ORTHOPEDIC EXPANSION TO MANAGE CONSTRICTED MAXILLARY ARCH

Constricted Maxillary Arch

Abstract

INTRODUCTION

The maxillary expansion is accomplished by a combination of skeletal (Orthopedic) expansion and dentoalveolar (orthodontic) expansion. Orthopedic expansion involves separation of the mid palatal suture while orthodontic expansion results in buccal tipping of the maxillary posterior teeth. The proportion of skeletal and dental movement is dependent on the rate of expansion and the age of the patient during the treatment [1,2]. The goal of palatal expansion is to maximize the skeletal movement and minimize the dental movement, while allowing for physiological adjustment of the suture during separation [3].

The incidence of posterior cross bite in American children is approximately 70% [4] while such prevalence studies are not available about the children of Pakistan.  Issacson and Wertz [5] thoroughly studied rapid palatal expansion and according to them forces maximize separation of mid palatal suture by overwhelming the suture before any dental movement or physiological sutural adjustment. They also noted that the traumatic separation of the mid palatal suture may induce patient’s discomfort. Moreover rapid palatal expansion also requires patient or parent co-operation in appliance activation and laborious laboratory procedures in fabrication of the appliance are involved.