Harim Kim , Amanda Cunha Regal de Castro , Christine Hong , Kee-Joon Lee
{"title":"Success and failure in miniscrew-assisted rapid palatal expansion – biologic and biomechanical clues","authors":"Harim Kim , Amanda Cunha Regal de Castro , Christine Hong , Kee-Joon Lee","doi":"10.1053/j.sodo.2024.07.006","DOIUrl":null,"url":null,"abstract":"<div><div>Nonsurgical maxillary orthopedic expansion in adults has gained increasing attention since the introduction of miniscrew-assisted rapid palatal expansion (MARPE). While there is consensus on the growing unpredictability of orthopedic expansion post-puberty, additional factors influencing successful suture separation remain contentious and unclear. Recent studies and case reports have demonstrated positive outcomes not only in young adults but also in middle-aged and older patients. Noticeable individual variations in suture morphology, along with insights into suture biology that underscore the necessity of bone remodeling for suture separation, imply potential contributing factors like epigenetic regulations and estrogen-influenced bone metabolism. The expansion protocol, integrating intermission for interval bone remodeling, may enhance success in adult patients with tightly interdigitated sutures. However, uncertainties persist in achieving suture separation, particularly in males. Despite advancements, many aspects of orthopedic expansion and determinant factors remain unknown. For a better understanding of the complexities involved in suture separation robust clinical and experimental studies are required.</div></div>","PeriodicalId":48688,"journal":{"name":"Seminars in Orthodontics","volume":"31 2","pages":"Pages 280-289"},"PeriodicalIF":2.2000,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Seminars in Orthodontics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1073874624000938","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
引用次数: 0
Abstract
Nonsurgical maxillary orthopedic expansion in adults has gained increasing attention since the introduction of miniscrew-assisted rapid palatal expansion (MARPE). While there is consensus on the growing unpredictability of orthopedic expansion post-puberty, additional factors influencing successful suture separation remain contentious and unclear. Recent studies and case reports have demonstrated positive outcomes not only in young adults but also in middle-aged and older patients. Noticeable individual variations in suture morphology, along with insights into suture biology that underscore the necessity of bone remodeling for suture separation, imply potential contributing factors like epigenetic regulations and estrogen-influenced bone metabolism. The expansion protocol, integrating intermission for interval bone remodeling, may enhance success in adult patients with tightly interdigitated sutures. However, uncertainties persist in achieving suture separation, particularly in males. Despite advancements, many aspects of orthopedic expansion and determinant factors remain unknown. For a better understanding of the complexities involved in suture separation robust clinical and experimental studies are required.
期刊介绍:
Each issue provides up-to-date, state-of-the-art information on a single topic in orthodontics. Readers are kept abreast of the latest innovations, research findings, clinical applications and clinical methods. Collection of the issues will provide invaluable reference material for present and future review.