equivalent to 0.133 mm of activation of the jackscrew. One revolution is equivalent to 6 turns or activation of the jackscrew by 0.8 mm. MSE II-12 indicates that the expansion size is 12 mm, which is equivalent to 90 turns. MSE, maxillary skeletal expander.

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  Figure 3 Anterior-coronal-microimplant section identified on the coronal view.

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  Figure 4 Parameters evaluated in the study. IMIA, inter-microimplant angle; IMIAD, inter-microimplant apical distance; SOMI, suture opening at microimplant level; PTMI, palatal thickness at microimplant level; PA, plate angle; MIPA, microimplant to plate angle; IMIND, inter-microimplant neck distance.

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  Figure 5 A, MSE expansion showing a more parallel displacement of the anterior and posterior microimplants. B, MSE expansion displaying a wider displacement pattern for the posterior microimplants. MSE, maxillary skeletal expander.

Reference

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