title: Rapid maxillary expansion screws on the test bench--a pilot study.
abstract: In order to apply high, short-term forces during rapid maxillary expansion (RME) to the sutures of the maxilla with minimum loss of force and without causing unwanted side-effects (dentoalveolar tipping, etc.), the appliance should be as rigid as possible. The retention arms of the RME screws, representing a particularly vulnerable and stressed weak point of RME appliances, were the focus of this laboratory technical study. Retention arms of 16 types of RME screws comprising four arms and one with eight arms were examined using a three-point bending test. According to their ability to absorb the applied bending loads, the screws were classified in product groups from 1 (highest) to 6 (lowest). Fifteen of the tested retention arms (stainless steel), despite having the same diameter (1.48-1.49 mm), differed up to 69.81 per cent between the highest (288.0 N) and lowest (169.6 N) maximum force parameters and up to 66.40 per cent between the highest (3325.9 N/mm(2)) and lowest (1998.7 N/mm(2)) maximum bending stress parameters. Due to optimum formability, though reduced rigidity, a titanium screw for nickel-sensitive patients (group 6) displayed the lowest force and bending tension values. The stainless steel double arms of the eight-arm screw device welded on both ends displayed the highest force data. The mean ductilities of the groups with the most and least rigid single steel arms differed by 22.77 per cent. Statistical analysis using the Pearson correlation coefficient revealed a significant indirect correlation between ductility and both maximum force (r = -0.780, P < 0.001) and maximum bending stress (r = -0.778, P < 0.001). The SUPERscrews, the Tiger Dental four-arm screw (group 1), and the eight-arm screw displayed the highest capacity to absorb an applied bending load. The screws in groups 3-6 appear acceptable for RME during the pre-pubertal period, whereas in the pubertal and post-pubertal period, groups 1 and 2 are sufficient. In early adulthood only the screws in group 1 and especially the eight-arm screw seem advisable, as mechanical demands increase with age.
authors.affiliation: Department of Clinical Orthodontics and Dentofacial Orthodontics, Medical University Clinic of Graz, Austria. alfred.muchitsch@medunigraz.at
authors.forename: Alfred Peter
authors.initials: AP
authors.lastname: Muchitsch
authors.forename: B
authors.initials: B
authors.lastname: Wendl
authors.forename: H
authors.initials: H
authors.lastname: Winsauer
authors.forename: M
authors.initials: M
authors.lastname: Pichelmayer
authors.forename: M
authors.initials: M
authors.lastname: Payer
mesh_terms: D000367:Age Factors; D003722:Dental Alloys; D003799:Dental Stress Analysis; D006801:Humans; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D021362:Palate, Hard / Q000254:growth & development; D010865:Pilot Projects; D018583:Pliability; D013193:Stainless Steel; D013314:Stress, Mechanical
chemical_list: D003722:Dental Alloys; D013193:Stainless Steel