Rapid maxilary expansion in young adults: comparison of tooth-borne and bone-borne appliances, a cohort study.

  • Victor Rojas Facultad de Odontología, Universidad de los Andes, Las Condes, Santiago, Chile.
  • Catalina Macherone Facultad de Odontología, Universidad de los Andes, Las Condes, Santiago, Chile.
  • Maria Ignacia Zursiedel Facultad de Odontología, Universidad de los Andes, Las Condes, Santiago, Chile.
  • Juan Guillermo Valenzuela Facultad de Odontología, Universidad de Chile, Santiago, Chile.


Introduction: Maxillary constrictions are one of the most frequent abnormalities, regardless of the type of dentition studied. They can be treated either with tooth-borne or bone-borne expander appliances, depending on the biological maturation of the patient. Treatment during prepubertal stages has been shown to be successful, but there is evidence of an open suture even in late adolescence stages. The aim of this study is to compare the effects of a rapid expansion bone-borne device to a tooth-borne device in young adults suffering from maxillary constriction, by means of Cone-Beam Computed Tomography. Materials and methods: A retrospective observational study was conducted in nine patients (three males, six females) with a mean age of 18±5.5 years, who attended the Dentistry Service of Universidad de Chile during 2014-2015. Six patients were treated with tooth-borne appliances (Hyrax type) and three patients with bone-borne appliances (MARPE). Linear measurements of the anterior and posterior transverse dimension and angular measurements of the inclination of molars and incisors were obtained through CBCT for each group in T1 and T2. Results: A significant increase in the posterior transverse dimensions in both groups was observed. Radiolucency of the suture was observed in all patients treated with miniscrews and in half of the patients treated with Hyrax. Greater angulation of molars was shown in the tooth-borne group in comparison with the bone-borne group. Conclusion: Both appliances caused an increase in the posterior transverse dimension, but bone anchored appliances achieved a more parallel and skeletal expansion. Randomized clinical trials with a larger sample and follow-up are needed.


1. Lin L, Ahn H-W, Kim S-J, Moon S-C, Kim S-H, Nelson G. Tooth-borne vs bone-borne rapid maxillary expanders in late adolescence. Angle Orthod. 2015 Mar;85(2):253–62. 2. Lagravère MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2010 Mar;137(3):304.e1-12; discussion 304-305.
3. Ladewig VM, Capelozza-Filho L, Almeida-Pedrin RR, Guedes FP, de Almeida Cardoso M, de Castro Ferreira Conti AC. Tomographic evaluation of the maturation stage of the midpalatal suture in postadolescents. Am J Orthod Dentofacial Orthop. 2018;153(6):818–24.
4. Angelieri F, Cevidanes LHS, Franchi L, Gonçalves JR, Benavides E, McNamara JA. Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2013;144(5):759–69.
5. Angelieri F, Franchi L, Cevidanes LHS, Gonçalves JR, Nieri M, Wolford LM, McNamara JA Jr. Cone beam computed tomography evaluation of midpalatal suture maturation in adults. Int J Oral Maxillofac Surg. 2017;46(12):1557–61.
6. Tonello DL, Ladewig VM, Guedes FP, de Castro AC, Almeida-Pedrin RR, Capelozza-Filho L. Midpalatal suture maturation in 11- to 15-year-olds: A cone-beam computed tomographic study. Am J Orthod Dentofacial Orthop. 2017;152(1):42–8.
7. Grünheid T, Larson CE, Larson BE. Midpalatal suture density ratio: A novel predictor of skeletal response to rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2017;151(2):267–76.
8. Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2008;134(1):8–9.
9. Baccetti T, Franchi L, McNamara JA. The Cervical Vertebral Maturation (CVM) Method for the Assessment of Optimal Treatment Timing in Dentofacial Orthopedics. Seminars in Orthodontics. 2005;1;11(3):119–29.
10. Tamburrino R, Bouchard N, Vanarsdall R, Secchi A. The Tranverse Dimensión:Diagnosis and Relevance for Functional Occlusion. RWISO 2010:12-21.
11. Lee HK, Bayome M1, Ahn CS, Kim SH, Kim KB, Mo SS, Kook YA. Stress distribution and displacement by different bone-borne palatal expanders with micro-implants: a three-dimensional finite-element analysis. Eur J Orthod. 2014;36(5):531–40.
12. Lagravere MO, Major PW, Flores-Mir C. Long-term skeletal changes with rapid maxillary expansion: a systematic review. Angle Orthod. 2005;75(6):1046–52.
13. Bazargani F, Feldmann I, Bondemark L. Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones. Angle Orthod. 2013;83(6):1074–82.
14. Garib DG, Navarro RDL, Francischone CE, Oltramari PVP. Rapid maxillary expansion using palatal implants. J Clin Orthod. 2008;42(11):665–71.
15. Chung C-H, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofacial Orthop. 2004;126(5):569–75.
16. Mosleh MI, Kaddah MA, Abd ElSayed FA, ElSayed HS. Comparison of transverse changes during maxillary expansion with 4-point bone-borne and tooth-borne maxillary expanders. Am J Orthod Dentofacial Orthop. 2015;148(4):599–607.
17. Choi S-H, Shi K-K, Cha J-Y, Park Y-C, Lee K-J. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod. 2016;86(5):713–20.
18. Haas AJ. Rapid Expansion Of The Maxillary Dental Arch And Nasal Cavity By Opening The Midpalatal Suture. The Angle Orthodontist. 1961;31(2):73–90.
19. Brunetto DP, Sant’Anna EF, Machado AW, Moon W. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE). Dental Press J Orthodontics. 2017;22(1):110–25.
How to Cite
ROJAS, Victor et al. Rapid maxilary expansion in young adults: comparison of tooth-borne and bone-borne appliances, a cohort study.. Journal of Oral Research, [S.l.], v. 8, n. 3, p. 201-209, aug. 2019. ISSN 0719-2479. Available at: <http://joralres.com/index.php/JOR/article/view/854>. Date accessed: 17 sep. 2019. doi: https://doi.org/10.17126/jor.v8i3.854.