The skeletal anchorage in the orthodontic treatment of constricted maxilla in the early mixed dentition: A case report

Abstract

Miniscrew assisted rapid palatal expansion (MARPE) is a minimally invasive and effective method of treatment for patients patients with maxillary constriction. The technique involves the design and manufacture of the rapid maxillary expansion appliance, with miniscrew anchorage in the palatal cortical bone tissue. Currently, using skeletal anchorage is becoming an increasingly common way to treatment in cases of constricted maxilla because this method: 1) facilitates the management of complex orthodontic biomechanics; 2) can be successfully used to treat transverse maxillary deficiency in borderline cases. It was also found that MARPE effectively opens the midpalatal suture in children at the initial stage of ossification. The stability of the appliance depends on the hard palate anatomical structure and the possibility for bicortical miniscrew placement taking into consideration application of orthopedic forces above 200 grams when the appliance is activated. The clinical case of a 8-year-old patient with maxillary constriction. The patient was treated with MARPE technique application. We described a full digital work-flow using CAD-CAM that can help clinicians in defining the appropriate placement of micro-implant supported maxillary skeletal expander according to quantitative and qualitative bone characteristics of the palate region and this workflow can also enhance cooperation between the orthodontists and lab technicians in construction of the appliance.