Orthopedic maxillary expansion in young adults: a case report
Abstract
This case report presents the orthodontic management of a 20-year-old male patient diagnosed with severe maxillary constriction, anterior open bite, and dental crowding. Treatment was performed using Mini screw-Assisted Rapid Palatal Expansion (MARPE) in combination with fixed orthodontic therapy. A digital workflow was used to design and manufacture the skeletally anchored expansion appliance as well as the placement guides, increasing accuracy and predictability of the outcome. Clinical and radiographic evaluations, including panoramic imaging and CBCT, confirmed orthopedic maxillary expansion, successful alignment and leveling of the dentition, intrusion of the lateral segments, and correction of the anterior open bite. This case demonstrates the clinical effectiveness of MARPE and digitally guided orthodontic approaches in young adult patients, offering a valid alternative to traditional methods when skeletal maturation limits their effectiveness.Keywords:
Maxillary Expansion, MARPE, Skeletal Anchorage, Orthodontics, Maxillary Constriction, Temporary Anchorage Devices (TADs), Non-Surgical Maxillary ExpansionDownloads
References
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Lee, K. J., Y. C. Park, J. Y. Park, W. S. Hwang, K. H. Kim, and Y. J. Choi. 2010. “Miniscrew-assisted Rapid Palatal Expansion (MARPE): A New Paradigm in Maxillary Expansion for Young Adults.” Am. J. Orthod. Dentofacial Orthop. 137(6):832–842. doi:10.1016/j.ajodo.2009.05.018.
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Moon, W., K. W. Wu, A. W. Machado, and B. M. Machado. 2021. “The Efficacy of MARPE in Late Adolescents and Adults: A Systematic Review and Meta-analysis.” Angle Orthod. 91(6):873–885. doi:10.2319/012421-63.1.
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Cantarella, D., R. Dominguez-Mompell, C. E. Moschik, H. C. Pan, J. Miller, and W. Moon. 2018. “Midfacial Changes Following Maxillary Expansion with a Bone-borne Appliance: A CBCT-based Study.” Int. J. Oral Maxillofac. Surg. 47(5):619–626. doi:10.1016/j.ijom.2017.09.004.
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Handelman, C. S., L. Wang, E. A. BeGole, and A. J. Haas. 2000. “Nonsurgical Rapid Maxillary Expansion in Adults: Report on 47 Cases Using the Haas Expander.” Angle Orthod. 70(2):129–144.
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Ludwig, B., S. Baumgaertel, B. Zorkun, L. Bonitz, B. Glasl, and J. A. Lisson. 2012. “Application of a New Viscoelastic Spring System for the Correction of Anterior Open Bite.” J. Orofac. Orthop. 73(1):35–43. doi:10.1007/s00056-011-0065-5.
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Lagravère, M. O., J. Carey, G. Heo, R. W. Toogood, and P. W. Major. 2010. “Transverse, Vertical, and Anteroposterior Changes from Bone-anchored Maxillary Expansion vs Traditional RPE in Adolescents: A Randomized Clinical Trial.” Am. J. Orthod. Dentofacial Orthop. 137(3):304.e1–304.e12. doi:10.1016/j.ajodo.2008.09.027.
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Garib, D. G., J. F. Henriques, G. Janson, M. R. Freitas, and R. A. Coelho. 2005. “Rapid Maxillary Expansion—Tooth-tissue-borne vs Tooth-borne Expanders: A Computed Tomography Evaluation of Dentoskeletal Effects.” Angle Orthod. 75(4):548–557.
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Lin, L., H. W. Ahn, S. J. Kim, S. C. Moon, G. Nelson, and S. H. Kim. 2015. “Tooth-borne vs Bone-borne Rapid Maxillary Expanders in Late Adolescence: A CBCT Study.” Angle Orthod. 85(2):253–262. doi:10.2319/052114-350.1.
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Wilmes, B., B. Ludwig, S. Vasudavan, M. Nienkemper, and D. Drescher. 2016. “The T-Zone: A Guide for Placement of Palatal Mini-implants.” J. Clin. Orthod. 50(9):543–551.
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Chugh, T., S. V. Ganeshkar, A. V. Revankar, A. K. Jain, and A. R. Parikh. 2019. “Emerging Trends in Digital Orthodontics.” J. Indian Orthod. Soc. 53(4):232–241. doi:10.1177/0301574219879510. Spiro Hashoti, Ilda Gribizi, Elona Kongo, Pajtim Rexha, Beatrice Manes Gravina
References
Lee, K. J., Y. C. Park, J. Y. Park, W. S. Hwang, K. H. Kim, and Y. J. Choi. 2010. “Miniscrew-assisted Rapid Palatal Expansion (MARPE): A New Paradigm in Maxillary Expansion for Young Adults.” Am. J. Orthod. Dentofacial Orthop. 137(6):832–842. doi:10.1016/j.ajodo.2009.05.018.
Moon, W., K. W. Wu, A. W. Machado, and B. M. Machado. 2021. “The Efficacy of MARPE in Late Adolescents and Adults: A Systematic Review and Meta-analysis.” Angle Orthod. 91(6):873–885. doi:10.2319/012421-63.1.
Cantarella, D., R. Dominguez-Mompell, C. E. Moschik, H. C. Pan, J. Miller, and W. Moon. 2018. “Midfacial Changes Following Maxillary Expansion with a Bone-borne Appliance: A CBCT-based Study.” Int. J. Oral Maxillofac. Surg. 47(5):619–626. doi:10.1016/j.ijom.2017.09.004.
Handelman, C. S., L. Wang, E. A. BeGole, and A. J. Haas. 2000. “Nonsurgical Rapid Maxillary Expansion in Adults: Report on 47 Cases Using the Haas Expander.” Angle Orthod. 70(2):129–144.
Ludwig, B., S. Baumgaertel, B. Zorkun, L. Bonitz, B. Glasl, and J. A. Lisson. 2012. “Application of a New Viscoelastic Spring System for the Correction of Anterior Open Bite.” J. Orofac. Orthop. 73(1):35–43. doi:10.1007/s00056-011-0065-5.
Lagravère, M. O., J. Carey, G. Heo, R. W. Toogood, and P. W. Major. 2010. “Transverse, Vertical, and Anteroposterior Changes from Bone-anchored Maxillary Expansion vs Traditional RPE in Adolescents: A Randomized Clinical Trial.” Am. J. Orthod. Dentofacial Orthop. 137(3):304.e1–304.e12. doi:10.1016/j.ajodo.2008.09.027.
Garib, D. G., J. F. Henriques, G. Janson, M. R. Freitas, and R. A. Coelho. 2005. “Rapid Maxillary Expansion—Tooth-tissue-borne vs Tooth-borne Expanders: A Computed Tomography Evaluation of Dentoskeletal Effects.” Angle Orthod. 75(4):548–557.
Lin, L., H. W. Ahn, S. J. Kim, S. C. Moon, G. Nelson, and S. H. Kim. 2015. “Tooth-borne vs Bone-borne Rapid Maxillary Expanders in Late Adolescence: A CBCT Study.” Angle Orthod. 85(2):253–262. doi:10.2319/052114-350.1.
Wilmes, B., B. Ludwig, S. Vasudavan, M. Nienkemper, and D. Drescher. 2016. “The T-Zone: A Guide for Placement of Palatal Mini-implants.” J. Clin. Orthod. 50(9):543–551.
Chugh, T., S. V. Ganeshkar, A. V. Revankar, A. K. Jain, and A. R. Parikh. 2019. “Emerging Trends in Digital Orthodontics.” J. Indian Orthod. Soc. 53(4):232–241. doi:10.1177/0301574219879510. Spiro Hashoti, Ilda Gribizi, Elona Kongo, Pajtim Rexha, Beatrice Manes Gravina
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