Abstract:

Maxillary hypoplasia is the most common form of skeletal jaw maldevelopment associated with the majority of malocclusions, increased periodontal and airway risks. Orthopedic maxillary skeletal expansion is the most effective treatment modality to resolve maxillary transverse deficiency. Historically optimal timing for maxillary skeletal expansion was determined to be in the mixed dentition due to mid facial sutural potency. Until recent maxillary skeletal expansion was only achievable with Le Fort I osteotomies in adults. Conventional tooth-supported palatal expanders are known to produce unfavorable periodontal outcomes with or without surgical facilitation.

Introduction of temporary anchorage devices (TADs) into expanders significantly reduces periodontal risks and broadens the envelop of non-surgical correction in skeletally mature patients. Fully customized 3D printed expanders in conjunction with TADs allows skeletal maxillary expansion in adults WITHOUT surgery. This is by far the greatest orthodontic innovation of the last century. This lecture will cover restorative benefits from non-surgical custom MARPE (Mini-screw Assisted Rapid Palatal Expansion).

Learning objectives:

1. Review clinical indicators of maxillary hypoplasia.
2. Review innovative protocol of non-surgical custom MARPE expansion.
3. Review restorative functional implications of resolving maxillary hypoplasia with MARPE.