The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding

  • Kim, Harim (Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry) ;
  • Park, Sun-Hyung (Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry) ;
  • Park, Jae Hyun (Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University) ;
  • Lee, Kee-Joon (Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry)
  • Received : 2020.08.25
  • Accepted : 2020.11.25
  • Published : 2021.05.25
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Abstract

Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-year-old patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

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References

  1. Atik E, Taner T. Stability comparison of two different dentoalveolar expansion treatment protocols. Dental Press J Orthod 2017;22:75-82. https://doi.org/10.1590/2177-6709.22.5.075-082.oar
  2. Papapanou PN, Wennstrom JL, Grondahl K. Periodontal status in relation to age and tooth type. A cross-sectional radiographic study. J Clin Periodontol 1988;15:469-78. https://doi.org/10.1111/j.1600-051X.1988.tb01602.x
  3. Van der Velden U. Effect of age on the periodontium. J Clin Periodontol 1984;11:281-94. https://doi.org/10.1111/j.1600-051X.1984.tb01325.x
  4. Angell EH. Treatment of irregularities of the permanent or adult teeth. In: White JD, McQuillen JH, Ziegler GJ, White JW, Kirk EC, Anthony LP, eds. The dental cosmos. Philadelphia: S.S. White Dental Manufacturing Company; 1860. p. 540-4, 99-600.
  5. Haas AJ. The treatment of maxillary deficiency by opening the midpalatal suture. Angle Orthod 1965;35:200-17.
  6. Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod 2016;86:713-20. https://doi.org/10.2319/101415-689.1
  7. Lee KJ, Park YC, Park JY, Hwang WS. Miniscrew-assisted nonsurgical palatal expansion before orthognathic surgery for a patient with severe mandibular prognathism. Am J Orthod Dentofacial Orthop 2010;137:830-9. https://doi.org/10.1016/j.ajodo.2007.10.065
  8. Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977;72:42-52. https://doi.org/10.1016/0002-9416(77)90123-3
  9. Melsen B. Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 1975;68:42-54. https://doi.org/10.1016/0002-9416(75)90158-X
  10. Shetty V, Caridad JM, Caputo AA, Chaconas SJ. Biomechanical rationale for surgical-orthodontic expansion of the adult maxilla. J Oral Maxillofac Surg 1994;52:742-9; discussion 750-1. https://doi.org/10.1016/0278-2391(94)90492-8
  11. Asscherickx K, Govaerts E, Aerts J, Vande Vannet B. Maxillary changes with bone-borne surgically assisted rapid palatal expansion: a prospective study. Am J Orthod Dentofacial Orthop 2016;149:374-83. https://doi.org/10.1016/j.ajodo.2015.08.018
  12. Kokich VG. Age changes in the human frontozygomatic suture from 20 to 95 years. Am J Orthod 1976;69:411-30. https://doi.org/10.1016/0002-9416(76)90209-8
  13. Uysal T, Memili B, Usumez S, Sari Z. Dental and alveolar arch widths in normal occlusion, class II division 1 and class II division 2. Angle Orthod 2005;75:941-7.
  14. Koo YJ, Choi SH, Keum BT, Yu HS, Hwang CJ, Melsen B, et al. Maxillomandibular arch width differences at estimated centers of resistance: comparison between normal occlusion and skeletal Class III malocclusion. Korean J Orthod 2017;47:167-75. https://doi.org/10.4041/kjod.2017.47.3.167
  15. Jang W, Shin C, Hwang S, Kim KH, Jackson T, Nguyen T, et al. Nonsurgical treatment of an adult with a skeletal Class III malocclusion combined with a functional anterior shift, severely overclosed vertical dimension, and a reverse smile. Am J Orthod Dentofacial Orthop 2020;157:561-70. https://doi.org/10.1016/j.ajodo.2019.01.029
  16. Choi NC, Park YC, Lee HA, Lee KJ. Treatment of Class II protrusion with severe crowding using indirect miniscrew anchorage. Angle Orthod 2007;77:1109-18. https://doi.org/10.2319/112106-476.1
  17. Bechtold TE, Kim JW, Choi TH, Park YC, Lee KJ. Distalization pattern of the maxillary arch depending on the number of orthodontic miniscrews. Angle Orthod 2013;83:266-73. https://doi.org/10.2319/032212-123.1
  18. Kraus CD, Campbell PM, Spears R, Taylor RW, Buschang PH. Bony adaptation after expansion with light-to-moderate continuous forces. Am J Orthod Dentofacial Orthop 2014;145:655-66. https://doi.org/10.1016/j.ajodo.2014.01.017
  19. Seong EH, Choi SH, Kim HJ, Yu HS, Park YC, Lee KJ. Evaluation of the effects of miniscrew incorporation in palatal expanders for young adults using finite element analysis. Korean J Orthod 2018;48:81-9. https://doi.org/10.4041/kjod.2018.48.2.81
  20. Wehrbein H, Merz BR, Diedrich P. Palatal bone support for orthodontic implant anchorage--a clinical and radiological study. Eur J Orthod 1999;21:65-70. https://doi.org/10.1093/ejo/21.1.65
  21. Kang S, Lee SJ, Ahn SJ, Heo MS, Kim TW. Bone thickness of the palate for orthodontic mini-implant anchorage in adults. Am J Orthod Dentofacial Orthop 2007;131(4 Suppl):S74-81. https://doi.org/10.1016/j.ajodo.2005.09.029
  22. McNamara JA. Maxillary transverse deficiency. Am J Orthod Dentofacial Orthop 2000;117:567-70. https://doi.org/10.1016/S0889-5406(00)70202-2
  23. Nascimento MM, Dilbone DA, Pereira PN, Duarte WR, Geraldeli S, Delgado AJ. Abfraction lesions: etiology, diagnosis, and treatment options. Clin Cosmet Investig Dent 2016;8:79-87.
  24. Moon W. Maxillary expansion in skeletally mature patients with TADs. In: Park JH, ed. Temporary anchorage devices in clinical orthodontics. Hoboken: John Wiley & Sons, Inc.; 2020.
  25. Proffit WR, Fields HW, Sarver DM. Contemporary orthodontics. St. Louis: Elsevier Health Sciences; 2014.
  26. Cohen MM Jr. Sutural biology and the correlates of craniosynostosis. Am J Med Genet 1993;47:581-616. https://doi.org/10.1002/ajmg.1320470507
  27. Opperman LA, Sweeney TM, Redmon J, Persing JA, Ogle RC. Tissue interactions with underlying dura mater inhibit osseous obliteration of developing cranial sutures. Dev Dyn 1993;198:312-22. https://doi.org/10.1002/aja.1001980408
  28. Wehrbein H, Yildizhan F. The mid-palatal suture in young adults. A radiological-histological investigation. Eur J Orthod 2001;23:105-14. https://doi.org/10.1093/ejo/23.2.105
  29. Castello JR, Olaso AS, Chao JJ, McCarthy JG, Molina F. Craniofacial shortening by contraction osteogenesis: an experimental model. Plast Reconstr Surg 2000;105:617-25; discussion 626-7. https://doi.org/10.1097/00006534-200002000-00021
  30. Garib DG, Henriques JF, Janson G, de Freitas MR, Fernandes AY. Periodontal effects of rapid maxillary expansion with tooth-tissue-borne and tooth-borne expanders: a computed tomography evaluation. Am J Orthod Dentofacial Orthop 2006;129:749-58. https://doi.org/10.1016/j.ajodo.2006.02.021
  31. Reitan K. Tissue rearrangement during retention of orthodontically rotated teeth. Angle Orthod 1959;29:105-13.
  32. Kassab MM, Cohen RE. The etiology and prevalence of gingival recession. J Am Dent Assoc 2003;134:220-5. https://doi.org/10.14219/jada.archive.2003.0137