title: Microimplant-assisted rapid palatal expansion appliance to orthopedically correct transverse maxillary deficiency in an adult.
abstract: This case report describes the use of a microimplant-assisted rapid palatal expansion (MARPE) appliance to orthopedically correct a transverse maxillary deficiency in an adult patient. Expansion forces transmitted through the teeth in traditional rapid palatal expansion appliances create unwanted dental effects rather than true skeletal expansion, particularly in older patients with more rigid interdigitation of the midpalatal suture. This 19-year-old patient had maxillary constriction with a unilateral posterior crossbite. A MARPE appliance secured to the palatal bones with 4 microimplants was expanded by 10 mm. Pre-MARPE and post-MARPE cone-beam computed tomography cross sections demonstrated 4 to 6 mm of expansion of the maxillofacial structures, including the zygoma and nasal bone area, and widening of the circummaxillary sutures. Minor buccal tipping of the dentition was observed, but the integrity of the alveolar bone was preserved. This report demonstrates that careful design and application of the MARPE appliance can achieve successful transverse expansion of the maxilla and the surrounding structures in a patient beyond the age typically considered acceptable for traditional rapid palatal expansion.
authors.affiliation: Private practice, Tustin, Calif.
authors.forename: Chuck
authors.initials: C
authors.lastname: Carlson
authors.affiliation: Graduate student, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Calif.
authors.forename: Jay
authors.initials: J
authors.lastname: Sung
authors.affiliation: Private practice, Culver City, Calif.
authors.forename: Ryan W
authors.initials: RW
authors.lastname: McComb
authors.affiliation: Associate professor, Department of Orthodontics, Universidade Federal da Bahia, Salvador, Bahia, Brazil.
authors.forename: Andre Wilson
authors.initials: AW
authors.lastname: Machado
authors.affiliation: Associate professor, Section of Orthodontics, School of Dentistry, Center for Health Science, University of California, Los Angeles, Calif. Electronic address: wmoon@dentistry.ucla.edu.
authors.forename: Won
authors.initials: W
authors.lastname: Moon
mesh_terms: D003131:Combined Modality Therapy; D006801:Humans; D008297:Male; D008310:Malocclusion / Q000628:therapy*; D016382:Orthodontic Appliance Design; D009967:Orthodontic Appliances; D019637:Orthopedic Procedures; D010155:Palatal Expansion Technique / Q000295:instrumentation*; D019736:Prostheses and Implants; D013997:Time Factors; D055815:Young Adult