Miniscrew-assisted rapid palatal expansion (MARPE) protocols applied in different ages and stages of maturation of the midpalatal suture: cases report
DOI:
https://doi.org/10.33448/rsd-v10i11.19480Keywords:
Palatal expansion technique; Orthodontic anchorage procedures; Transverse maxillary atresia; Microimplant-assisted rapid palatal expansion; Case report.Abstract
Objective: To evaluate the Microimplant-assisted Rapid Palatal Expansion (MARPE), considered an alternative to surgical interventions for disjunction of the midpalatal suture in adolescent patients and young adults with maxillary transverse deficiency. The stage of ossification of the midpalatal suture, bone quality and adequate activation protocols are factors that can influence the quantity and quality of the orthopedic separation. Methodology: This paper demonstrates the application of MARPE in an unfavorable case report, of an adult patient with total crossbite, in an advanced stage of fusion of the palatine and maxillary processes, with poverty in the posterior bone volume, in comparison with the same therapy in an adolescent at an earlier stage of sutural maturation. In both cases, after tomographic examinations and oral scanning, the installations and recommended activation protocol were performed. These were not sufficient in the case of the adult patient, and generated side effects that, to be overcome, required changes in activations and additional maneuvers. Results: The application of MARPE may require clinical versatility to adopt differentiated protocols in relation to chronological age, bone thickness and sutural ossification stage. Conclusion: In the end, new computer tomography scans and a clinical examination showed satisfactory results in both patients. In the unfavorable case, the opening of the midpalatal suture occurred at more modest levels, but it was sufficient to correct the posterior crossbite.
References
Aloufi, F., Preston, C. & Zawawi, K. (2012). Changes in the Upper and Lower Pharyngeal Airway Spaces Associated with Rapid Maxillary Expansion. ISRN Dentistry;1-5.
André, C. Análise tomográfica para a técnica MARPE. (2018). Revista Clínica de Ortodontia Dental Press.17(4):50-53.
Angelieri, F., Cevidanes, L., Franchi, L., Gonçalves, J., Benavides, E. & Mc Namara Jr, J (2013). Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion. American Journal Orthodontic and Dentofacial Orthopedic; 144(5):759-769.
Angelieri, F., Franchi, L., Cevidanes, L., Bueno-Silva, B. & Mc Namara Jr., J. (2016) Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT. Dental Press Journal Orthodontic; 21(6):115-125.
Angelieri, F., Franchi, L., Cevidanes, L., Gonçalves, J., Nieri, M. & Wolford L et al. Cone beam computed tomography evaluation of midpalatal suture maturation in adults. Internacional Journal Oral Maxillofacial Surgeous. 2017; 46(12):1557-1561.
Brunetto, D. P., Sant’Anna, E. F., Machado, A. W. & Moon, W. (2017) Non-surgical treatment of transverse deficiency in adults using microimplant-assisted Rapid Palatal Expansion (MARPE). Dental Press Journal Orthodontic. 22(1):110-25.
Choi, S., Shi, K., Cha. J., Park, Y., & Lee, K (2016): Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthodontic. 86(5):713-720.
Garcez, A., Suzuki, S., Storto, C., Cusmanich, K., Elkenawy, I. & Moon, W. (2019). Effects of maxillary skeletal expansion on respiratory function and sport performance in a para-athlete – A case report. Physical Therapy Sport. 36:70-77.
Grünheid, T., Larson, C., & Larson, B. (2017): Midpalatal suture density ratio: A novel predictor of skeletal response to rapid maxillary expansion. American Journal Orthodontic and Dentofacial Orthopedic; 151(2):267-276.
Gurgel, J.A.: Marpe: Expandindo os limites da Ortodontia. Maringá: Editora Dental Press, 2019.
Korbmacher, H., Schilling, A., Püschel, K., Amling, M. & Kahl-Nieke, B (2007). Age-dependent Three-dimensional Microcomputed Tomography Analysis of the Human Midpalatal Suture. Journal of Orofacial Orthopedics / Fortschritte der Kieferorthopädie. 68(5):364-376.
Lee, K.J., Park, Y.C., Park, J.Y. & Hwang, W.S. (2010): Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. American Journal Orthodontic and Dentofacial Orthopedic; 137:830-839.
MacGinnis, M., Chu, H., Youssef, G., Wu, K., Machado, A. & Moon, W. (2014). The effects of micro-implant assisted rapid palatal expansion (MARPE) on the nasomaxillary complex — a finite element method (FEM) analysis. Prognostic Orthodontic. 15(1).
Machado, A., Crespo, A. & Pauna, H. (2018). Rapid maxillary expansion in pediatric patients with obstructive sleep apnea: current and future perspectives. Sleep Medicine. 7-8.
Matsuyama, Y., Motoyoshi, M., Tsurumachi, N. & Shimizu, N. (2014). Effects of palate depth, modified arm shape, and anchor screw on rapid maxillary expansion: a finite element analysis. European Journal Orthodontic. 37(2):188-193.
McNamara Jr., Lione, R., Franchi, L., Angelieri, F., Cevidanes, L. & Darendeliler, M. et al. (2015). The role of rapid maxillary expansion in the promotion of oral and general health. Prognostic Orthodontic; 16(1).
Nojima, L. I., Nojima, M. C. G, Cunha, A. C., Guss, N. O. & Sant’Anna, E. F (2018). Mini-implant selection protocol applied to MARPE. Dental Press Journal Orthodontic.; 23(5):93-101.
Rossi, R., Araújo, M. & Bolognese, A. (2009): Expansão maxilar em adultos e adolescentes com maturação esquelética avançada. Revista Dental Press de Ortodontia e Ortopedia Facial;14(5):43-52.
Seong, E., Choi, S., Kim, H., Yu, H., Park, Y. & Lee, K. (2018). Evaluation of the effects of miniscrew incorporation in palatal expanders for young adults using finite element analysis. Korean Journal Orthodontic; 48(2):81.
Shin, H., Hwang, C., Lee, K., Choi, Y., Han, S. & Yu, H. (2019). Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: A preliminary study. Korean Journal Orthodontic;49(6):360.
Silva Filho, O., Garib, D. & Lara, T. (2013) Ortodontia interceptiva: protocolo de tratamento em duas fases. Editora Artes Médicas.
Suzuki, S. S., Braga, L. S. F., Fujii, D. N., Moon, W. & Suzuki, H. (2018). Corticopuncture Facilitated Microimplant-Assisted Rapid Palatal Expansion. Case Reports in Dentistry. 12. https://doi.org/10.1155/2018/1392895.
Suzuki. H., Moon, W., Pevidente, L. H., Suzuki, S. S., Garcez, A. S. & Consolaro, A. Expansão rápida da maxila assistida com mini-implantes MARPE: em busca de um movimento ortopédico puro. Revista Clínica de Ortodontia Dental Press. 2016;15(2) 100-108.
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Copyright (c) 2021 Marcelo de Melo Quintela; Sabrina Buchmann Rossi; Katty Lalangui Vera; Jaime Cordova Peralta; Isaias Donizeti Silva; Letícia Alecrim de Souza; Caio Vinicius Gonçalves Roman-Torres; Heloísa Fonseca Marao; Wilson Roberto Sendyk; Angélica Castro Pimentel
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