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OBJECTIVE: : To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. OBJECTIVE: measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). RESULTS: : Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. CONCLUSIONS: : Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.

Class III malocclusion prevalence varies significantly among racial groups, with the highest prevalence observed in southeast Asian populations at 15.80%. These malocclusions often involve maxillary retrognathism, mandibular prognathism, or both, accompanied by maxillary constriction and crossbites. Comprehensive treatment should address anteroposterior, transverse, and vertical imbalances. Microimplant-assisted rapid palatal expansion (MARPE) has shown high success rates for transverse maxillary expansion in late adolescents and adults, presenting a viable alternative to surgically-assisted rapid palatal expansion (SARPE). This case report aims to demonstrate the successful treatment of a young adult female with borderline Class III malocclusion using MARPE and mandibular backward rotation (MBR) techniques. A 21-year-old female presented with a Class III skeletal pattern, anterior/posterior crossbites, and mild dental crowding. Despite her concerns about a concave facial profile, the patient declined orthognathic surgery due to a negative experience reported by a friend. The treatment plan included MARPE to correct maxillary transverse deficiency and MBR to alleviate Class III malocclusion severity. Lower arch distalization was performed using temporary anchorage devices (TADs) on the buccal shelves, and Class II elastics were used to maintain MBR and prevent retroclination of the lower labial segment during anterior retraction. Significant transverse correction was achieved, and the severity of Class III malocclusion was reduced. The lower dentition was effectively retracted, and the application of Class II elastics helped maintain MBR. The patient's final facial profile was harmonious, with well-aligned dentition and a stable occlusal relationship. The treatment results were well-maintained after one year. The MARPE with MBR approach presents a promising alternative for treating borderline Class III cases, particularly for patients reluctant to undergo orthognathic surgery. This case report highlights the effectiveness of combining MARPE and MBR techniques in achieving stable and satisfactory outcomes in the treatment of Class III malocclusion. [ABSTRACT FROM AUTHOR]

Class III malocclusion prevalence varies significantly among racial groups, with the highest prevalence observed in southeast Asian populations at 15.80%. These malocclusions often involve maxillary retrognathism, mandibular prognathism, or both, accompanied by maxillary constriction and crossbites. Comprehensive treatment should address anteroposterior, transverse, and vertical imbalances. Microimplant-assisted rapid palatal expansion (MARPE) has shown high success rates for transverse maxillary expansion in late adolescents and adults, presenting a viable alternative to surgically-assisted rapid palatal expansion (SARPE). This case report aims to demonstrate the successful treatment of a young adult female with borderline Class III malocclusion using MARPE and mandibular backward rotation (MBR) techniques. A 21-year-old female presented with a Class III skeletal pattern, anterior/posterior crossbites, and mild dental crowding. Despite her concerns about a concave facial profile, the patient declined orthognathic surgery due to a negative experience reported by a friend. The treatment plan included MARPE to correct maxillary transverse deficiency and MBR to alleviate Class III malocclusion severity. Lower arch distalization was performed using temporary anchorage devices (TADs) on the buccal shelves, and Class II elastics were used to maintain MBR and prevent retroclination of the lower labial segment during anterior retraction. Significant transverse correction was achieved, and the severity of Class III malocclusion was reduced. The lower dentition was effectively retracted, and the application of Class II elastics helped maintain MBR. The patient’s final facial profile was harmonious, with well-aligned dentition and a stable occlusal relationship. The treatment results were well-maintained after one year. The MARPE with MBR approach presents a promising alternative for treating borderline Class III cases, particularly for patients reluctant to undergo orthognathic surgery. This case report highlights the effectiveness of combining MARPE and MBR techniques in achieving stable and satisfactory outcomes in the treatment of Class III malocclusion.

Introduction: This study investigated the factors of the effectiveness of microimplant-assisted rapid palatal expansion (MARPE) in late adolescents and adults, such as age, midpalatal suture maturation (MPSM) stage, palate length (PL), palatal index (PI), and midpalatal bone thickness (MBT), and at each microimplant position, the palate bone thickness (PBT), the nasal cortical bone thickness (CoTN), the cancellous bone thickness (CaT), and the palate cortical bone thickness (CoTP) were evaluated. Methods: Cone-beam computed tomography (CBCT) images of 50 patients (mean, 23.30 ± 7.03 years; range, 16–51 years) treated with MARPE were evaluated. Maxillary expansion ratio (MER) was used to assess the MARPE effectiveness and grouped patients into low and high MER groups according to the mean of MER. MER was the ratio of maxillary expansion width to MARPE screw expansion measured in CBCT images. The t-test was used to analyze the differences between the low and high MER groups. The Pearson correlation test was performed to investigate the correlation between MER and age, MPSM stage, PL, PI, MBT, PBT, CoTN, CaT, and CoTP. Results: Age, MPSM stage, and MBT in regions 18 mm and 21 mm behind the incisor foramen correlated negatively with MER ( r = - 0.340 , − 0.390, − 0.386, and − 0.335, respectively, all P < 0.05 ), whereas PBT and CoTN of anterior microimplant positions correlated positively with MER ( r = 0.365 and 0.418, respectively, all P < 0.01 ). No correlation was observed between other variables and MER. Conclusions: MARPE effectiveness decreased as age and midpalatal suture maturation stage increased, respectively. Thinner midpalatal suture bone in regions 18 mm and 21 mm behind the incisor foramen, thicker palate bone, and nasal cortical bone of anterior microimplant positions were related to more effective MARPE. Clinical relevance: In patients with older chronological age and later MPSM stages, MARPE effectiveness might be unsatisfactory. Clinicians should carefully evaluate the palate bone thickness before MARPE treatment. [ABSTRACT FROM AUTHOR]

Microimplant-assisted rapid palatal expansion (MARPE) has been demonstrated successfully in maxillary expansion in late adolescence and adulthood. The maxillary advancement accompanied by expansion is frequently anticipated, which is beneficial for the treatment of class III malocclusion. Airway volume increase can also be noted in some cases from the measurement of cone beam computerized tomography (CBCT) after expansion. The objective of this case report is to demonstrate the feasibility of applying MARPE on late adolescence patients with maxillary transverse deficiency and to present the changes in transverse and anteroposterior dimensions as well as the volume increase in velopharyngeal airway after MARPE. A 15-year-old female presented class III skeletal pattern. She had maxillary transverse deficiency with moderate crowding and posterior/anterior crossbites. Maxillary Skeletal Expander (MSE; Biomaterials Korea Inc.) type-2 was used as a MARPE device in this case. After four weeks of maxillary expansion, a significant amount of expansion was achieved and the anterior crossbite was spontaneously corrected. Fixed appliance treatment was commenced four weeks after MARPE with 0.022-slot preadjusted brackets (MBT prescription). Temporary anchorage devices (TADs) were placed over the mandibular buccal shelves for posterior teeth distalization and crowding relief. After 25 months of treatment, the facial profile was improved with maxillary advancement (SNA: 83° to 83.5°) and mandibular backward rotation (SNB: 83° to 82°; SN-MP: 34.5° to 35°). In this case, MARPE not only engenders significant transverse correction but also aids in anteroposterior change. The treatment effects of maxillary advancement and mandibular backward rotation can lead to a more esthetic profile in skeletal class III cases. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the possible predictors of success of microimplant-assisted rapid palatal expansion (MARPE) in skeletally mature patients. Additionally, factors associated with the amount of maxillary expansion were analyzed. Factors associated with MARPE success were analyzed in 53 adult patients (27 males, 26 females, mean age 25.8 ± 8.9 years, and range 18.0 to 56.6 years) who had a maxillary transverse deficiency greater than 2 mm and a cervical vertebral maturation stage of 6. Age at pretreatment (T1), sex, sutural bone density at T1, type of appliance, mode of microimplant fixation, and lateral cephalometric variables at T1 were considered for inclusion as predictors for MARPE success. In patients who showed successful maxillary skeletal expansion, the linear distances of maxillary widths were measured on cone-beam-computed-tomography images at T1 and after MARPE (T2), and factors associated with the amount of expansion were analyzed. In total, 41 of the 53 patients showed successful maxillary expansion. Age (p = 0.019), sex (p = 0.002), and A-N perp (p = 0.015) were significantly associated with the success of MARPE. The factors associated with the amount of maxillary skeletal expansion were SN-MP and midpalatal-suture density at T1. In conclusion, there is a greater chance of failure in male patients who are older and have maxillary retrusion. A greater amount of maxillary expansion can be expected in patients with a higher mandibular-plane angle and with lower midpalatal-suture density. [ABSTRACT FROM AUTHOR]

Microimplant-assisted rapid palatal expansion (MARPE) has been demonstrated successfully in maxillary expansion in late adolescence and adulthood. The maxillary advancement accompanied by expansion is frequently anticipated, which is beneficial for the treatment of class III malocclusion. Airway volume increase can also be noted in some cases from the measurement of cone beam computerized tomography (CBCT) after expansion. The objective of this case report is to demonstrate the feasibility of applying MARPE on late adolescence patients with maxillary transverse deficiency and to present the changes in transverse and anteroposterior dimensions as well as the volume increase in velopharyngeal airway after MARPE. A 15-year-old female presented class III skeletal pattern. She had maxillary transverse deficiency with moderate crowding and posterior/anterior crossbites. Maxillary Skeletal Expander (MSE; Biomaterials Korea Inc.) type-2 was used as a MARPE device in this case. After four weeks of maxillary expansion, a significant amount of expansion was achieved and the anterior crossbite was spontaneously corrected. Fixed appliance treatment was commenced four weeks after MARPE with 0.022-slot preadjusted brackets (MBT prescription). Temporary anchorage devices (TADs) were placed over the mandibular buccal shelves for posterior teeth distalization and crowding relief. After 25 months of treatment, the facial profile was improved with maxillary advancement (SNA: 83° to 83.5°) and mandibular backward rotation (SNB: 83° to 82°; SN-MP: 34.5° to 35°). In this case, MARPE not only engenders significant transverse correction but also aids in anteroposterior change. The treatment effects of maxillary advancement and mandibular backward rotation can lead to a more esthetic profile in skeletal class III cases.

The purpose of this study was to investigate the possible predictors of success of microimplant-assisted rapid palatal expansion (MARPE) in skeletally mature patients. Additionally, factors associated with the amount of maxillary expansion were analyzed. Factors associated with MARPE success were analyzed in 53 adult patients (27 males, 26 females, mean age 25.8 ± 8.9 years, and range 18.0 to 56.6 years) who had a maxillary transverse deficiency greater than 2 mm and a cervical vertebral maturation stage of 6. Age at pretreatment (T1), sex, sutural bone density at T1, type of appliance, mode of microimplant fixation, and lateral cephalometric variables at T1 were considered for inclusion as predictors for MARPE success. In patients who showed successful maxillary skeletal expansion, the linear distances of maxillary widths were measured on cone-beam-computed-tomography images at T1 and after MARPE (T2), and factors associated with the amount of expansion were analyzed. In total, 41 of the 53 patients showed successful maxillary expansion. Age (p = 0.019), sex (p = 0.002), and A-N perp (p = 0.015) were significantly associated with the success of MARPE. The factors associated with the amount of maxillary skeletal expansion were SN-MP and midpalatal-suture density at T1. In conclusion, there is a greater chance of failure in male patients who are older and have maxillary retrusion. A greater amount of maxillary expansion can be expected in patients with a higher mandibular-plane angle and with lower midpalatal-suture density.

To investigate the efficacy of microimplant-assisted rapid palatal expansion (MARPE) to treat skeletal maxillary discrepancies during the post-pubertal growth spurt stage. Sixty patients with skeletal maxillary transverse deficiency during the post-pubertal growth spurt stage were randomly divided into MARPE and Hyrax groups. Thirty patients (mean age: 15.1 ± 1.6 years) were treated using the four-point MARPE appliance; 30 patients (mean age, 14.8 ± 1.5 years) were treated using the Hyrax expander. Cone beam computed tomography scans and dental casts were obtained before and after expansion. The data were analyzed using paired t-tests and independent t-tests. The success rates of midpalatal suture separation were 100% and 86.7% for MARPE and Hyrax groups, respectively. Palatal expansion and skeletal to dental ratio at the first molar level were greater in the MARPE group (3.82 mm and 61.4%, respectively) than in the Hyrax group (2.20 mm and 32.3%, respectively) (P <.01). Reductions in buccal alveolar bone height and buccal tipping of the first molars were less in the MARPE group than in the Hyrax group (P <.01). MARPE enabled more predictable and greater skeletal expansion, as well as less buccal tipping and alveolar height loss on anchorage teeth. Thus, MARPE is a better alternative for patients with skeletal maxillary deficiency during the post-pubertal growth spurt stage. [ABSTRACT FROM AUTHOR]

This study presents the development and validation of a fibre Bragg gratings (FBGs)‐based sensor system for the assessment of strain in the midpalatal suture in subjects using rapid palatal expanders (RPEs). The ex‐vivo experiments were made by means of positioning two RPEs in a porcine palatal region. The RPEs used were the Hyrax, a tooth‐borne expander and MARPE (microimplant‐assisted rapid palatal expansion), a bone‐borne expander. In order to define the regions in the palatal region for the sensors positioning, a finite‐element analysis was performed in a porcine head subjected to the loadings caused by an RPE. In addition, a strain transfer model was used to obtain a correction coefficient that approximates the strain estimated by the FBG to the actual strain in the structure under shear and normal stress. Results show high linearity in the sensors characterisation tests with the advantages of compactness, intrinsic safe operation and multiplexing capabilities of FBGs. In the RPE analysis, a higher strain was estimated in the anterior region, which is in accordance with the simulation and previously reported results, where MARPE showed a higher strain (with an exponential pattern) than Hyrax as the number of activations increase. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the following null hypothesis: the skeletal and dentoalveolar expansion patterns in the coronal and axial planes are not different with two different types of microimplant-assisted rapid palatal expansion (MARPE) systems., Methods: Pretreatment (T0) and post-MARPE (T1) cone-beam computed tomography (CBCT) images of 32 patients (14 males and 18 females; mean age, 19.37) were analyzed. We compared two different MARPE systems. One MARPE system included the maxillary first premolars, maxillary first molars, and four microimplants as anchors (U46 type, n = 16), while the other included only the maxillary first molars and microimplants as anchors (U6 type, n = 16)., Results: In the molar region of the U6 and U46 groups, the transverse expansion at the midnasal, basal, alveolar, and dental levels was 2.64, 3.52, 4.46, and 6.32 mm and 2.17, 2.56, 2.73, and 5.71 mm, respectively. A significant difference was observed in the posterior alveolar-level expansion ( p = 0.036) and posterior basal-bone-level expansion ( p = 0.043) between the groups, with greater posterior skeletal and alveolar expansion in the U6 group., Conclusions: Compared with the U46 group, the U6 group showed greater posterior expansion at the alveolar and basal-bone levels, with an almost parallel split. Both groups showed a pyramidal expansion pattern in the coronal view.