Evaluation of palate-related factors of the effectiveness of microimplant-assisted rapid palatal expansion in late adolescents and adults

In-silico evaluation of orthodontic miniscrew-assisted rapid palatal expanders for patients with various stages of skeletal maturation

INTRODUCTION

This study aimed to use a finite element method to assess the stress on the miniscrews, skeletal and dental changes resulting from maxillary expansion using either a tooth-bone-borne (TBB) or a bone-borne (BB) device on patients with various skeletal maturation.

METHODS

Two types of expanders were modeled using SolidWorks. The design of the 2 expanders was similar, with the exception that the BB appliance lacked support for teeth (rods and bands). Both were placed on the palatal bones with the help of 4 miniscrews as bony anchorage. Five skeletal maturation stages were examined using suture maturation classification by Angelieri. A lateral displacement of 0.2 mm was applied to simulate 1 turn of jackscrew per day. The dental and skeletal changes from the treatment were quantified.

RESULTS

Stage A sutural maturation exhibited the greatest skeletal movement (0.13 mm/d) with a V-shaped displacement pattern. Stages B and C exhibited a more parallel expansion pattern. Stages D and E exhibited the least amount of skeletal movement with either device. Compared with the BB device, TBB demonstrated greater dental displacement. On average, the BB device exhibited a skeletal-to-dental expansion ratio of 70% from stage A to C compared with 49% with the TBB device.

CONCLUSIONS

BB device showed more skeletal displacement than TBB, and the latter showed more dental side effects, particularly during stages B and C. The miniscrew-assisted rapid palatal expansion appliance was effective with sutural maturation stages A to C using the classification by Angelieri with a more parallel separation of the midpalatal sutures in stages B and C.

Evolution, current status, and future trends of maxillary skeletal expansion: a bibliometric analysis

OBJECTIVES

The study aims to conduct a bibliometric analysis on maxillary skeletal expansion to elucidate the evolution and current status and predict future research hotspots and trends.

MATERIAL AND METHODS

A search was conducted in the Web of Science Core Collection at the University of Hong Kong's electronic library using the query "(TS = maxillary expansion) AND (TS = skeletal expansion)." The resulting literature data were imported into CiteSpace 6.2.R4 and VOS viewer software to analyze authorship, countries, institutions, keywords, etc. RESULTS: A total of 923 articles were analyzed. The research in this field has shown a steady growth, with a significant increase since 2019. The USA and Italy have played prominent roles in contributing to the publication volume and strengthening collaborative exchanges. Clustering labels provide directions for in-depth analysis of the literature.

CONCLUSIONS

(1) MARPE (miniscrew-assisted rapid palatal expansion) and SARME (surgically assisted rapid maxillary expansion) have gained widespread attention and become research hotspots due to their applicability in adults whose growth and development have ceased, while still producing favorable skeletal effects. (2) In addition to widening the maxillary arch, maxillary expansion techniques have shown significant effects on increasing nasal cavity width and volume. However, there is still controversy regarding whether they can effectively improve the deviated nasal septum. (3) Maxillary skeletal expansion techniques have been shown to increase upper airway volume and improve breathing, making them potentially valuable in the treatment of obstructive sleep apnea (OSA).

CLINICAL RELEVANCE

This study can provide cutting-edge clinical recommendations for healthcare professionals to better formulate clinical strategies.