A maxillary or palatal expander is a device in dentistry that is used to expand the upper jaw in order to compensate for the deficit left when the upper jaw is not of the normal width it supposed to be and even to allow the upper and lower teeth fit together equally and effectively.
This is a common orthodontic procedure. Expander fixation time 8- 18 years.
Moreover, palatal expansion is more, disturbing, uncomfortable and takes longer in adults. Last but not least, a palatal expander fixation is often concluded by braces to then straighten the teeth and to close any gaps that might accompany the expansion process.
"It is believed that expansion therapy should be started in patients either before or during their peak growth spurt. To obtain maximal skeletal changes, the therapy is typically initiated at a very early age. Expansion therapy performed after the peak growth spurt will lead to more dental changes than skeletal ones, leading to tipping of buccal teeth."source
Indications for Maxillary Expanders
Maxillary expanders is usually employed when there is deficient relationship as regards the width of upper and lower jaw ranging up to 4mm or more.
The width calculated using the first molar of the maxilla by considering that molar tip or flare outward to compensate for the difference in space.
Likewise, Rpe is used to correct cleft palate and space compensation for overcrowding.
Types of Expansion of the Maxilla
1- Rapid Maxillary Expansion
2- Slow Maxillary Expansion
1- Rapid Maxillary Expansion
Rapid palatal expansion (RPE) or Rapid Maxillary Expansion (RME) is an bony expansion methodology where expansion of 0.5 mm to 1 mm is achieved each day nearly up to the point of posterior crossbite is relieved.
The key turning pushes the arms of the expander within 0.25mm to 1mm dimensions daily.
RPE can be retained by tooth support, bone support or both.
Effects of Rapid Maxillary Expansion
The major effect of the use of maxillary expanders is midline diastemas. It takes a week to two weeks before a patient can adjust to palatal expander use with reference to eating and speech articulation.
For expansion that can not be managed by the patient and located on the mandible, a bionator appliance may be necessary and a suitable alternative for effective yield of expansion.
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