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58:) 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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136:. 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
248:. 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.
124:" 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
341:. 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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257:(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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604:"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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651:"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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95:, 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
565:"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
417:"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)
228:Diastema – Space between upper front two teeth
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514:Agarwal A, Mathur R (2010). Marwah N (ed.).
649:Li, K.; Quo, S.; Guilleminault, C. (2019).
299:. Unsourced material may be challenged and
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66:than skeletal ones, leading to tipping of
27:Orthodontics device to widen the upper jaw
1693:Society for Orthodontic Dental Technology
1688:Italian Academy of Orthodontic Technology
1176:List of orthodontic functional appliances
539:
387:List of orthodontic functional appliances
319:Learn how and when to remove this message
369:in 1975 which was a modification of the
42:Upper and lower jaw functional expanders
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373:. Biederman introduced the tooth-borne
244:One of the limits of expansion is the
54:which is used to widen the upper jaw (
1678:Canadian Association of Orthodontists
1663:American Association of Orthodontists
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297:adding citations to reliable sources
140:may be a more suitable alternative.
112:Palatal expander in mixed dentition.
210:Side-effects of a palatal expansion
74:Indications for a palatal expander
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911:. Gulf Professional Publishing.
569:American Journal of Orthodontics
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1668:American Board of Orthodontics
532:10.5005/jp-journals-10005-1069
62:to then straighten the teeth.
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1422:Harold Chapman (Orthodontist)
1105:Temperomandibular dysfunction
349:who was the president of the
1014:Standard anatomical position
994:Failure of eruption of teeth
581:10.1016/0002-9416(70)90241-1
237:Extrusion of posterior teeth
50:is a device in the field of
1736:Angle School of Orthodontia
1673:British Orthodontic Society
999:Little's Irregularity Index
905:Bluestone CD (2003-01-01).
834:10.1016/j.ajodo.2006.02.021
795:10.1016/j.ajodo.2011.02.017
667:10.1016/j.sleep.2018.09.008
620:10.1016/j.sleep.2019.06.002
351:American Dental Association
231:Fenestration of buccal bone
122:"six month retention period
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1683:Indian Orthodontic Society
1477:John Hooper (Orthodontist)
727:10.1016/j.ijom.2012.09.021
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157:Implant-assisted expansion
117:the arms of the expander.
1181:List of palatal expanders
392:List of palatal expanders
1592:Frederick Lester Stanton
1275:Intrusion (orthodontics)
1257:Anchorage (orthodontics)
908:Pediatric Otolaryngology
1720:Journal of Orthodontics
1270:Interproximal reduction
1206:Palatal lift prosthesis
173:Obstructive sleep apnea
104:Rapid palatal expansion
1757:Orthodontic appliances
1715:The Angle Orthodontist
1196:Orthodontic technology
1070:Bimaxillary Protrusion
979:Cephalometric analysis
753:The Angle Orthodontist
563:Haas AJ (March 1970).
489:The Angle Orthodontist
443:The Angle Orthodontist
421:Orthodontics Australia
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93:in cleft palate repair
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1547:Frederick Bogue Noyes
697:"Plataforma Sucupira"
516:"Maxillary Expansion"
191:Intermaxillary suture
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1597:Earl Emanuel Shepard
1350:Notable contributors
1261:Cantilever mechanics
1241:Twin Block Appliance
1231:Self-ligating braces
1090:Condylar hyperplasia
1085:Maxillary hypoplasia
293:improve this section
1447:John Nutting Farrar
1407:Charles J. Burstone
1397:Holly Broadbent Sr.
1280:Molar distalization
1131:Activator appliance
252:Amount of expansion
1632:Robert M. Ricketts
1572:Alfred Paul Rogers
1567:Robert M. Ricketts
1201:Orthodontic spacer
989:Dentition analysis
363:Robert M. Ricketts
246:zygomatic buttress
138:bionator appliance
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99:Types of expansion
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34:A palatal expander
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1622:Edmund H. Wuerpel
1557:Herbert A. Pullen
1542:Dean Harold Noyes
1537:George Northcroft
1512:James A. McNamara
1467:Charles A. Hawley
1392:Charles B. Bolton
1377:Hans Peter Bimler
1290:Serial extraction
1151:Frankel appliance
358:Dr. Andrew J Haas
333:Emerson C. Angell
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16:(Redirected from
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1762:Dental equipment
1612:Charles H. Tweed
1602:Cecil C. Steiner
1462:Thomas M. Graber
1442:William B. Downs
1437:Terry Dischinger
1367:Clifford Ballard
1362:Spencer Atkinson
1236:Splint activator
1211:Palatal expander
1171:Herbst Appliance
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1627:Won-Sik Yang
1517:Birte Melsen
1452:Rolf Frankel
1432:Jean Delaire
1372:Raymond Begg
1357:Edward Angle
1161:Lingual arch
1141:Damon system
1095:Overeruption
1009:Scissor bite
1004:Malocclusion
984:Cephalometry
960:Orthodontics
907:
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425:. Retrieved
423:. 2020-10-12
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309:January 2024
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291:Please help
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200:orthodontist
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81:first molars
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68:buccal teeth
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52:orthodontics
47:
45:
1729:Institution
1577:Ronald Roth
1527:Hayes Nance
1502:Craven Kurz
1417:Calvin Case
1075:Prognathism
614:: 172–176.
1751:Categories
1497:Juri Kurol
1387:Arne Björk
1265:Fiberotomy
1250:Procedures
1216:Quad helix
1166:Lip bumper
1156:Invisalign
1114:Appliances
1033:Conditions
886:: 469–81.
863:: 131–42.
476:: 540–544.
449:: 200–17.
427:2021-02-06
403:References
367:Quad Helix
1695:(Germany)
1336:Composite
1299:Materials
1226:SureSmile
1055:Crossbite
1050:Open bite
967:Diagnosis
661:: 53–59.
636:196555256
280:does not
89:lower jaw
85:upper jaw
1703:Journals
1321:TiMolium
1221:Retainer
1191:Headgear
1146:Elastics
1126:Archwire
1040:Overbite
869:14318002
842:16769493
803:21803236
765:16448271
735:23092854
683:53218014
675:30393018
628:31606311
550:27616835
501:11605867
455:14331020
381:See also
371:W Spring
134:diastema
1331:Ceramic
1326:Elgiloy
1045:Overjet
892:5272797
589:5263785
541:4993819
301:removed
286:sources
261:History
128:Effects
83:in the
56:maxilla
1136:Braces
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217:saliva
204:molars
60:braces
1285:SARPE
679:S2CID
632:S2CID
397:SARPE
185:SARPE
168:SARPE
913:ISBN
888:PMID
865:PMID
838:PMID
799:PMID
761:PMID
731:PMID
671:PMID
624:PMID
585:PMID
546:PMID
497:PMID
451:PMID
284:any
282:cite
830:doi
826:129
791:doi
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723:doi
663:doi
616:doi
577:doi
536:PMC
528:doi
295:by
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