Rapid palatal expansion(RPE) with the tooth-born appliance is not sufficient to apply to the patients with periodontal problem or insufficient tooth anchorage, and it leads to tipping of the anchorage teeth and increasing teeth mobility and root resorption. To avoid these disadvantages, we present the case using palatal screws and custommade palatal expander. A 23-year-old patient underwent surgically assisted rapid maxillary expansion with the Hyrax expansion using 4 tent screws. The study models were used to measure the pre-/-post surgical width of the anterior and posterior dental arches with a digital sliding caliper. In the result, the custom-made palatal expander with 4 tent screws is suitable for delivering a force to the mid-palatal suture expansion. And it is low cost, small sized and simply applied. The results indicated that maxillary expansion with the custom-made palatal anchorage device is predictable and stable technique without significant complications in patients.
Dental Arch ; Humans ; Hyraxes ; Palatal Expansion Technique ; Root Resorption ; Sutures ; Tooth ; Young Adult

PURPOSE: The aim of this study was to investigate the initial effects of maxillary expansion therapy with Hyrax appliance and to evaluate the related changes in maxillary sinus volume. MATERIALS AND METHODS: Thirty patients (20 females, 10 males; 13.8 years) requiring maxillary expansion therapy, as part of their comprehensive orthodontic treatment, were examined. Each patient had cone-beam computed tomography (CBCT) images taken before (T1) and after (T2) maxillary expansion therapy with a banded Hyrax appliance. Multiplanar slices were used to measure linear dimensions and palatal vault angle. Volumetric analysis was used to measure maxillary sinus volumes. Student t tests were used to compare the pre- and post-treatment measurements. Additionally, differences between two age groups were compared with Mann-Whitney U test. The level of significance was set at p=0.05. RESULTS: Comparison of pre-treatment to post-treatment variables revealed significant changes in the transverse dimension related to both maxillary skeletal and dental structures and palatal vault angle, resulting in a widened palatal vault (p<0.05). Hard palate showed no significant movement in the vertical and anteroposterior planes. Nasal cavity width increased on a mean value of 0.93mm(SD=0.23, p<0.05). Maxillary sinus volume remained virtually stable. No significant age differences were observed in the sample. CONCLUSION: Hyrax expansion therapy did not have a significant impact on maxillary sinus volume.
Cone-Beam Computed Tomography ; Female ; Humans ; Hyraxes ; Maxillary Sinus ; Nasal Cavity ; Palatal Expansion Technique ; Palate, Hard

Rapid maxillary expansion is widely used for the correction of anteroposterior discrepancies, constriction of the maxillary arch, etc. This experiment was undertaken to examine the serial changes in the osteogenesis as well as the collagen fiber bundles in the intermaxillary suture during the rapid maxillary expansion treatment. Four young female dogs aged 6 to 8 months old and not showing menarche yet were used for the experiment. The maxillary impression of dogs were taken, expansion device cast and Hyrax screw soldered at the midline in the 1st premolar area. RME device was delivered to the dogs and the activation of 0.25mm per quarter-tum was done 2 times per day for 10 days until 5mm separation was made. Separation of the maxilla was confirmed by X ?ray. The animals were sacrificed on 0, 15, 30, 60 days from the finish of maxillary separation and preparations for light microscopy and surface electron microscopy were made. The sutures were cut into frontal serial sections for examination of the histological reactions. The following results were obtained and the conclusions made. 1. The edges of the two palatal plates bordering the midpalatal suture which at the beginning of the retention period were mainly composed of compact bone, underwent extensive resorption followed by new bone formation and gradually became spongy bone rich in bone marrow which in the 60 day retention animal became the compact bone with short intermaxillary suture space. During this transformation, newly formed trabecular bone tissues were added to the original margin. 2. Throughout the expansion period, the collagen fibers underwent successive changes such as stretching, loss of polarity, and finally fibrillogenesis. Towards the end of the expansion procedure, sharpey's fiber formation in newly formed bones were observed. 3. Bony spicules were found in the initial stage of retention on occlusal topographic X -rays, which later were confirmed to have ossified. 4. Judging from the histological changes occuring during the experimental expansion, excessive expansion will cause an excessive bleeding, and retard the remodeling of intermaxillary suture. According to the above results, the bone remodeling after rapid maxillary expansion was preceded by the migration of migratory cells into the intermaxillary suture area. The bone remodeling phenomena were on-going during the 2 months retention sample.
Animals ; Bicuspid ; Bone and Bones ; Bone Marrow ; Bone Remodeling ; Collagen ; Constriction ; Dogs* ; Female ; Hemorrhage ; Humans ; Hyraxes ; Infant ; Maxilla ; Menarche ; Microscopy ; Microscopy, Electron ; Osteogenesis ; Palatal Expansion Technique* ; Sutures* ; Young Adult*