Kim Harim, Park Sun-Hyung, Park Jae Hyun, Lee Kee-Joon
Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.
Postgraduate Orthodontic Program, Arizona School of Dentistry & Oral Health, A. T. Still University, Mesa, AZ, USA.
Korean J Orthod. 2021 May 25;51(3):217-227. doi: 10.4041/kjod.2021.51.3.217.
Maxillary transverse deficiency often manifests as a posterior crossbite or edge-to-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-year-old 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.
上颌横向发育不足常表现为后牙反合或对刃合以及前牙拥挤。然而，由于可能出现牙槽骨裂开和牙龈退缩等牙周不良反应，在成年患者中进行任意的牙弓扩展被认为具有挑战性。为克服这些局限性，已在年轻成年人中证实了对基骨进行非手术上颌扩展。然而，成功进行正畸扩展的年龄范围仍是一个有争议的话题，可能是由于缝合成熟度存在个体差异。本病例报告展示了在一名60岁上颌横向发育不足并伴有前后牙反合、拥挤和牙龈退缩的患者中进行非手术微螺钉辅助快速腭扩展（MARPE）。使用MARPE可缓解拥挤并纠正反合，且不会引起明显的牙周不良反应。
