Korean J Orthod.  2021 May;51(3):217-227. 10.4041/kjod.2021.51.3.217.

Nonsurgical maxillary expansion in a 60-year-old patient with gingival recession and crowding

• Kim H
• Park SH
• Park JH
• Lee KJ

• KMID: 2515824
• DOI: http://doi.org/10.4041/kjod.2021.51.3.217

Abstract

Maxillary transverse deficiency often manifests as a posterior crossbite or edgeto-edge bite and anterior crowding. However, arbitrary arch expansion in mature patients has been considered to be challenging due to the possible periodontal adverse effects such as alveolar bone dehiscence and gingival recession. To overcome these limitations, nonsurgical maxillary expansion of the basal bone has been demonstrated in young adults. However, the age range for successful orthopedic expansion has remained a topic of debate, possibly due to the underlying individual variations in suture maturity. This case report illustrates nonsurgical, miniscrew-assisted rapid palatal expansion (MARPE) in a 60-yearold patient with maxillary transverse deficiency accompanied by anterior and posterior crossbites, crowding, and gingival recession. The use of MARPE allowed relief of crowding and correction of the crossbite without causing significant periodontal adverse effects.

Keyword

Nonsurgical palatal expansion; Miniscrew-assisted rapid palatal expansion; Adult treatment; Gingival recession

Figure

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  Figure 1 Pretreatment facial and intraoral photographs.

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  Figure 2 Pretreatment radiographs and cephalometric tracing.

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  Figure 3 Treatment progress using the miniscrew-assisted rapid palatal expansion appliance. A, Opening of diastema after 4 weeks of activation (0.2 mm/day). B, Post-expansion.

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  Figure 4 Periapical radiographs. A, Pre-expansion. B, Post-expansion. C, At the end of active treatment.

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  Figure 5 Final facial and intraoral photographs.

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  Figure 6 Cephalometric superimposition.

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  Figure 7 Interapex width before and after palatal expansion measured between the maxillary first premolars (A); second premolars (B); first molars (C); second molars (D); and Yonsei Transverse Index measured before and after palatal expansion in the maxilla (E) and mandible (F).

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  Figure 8 Comparison of cone-beam computed tomography (CBCT) images before and after palatal expansion. A, Superimposition of pre- and post-expansion CBCT scans. B, Axial palatal section before expansion. C, Axial view showing suture opening after expansion.

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  Figure 9 Comparison of pretreatment (A), posttreatment (B), and follow-up (C) dental casts.

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  Figure 10 Buccal bone plate before (A) and after (B) palatal expansion.

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  Figure 11 Intraoral photographs taken at the 6-month follow-up.

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