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47:) so that the bottom and upper teeth will fit together better. This is a common orthodontic procedure. The use of an expander is most common in children and adolescents 8–18 years of age. It can also be used in adults, although expansion is more uncomfortable and takes longer in adults. A patient who would rather not wait several months for the end result achieved by a palatal expander may be able to opt for a surgical separation of the maxilla. Use of a palatal expander is most often followed by
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125:. This gap is closed naturally and the teeth may overlap which leads to braces being needed. Some may develop a large space while others do not develop a space at all. It usually takes a week or two for one to adjust to eating and speaking after first receiving the rapid palatal expander. This process requires patients to turn the expansion screw themselves to widen the expander. For expansion that is not managed by the patient and on the lower jaw, a
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and of achieving a greater degree of skeletal expansion compared to dentoalveolar expansion. In most adults, especially males a surgical assist may be recommended to achieve consistent outcomes, such as a typical SARPE procedure (now SAMARPE) or less invasive techniques. It has been demonstrated that
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Rapid palatal expansion (RPE) or Rapid
Maxillary Expansion (RME) is an expansion technique where expansion of 0.5 mm to 1 mm is achieved each day until the posterior crossbite is relieved. The expander works by turning a key inside the center of the expander. The turn of this key will push
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Mini-implant
Assisted Rapid Palatal Expansion (MARPE) involves the forces being applied directly to the maxillary bone instead of the teeth. This technique involves placing anywhere from 2–4 mini-implants in the palatal vault area of maxilla to anchor the RME appliance to the screws. The patient is
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Each patient presents with different malocclusion and will need different amount of expansion. It is a general rule to expand the maxilla to a point where the lingual cusp of maxillary molar teeth touch the buccal cusp of mandibular molar teeth. Studies done decades ago by Krebs (1964), Stockfisch
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Slow expansion has also been advocated to be more physiologic to the tissues of the maxilla and it causes less pain. Some studies have reported that diastema in slow type of expansion also happens less due to the interdental fibers having chance to close the space as the maxilla is being expanded.
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Slow expansion techniques expands maxilla at a much slower rate compared to the rapid maxillary expansion technique. In slow expansion technique, a patient is ordered to turn the screw 4 times which amounts of 1mm per week. Patient is instructed to turn the jackscrew at the same rate for next 8–10
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It is believed that expansion therapy should be started in patients either before or during their peak growth spurt. To obtain maximal skeletal changes, the therapy is typically initiated at a very early age. Expansion therapy performed after the peak growth spurt will lead to more dental changes
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fuses together into a single palate tissue. If the patient suffers with a constricted maxillary arch, a palatal expander would need to be used. However, with the matured palate, the palatal expander would need to be surgically inserted onto the mid-palatal suture. Typically, the patient would be
237:. It is known that this anatomical bony complex limits the maxillary expansion posteriorly. Maxillary expansion does tend to open up circumaxillary sutures, circumzygomatic sutures, intermaxillary sutures and midpalatal sutures. Expansion also tends to happen more anteriorly than posteriorly.
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weeks to achieve the desired expansion. This slow rate of expansion allows skeletal and dental changes to happen in a 1:1 ratio. This means that equal amount of dental and skeletal expansion is achieved, compared to RME technique where mostly skeletal expansion is achieved initially.
113:" during which the bone fills the gap in the maxilla that was created by the expansion process. To prevent any type of relapse, a retainer is given to the patient to keep the teeth in proper alignment. RPE can be tooth supported, bone supported or both.
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at that time, opposed Angell's idea regarding arch expansion. Goddard, in 1890, and
Landsberger, in 1910, revisited the idea of arch expansion. Goddard standardized the expansion protocol in adjusting the expander twice a day for three weeks.
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This technique allows palatal expansion to be performed in young adults, in which the palatal suture is already fused, a result which was previously only achieved surgically. It has the advantage of being minimally invasive compared to
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The mid-palatal suture is first cut open into two parts. The center of the midpalatal suture is then inserted into the open slit. Once fully inserted, the mid-palatal suture of the patient is then closed by the surgeon. The
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reintroduced his expansion device to United States called Haas
Expander in 1956. He was also one of the first people to report lowering of mandible with bite opening and increase in nasal width and gain in arch perimeter.
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Garib DG, Henriques JF, Janson G, de
Freitas MR, Fernandes AY (June 2006). "Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation".
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Maxillary expansion is indicated in cases with a difference in the width of the upper jaw to the lower jaw equal to or greater than 4 mm. Typically this is measured from the width of the outside of the
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Reinbacher KE, Wallner J, Pau M, Feichtinger M, Kärcher H, Quehenberger F, Zemann W (March 2013). "Surgically assisted rapid maxillary expansion: feasibility of not releasing the nasal septum".
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For stability purposes, the RPE usually remain in the patient's mouth anywhere between 3–6 months, but this time may vary between patients. This is often known as
330:. He placed a screw between the maxillary premolars of a 14-year-old girl for two weeks. When she returned, he observed expansion in her upper arch. In 1877,
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Babacan H, Sokucu O, Doruk C, Ay S (January 2006). "Rapid maxillary expansion and surgically assisted rapid maxillary expansion effects on nasal volume".
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246:(1969) and Linder Aronson (1979) showed that about one-third to one-half of the expansion was lost before the expansion was eventually stabilized.
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593:"Distraction Osteogenesis Maxillary Expansion (DOME) for adult obstructive sleep apnea patients with narrow maxilla and nasal floor"
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taking into account that the molars will often tip outward to compensate for the difference. Rapid palatal expansion is also used
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Stevens K, Bressmann T, Gong SG, Tompson BD (August 2011). "Impact of a rapid palatal expander on speech articulation".
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Baccetti T, Franchi L, Cameron CG, McNamara JA (October 2001). "Treatment timing for rapid maxillary expansion".
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Pain – Patients may experience pain and headaches while wearing palatal expanders and when the screw is turned.
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The expansion process usually results in a large gap between the patient's two top front teeth, often known as
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Krebs A (1964-01-01). "Midpalatal Suture
Expansion Studies by the Implant Method Over a Seven-Year Period".
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both posterior expansion at the PNS, as well as expansion of the nasal aperture are critical in treating
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will then finish the procedure by connecting the palatal expanders band rings to the patients maxillary
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640:"Endoscopically-assisted surgical expansion (EASE) for the treatment of obstructive sleep apnea"
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Haas AJ (July 1965). "The
Treatment of Maxillary Deficiency by Opening the Midpalatal Suture".
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in 1968. Cohen and
Silverman were first ones to introduce the Bonded type of expander in 1973.
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84:, and to gain room for teeth in patients with moderate crowding of the teeth in the upper jaw.
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under the care of an oral-maxillofacial surgeon and the surgical procedure would commence.
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Stockfisch H (1969-01-01). "Rapid expansion of the maxilla--success and relapse".
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Sores on tongue – This can happen due to contact with the expander's metal bars.
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then asked to turn the jackscrew with the rapid approach over next two weeks.
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Angle EH (1860). "Treatment of irregularity of the permanent or adult teeth".
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and lisps (pronouncing the letter s, t, and r blends become very difficult).
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was the first person to publish a paper about palatal expansion in 1860 in
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developed the Coffin Spring for the purpose of arch expansion. In 1889,
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Trouble with speech – Patients who have expanders may experience extra
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Westcott first reported placing mechanical forces on maxilla in 1859.
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Once a patient reaches maturity (puberty) the palate halves or the
554:"Palatal expansion: just the beginning of dentofacial orthopedics"
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Increased lingual bone thickness, decreased buccal bone thickness
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American
Journal of Orthodontics and Dentofacial Orthopedics
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American
Journal of Orthodontics and Dentofacial Orthopedics
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American Journal of Orthodontics and Dentofacial Orthopedics
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Yoon, A.; Guilleminault, C.; Zaghi, S.; Liu, S. Y. (2020).
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Compression of periodontal ligament near posterior teeth
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International Journal of Oral and Maxillofacial Surgery
406:"Palatal Expanders: What Are They and How Do They Work"
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International Journal of Clinical Pediatric Dentistry
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Report of the Congress. European Orthodontic Society
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Report of the Congress. European Orthodontic Society
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Surgically Assisted Rapid Palatal Expansion (SARPE)
217:Diastema – Space between upper front two teeth
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503:Agarwal A, Mathur R (2010). Marwah N (ed.).
638:Li, K.; Quo, S.; Guilleminault, C. (2019).
288:. Unsourced material may be challenged and
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55:than skeletal ones, leading to tipping of
16:Orthodontics device to widen the upper jaw
1682:Society for Orthodontic Dental Technology
1677:Italian Academy of Orthodontic Technology
1165:List of orthodontic functional appliances
528:
376:List of orthodontic functional appliances
308:Learn how and when to remove this message
358:in 1975 which was a modification of the
31:Upper and lower jaw functional expanders
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362:. Biederman introduced the tooth-borne
233:One of the limits of expansion is the
43:which is used to widen the upper jaw (
1667:Canadian Association of Orthodontists
1652:American Association of Orthodontists
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286:adding citations to reliable sources
129:may be a more suitable alternative.
101:Palatal expander in mixed dentition.
199:Side-effects of a palatal expansion
63:Indications for a palatal expander
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900:. Gulf Professional Publishing.
558:American Journal of Orthodontics
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1657:American Board of Orthodontics
521:10.5005/jp-journals-10005-1069
51:to then straighten the teeth.
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1411:Harold Chapman (Orthodontist)
1094:Temperomandibular dysfunction
338:who was the president of the
1003:Standard anatomical position
983:Failure of eruption of teeth
570:10.1016/0002-9416(70)90241-1
226:Extrusion of posterior teeth
39:is a device in the field of
1725:Angle School of Orthodontia
1662:British Orthodontic Society
988:Little's Irregularity Index
894:Bluestone CD (2003-01-01).
823:10.1016/j.ajodo.2006.02.021
784:10.1016/j.ajodo.2011.02.017
656:10.1016/j.sleep.2018.09.008
609:10.1016/j.sleep.2019.06.002
340:American Dental Association
220:Fenestration of buccal bone
111:"six month retention period
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1672:Indian Orthodontic Society
1466:John Hooper (Orthodontist)
716:10.1016/j.ijom.2012.09.021
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146:Implant-assisted expansion
106:the arms of the expander.
1170:List of palatal expanders
381:List of palatal expanders
1581:Frederick Lester Stanton
1264:Intrusion (orthodontics)
1246:Anchorage (orthodontics)
897:Pediatric Otolaryngology
1709:Journal of Orthodontics
1259:Interproximal reduction
1195:Palatal lift prosthesis
162:Obstructive sleep apnea
93:Rapid palatal expansion
1746:Orthodontic appliances
1704:The Angle Orthodontist
1185:Orthodontic technology
1059:Bimaxillary Protrusion
968:Cephalometric analysis
742:The Angle Orthodontist
552:Haas AJ (March 1970).
478:The Angle Orthodontist
432:The Angle Orthodontist
410:Orthodontics Australia
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82:in cleft palate repair
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1536:Frederick Bogue Noyes
686:"Plataforma Sucupira"
505:"Maxillary Expansion"
180:Intermaxillary suture
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1586:Earl Emanuel Shepard
1339:Notable contributors
1250:Cantilever mechanics
1230:Twin Block Appliance
1220:Self-ligating braces
1079:Condylar hyperplasia
1074:Maxillary hypoplasia
282:improve this section
1436:John Nutting Farrar
1396:Charles J. Burstone
1386:Holly Broadbent Sr.
1269:Molar distalization
1120:Activator appliance
241:Amount of expansion
1621:Robert M. Ricketts
1561:Alfred Paul Rogers
1556:Robert M. Ricketts
1190:Orthodontic spacer
978:Dentition analysis
352:Robert M. Ricketts
235:zygomatic buttress
127:bionator appliance
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88:Types of expansion
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23:A palatal expander
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1611:Edmund H. Wuerpel
1546:Herbert A. Pullen
1531:Dean Harold Noyes
1526:George Northcroft
1501:James A. McNamara
1456:Charles A. Hawley
1381:Charles B. Bolton
1366:Hans Peter Bimler
1279:Serial extraction
1140:Frankel appliance
347:Dr. Andrew J Haas
322:Emerson C. Angell
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1601:Charles H. Tweed
1591:Cecil C. Steiner
1451:Thomas M. Graber
1431:William B. Downs
1426:Terry Dischinger
1356:Clifford Ballard
1351:Spencer Atkinson
1225:Splint activator
1200:Palatal expander
1160:Herbst Appliance
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1616:Won-Sik Yang
1506:Birte Melsen
1441:Rolf Frankel
1421:Jean Delaire
1361:Raymond Begg
1346:Edward Angle
1150:Lingual arch
1130:Damon system
1084:Overeruption
998:Scissor bite
993:Malocclusion
973:Cephalometry
949:Orthodontics
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298:January 2024
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280:Please help
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189:orthodontist
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70:first molars
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41:orthodontics
36:
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1718:Institution
1566:Ronald Roth
1516:Hayes Nance
1491:Craven Kurz
1406:Calvin Case
1064:Prognathism
603:: 172–176.
1740:Categories
1486:Juri Kurol
1376:Arne Björk
1254:Fiberotomy
1239:Procedures
1205:Quad helix
1155:Lip bumper
1145:Invisalign
1103:Appliances
1022:Conditions
875:: 469–81.
852:: 131–42.
465:: 540–544.
438:: 200–17.
416:2021-02-06
392:References
356:Quad Helix
1684:(Germany)
1325:Composite
1288:Materials
1215:SureSmile
1044:Crossbite
1039:Open bite
956:Diagnosis
650:: 53–59.
625:196555256
269:does not
78:lower jaw
74:upper jaw
1692:Journals
1310:TiMolium
1210:Retainer
1180:Headgear
1135:Elastics
1115:Archwire
1029:Overbite
858:14318002
831:16769493
792:21803236
754:16448271
724:23092854
672:53218014
664:30393018
617:31606311
539:27616835
490:11605867
444:14331020
370:See also
360:W Spring
123:diastema
1320:Ceramic
1315:Elgiloy
1034:Overjet
881:5272797
578:5263785
530:4993819
290:removed
275:sources
250:History
117:Effects
72:in the
45:maxilla
1125:Braces
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206:saliva
193:molars
49:braces
1274:SARPE
668:S2CID
621:S2CID
386:SARPE
174:SARPE
157:SARPE
902:ISBN
877:PMID
854:PMID
827:PMID
788:PMID
750:PMID
720:PMID
660:PMID
613:PMID
574:PMID
535:PMID
486:PMID
440:PMID
273:any
271:cite
819:doi
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525:PMC
517:doi
284:by
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