Posterior crossbite or narrow maxillary arch is frequently encountered in patients presenting for orthodontic treatment. How do you decide in your clinical practice regarding the situations in which to use a hyrax rapid palatal expansion appliance, or use an alternative expansion appliance known as mini-screw assisted rapid palatal expansion appliance (MARPE), and when to expand with only arch-wires.
MARPE is generally recommended after the mid palatine sutures fuse. it is instead of SARPE. broader arch wires are recommended for dental expansion
Thank you Dr. Ravindra for your comments. Yes MARPE may help in expansion in late adolescents after the fusion of suture as a non-surgical method instead of SARPE. But is chronological age still used as a barometer to judge the fusion of mid palatal suture.
MARPE is basically an option to SARPE and need to be done in severe maxillary constriction cases, in adolescents where the midpalatine suture is already fused, on the other hand in younger patients with similar symptoms , where the suture has nit fused , Hyrax appliance has to be used.
Regarding NiTi wires, only dentoalveolar expansion can be brought about and hence can be used in only mild - moderate maxillary arch constriction cases
Orthodontics clinic can use hyrax expanders traditionally between age group
7-14 years. In this situation traditional expander is glued to the teeth to create both dental and skeletal expansion. the most common style hyrax completely metal design with bands around the molar teeth.
Marpe expander can age group 7-8 years old at the time jaw formation that is the treatment no difficulty patients
Orthodontics can see the situation patients with crowd of teeth or breathing problems to upper anterior teeth expand .
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