Success and complication rate of miniscrew assisted non-surgical palatal expansion in adults - a consecutive study using a novel force-controlled polycyclic activation protocol

Head & Face Medicine

Christos Katsaros¹  Andre Walter²  Heinz Winsauer³  Oliver Ploder⁴ 

[1] Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Bern, Switzerland;Department of Orthodontics, Universitat International de Catalunya (UIC), Barcelona, Spain;Orthodontic Office, Belruptstrasse, Bregenz, Austria;Private Office for Oral and Maxillofacial Surgery, Facesurgery.at, Feldkirch, Austria;

关键词: Maxillary expansion;    Bone-borne;    Miniscrew;    Non-surgical;    Adult patients;    MAPE;    MARPE;    Success;    Complication;   

DOI  :  10.1186/s13005-021-00301-2

来源: Springer

【 摘 要 】

IntroductionBone-borne miniscrew assisted palatal expansion (MAPE) is a common technique to improve maxillary transverse deficiency in young adolescents. Adult patients usually present a challenge, as they often require additional surgical assisted maxillary expansion (SARPE). There is still no clear statement about non-surgical expansion in adult patients using this technique. The aim of this study was to evaluate the success and complication rate of non-surgical palatal expansion in adults utilizing MAPE with a novel force-controlled polycyclic expansion protocol (FCPC).MethodsThis consecutive study consisted of 33 adult patients with an average age of 29.1 ± 10.2 years (min. 18 years, max. 58 years), including one dropout patient. First, four miniscrews were inserted and after 12-weeks latency, the expander was placed and the FCPC protocol was applied (MAPE group). In case of missing expansion, a SARPE was performed (SARPE group). After maximum expansion, a cone beam CT was made and widening of the midpalatal suture was measured. The outcome variables were successful non-surgical expansion and, with sample size power above 80%, the odds of failed non-surgical expansion and associated complications were evaluated. The primary predictor variable was age. Statistical analysis was performed using R (Version 3.1) to calculate power, to construct various models for measuring the odds of requiring surgical intervention/complications, and others.ResultsSuccessful non-surgical expansion was achieved in 27 patients (84.4%), ranging from 18 to 49 years. Mean age differed significantly between both groups (26.8 ± 8.2 years vs. 41.3 ± 9.9 years; p < 0.001). Mean expansion at the anterior and posterior palate for the MAPE group was 5.4 ± 1.5 mm and 2.5 ± 1.1 mm, respectively. Among these subjects’ complications were observed in 18.5%. Age significantly increased the odds of complications (p = 0.019).Conclusions1. The success rate of MAPE among individuals aged 18 to 49 years was 84.4%.2. A V-shaped expansion pattern in the antero-posterior dimension was mostly observed.3. Complications were significantly associated with age.4. A careful expansion protocol seems to be beneficial to prevent unfavorable results in adult patients.Trial registrationConsecutive cohort study, Review Board No. EK-2-2014/0016.

【 授权许可】

CC BY