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P.G. Makhija
Modern Dental College & Research Centre, Indore, INDIA
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Some of the authors of this publication are also working on these related projects:
(i) Occlusal force distribution in Class I, Class II, Class III malocclusions FEM study on CBCT generated models with (A) normal mandible in different classes, and (B)
normal maxilla in different classes View project
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Abstract:
INTRODUCTION
Maxillary width deficiencies normally do Study on histological suture appearance.
not present an orthodontic challenge if Other recent evidence suggests that it is
they are detected before or during the indeed possible to successfully expand the
adolescent growth spurt. Correction of palate in young adults.7–11 This article
these deficiencies with a maxillary rapid reviews the recent literature on nonsurgical
palatal expander, first popularized more RPE in young adults and provides a
than 40 years ago by Haas,1 yielded well- rationale for using this approach based on
controlled and predictable results. a case the authors successfully treated by
However, once patients are past their RPE alone. Patients and parents are
growth spurt, which occurs at about the sometimes reluctant to accept treatment
age of 12–13 years in females and\ 14–15 plans that incorporate surgically assisted
years in males,2 the protocol for rapid RPE, because they are concerned about the
palatal expansion (RPE) is not quite so inherent risks of surgery and the gravity of
clear. According to some authors, the procedure. Clinicians are thus faced
expansion of the maxillary arch in mature with a dilemma when treating patients
patients is not feasible.3–5 Proffit3 reports after the palatal sutures have closed. The
that “by the late teens, interdigitation and palatal sutures reportedly close as early as
areas of bony bridging across the suture when a patient reaches 12–13 years of
develop to the point that maxillary age.12 Furthermore, other sutures adjacent
expansion becomes impossible,” a belief to the midpalatal suture reportedly are too
based on Melsen’s6 rigid to expand past the late teens.3,4,6,13 A
popular treatment option from early
* Post Graduate Student adulthood onwards is the LeFort 1
** Professor and Clinical incharge
osteotomy, or osteotomies of the palatal
*** Professor and Head,
**** Professor. Department of Orthodontics, midline and the lateral aspects of the
Modern Dental College & Research Centre, maxillae combined with orthodontics.
Indore. However, many patients decline surgery,
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