Maxillary skeletal expansion using MARPE: Akram Alhuwaizi

orthodontics In summary

Join me for a summary of Akram Alhuwaizi’s lecture on MARPE – Miniscrew assisted rapid palatal expansion. This summary explores MARPE from a clinical aspect, assessing the advantages and disadvantages, followed by a case discussion of success and failure, a discussion of MSE and lessons learned for designing MARPE. The full lecture is available on Akram’s youtube channel: Maxillary Skeletal Expansion using MARPE from A to Z (Updated) - YouTube Introduction Purpose of expansion Correction of crossbite Creating space Pre myofunctional treatment Widening smiles Methods available Removable appliance Quad Helix Rapid Maxillary Expander RME Surgically assisted Rapid Palatal Expansion SARPE Expansion methods Ideal features of expansion appliances are to achieve bodily movement, minimal compliance required from the patient, applicable to a range of ages and straightforward for patients MARPE experience Case 1 Attended Peter Ngan lecture Arab conference Surgical case requiring expansion – 2019 4 palatal TADs FAILIURE – TADs moved, one got embedded into the palatal tissue, no significant expansion occurred Cause of failure Hyrax position: Too posterior = near to Pterygo palatine suture and the zygomatic buttress which causes more resistance to the expansion No guiding arms, greatert risk of dental movements but they help in seating of the appliance Lack of guiding arm allowed rotation of the device by failure of only one TAD. TADs Length: Short: Ideally bi-cortical engagement to avoid bending and increase retention Appliance design There was a play between the TAD and the device Lab fabricated loops, not precision fit Case 2 Design Used 2 TADs 2mm D/12mm L Guiding arms to the 1st molars Hyrax more anterior Good fit abutment / screw and expander Longer screws – bicortical engagement Younger patient and female Successful palatal expansion