심한 크라우딩과 안면 비대칭을 동반한 골격성 III급 환자에서 Maxillary Skeletal Expander를 다각적으로 이용한 비발치 절충 치험례

이승렬,차경석,이진우,정동화,이상민 대한치과교정학회 2020 대한치과교정학회 임상저널 Vol.10 No.2

This case report describes a case in skeletal Class III malocclusion with asymmetry, maxillary skeletal expander (MSE) can be a compromised treatment option that successfully improves the occlusion. A 14-year-old female patient with facial asymmetry visited our orthodontic department, exhibiting left displacement of the mandible, severe crowding of the maxillary arch, shallow overjet and maxillary transverse deficiency. At the beginning of treatment, MSE was installed to expand maxillary transverse width. For unilateral expansion, the arm on the right side was removed after expansion to induce relapse. Afterwards, the rear arm was left without removing the MSE and was used for distal movement of the molars with the horseshoe application. In the mandible, the bi-dimensional wire and MEAW was applied. Appropriate use of MSE can achieve both unilateral expansion and distal movement of the molars.

Midfacial soft tissue changes after maxillary expansion using micro-implant-supported maxillary skeletal expanders in young adults

Hieu Nguyen,Jeong Won Shin,Hai-Van Giap,Ki Beom Kim,Hwa Sung Chae,Young Ho Kim,Hae Won Choi 대한치과교정학회 2021 대한치과교정학회지 Vol.51 No.3

soft tissue changes following maxillary expansion using micro-implantsupported maxillary skeletal expanders (MSEs) in young adults by cone-beam computerized tomography (CBCT) and to evaluate the correlations between hard and soft tissue changes after MSE usage. Methods: Twenty patients (mean age, 22.4 years; range, 17.6–27.1) with maxillary transverse deficiency treated with MSEs were selected. Mean expansion amount was 6.5 mm. CBCT images taken before and after expansion were superimposed to measure the changes in soft and hard tissue landmarks. Statistical analyses were performed using paired t-test and Pearson’s correlation analysis on the basis of the normality of data. Results: Average lateral movement of the cheek points was 1.35 mm (right) and 1.08 mm (left), and that of the alar curvature points was 1.03 mm (right) and 1.02 mm (left). Average forward displacement of the cheek points was 0.59 mm (right) and 0.44 mm (left), and that of the alar curvature points was 0.61 mm (right) and 0.77 mm (left) (p < 0.05). Anterior nasal spine (ANS), posterior nasal spine (PNS), and alveolar bone width showed significant increments (p < 0.05). Changes in the cheek and alar curvature points on both sides significantly correlated with hard tissue changes (p < 0.05). Conclusions: Maxillary expansion using MSEs resulted in significant lateral and forward movements of the soft tissues of cheek and alar curvature points on both sides in young adults and correlated with the maxillary suture opening at the ANS and PNS.

상악 골격성 확장장치와 페이스 마스크를 사용한 골격성 III급 성장기 아동의 치험례

김태균(Tae-Gyun Kim),이영준(Young-Jun Lee),채종문(Jong-Moon Chae),장나영(Na-Young Chang) 대한치과교정학회 2021 대한치과교정학회 임상저널 Vol.11 No.2

Face mask treatment with a rapid palatal expander is common in children with Class III malocclusion and maxillary deficiency. However, it can cause anchorage loss and dental side effects. To overcome these disadvantages, the use of skeletal anchorage such as miniplates in the infrazygomatic crest area or palate has been reported. This clinical case report presents face mask treatment in skeletal Class III adolescent with maxillary skeletal expander (MSE). MSE has been developed for the maxillary expansion in adults, but it can be used as a skeletal anchorage for face mask treatment in children. The post-treatment profile was significantly improved without any dental side effects.

미니 임플랜트를 이용한 상악골 확장 시 성공을 위한 임상 팁

조진형 대한치과교정학회 2019 대한치과교정학회 임상저널 Vol.9 No.4

Patients with severe dental crowding or transverse disharmony between the maxilla and mandibular arches required expansion of the maxilla. In the past, there were several methods to expand the maxillary arch such as removable, fixed appliances, or surgery. Recently, mini-implants have been used as a new orthodontic technique to expand the maxilla in difficult cases. Microimplant-assisted rapid palatal expander (MARPE) was introduced as an alternative to surgically assisted rapid maxillary expansion (SARME). In this article, three cases using maxillary skeletal expander (MSE, a specific type of MARPE) and clinical tips (additional mini-implants, corticotomy and cortipuncture) that increase the success rate of these appliances are presented.

Long-term effects of maxillary skeletal expander treatment on functional breathing

Andrew Combs,Ney Paredes,Ramon Dominguez-Mompell,Martin Romero-Maroto,Boshi Zhang,Islam Elkenawy,Luca Sfogliano,Layla Fijany,Ozge Colak,Ben Wu,Won Moon 대한치과교정학회 2024 대한치과교정학회지 Vol.54 No.1

Objective: To investigate the long-term effects of maxillary skeletal expander (MSE) treatment on functional breathing. Methods: Objective measures of breathing, the peak nasal inspiratory flow (PNIF), and peak oral inspiratory flow (POIF), and subjective measures of breathing, the visual analog scale (VAS) and nasal obstruction symptom evaluation (NOSE) survey, were used to investigate the long-term effects of MSE in functional breathing. Seventeen patients, mean age 19.4 ± 3.9 years treated at the UCLA Orthodontics Clinic were assessed on their functional breathing at 3 timepoints: pre-expansion (T0), post-expansion (T1), and post-orthodontic treatment (T2). Results: Immediately after expansion (T1), all the objective functional breathing values were significantly increased in comparison to T0 (P < 0.05). The VAS total, VAS right and VAS left were significantly lower at T1 in comparison to T0 (P < 0.05). At 26.8 ± 3.9 months after MSE expansion (T2), PNIF total, PNIF right, PNIF left, and POIF were significantly higher when compared to T0 (P < 0.05). Also, VAS total, VAS right and VAS left were significantly lower at T2 when compared to T0 (P < 0.05). Additionally, there was a positive correlation between PNIF and the magnitude of expansion at anterior nasal spine and zygomaticomaxillary point (ZMA). There was a positive correlation between total VAS and the magnitude of expansion at the ZMA. There were no significant changes for the NOSE subjective breathing measurement at all time comparisons. Conclusions: Overall, MSE treatment produces an increased objective and subjective airway improvement that continues to remain stable in the long-term post expansion.

Pattern of microimplant displacement during maxillary skeletal expander treatment: A cone-beam computed tomography study

Ney Paredes,Ausama Gargoum,Ramon Dominguez-Mompell,Ozge Colak,Tam Duong,Maya Giannetti,Fernanda Silva,Kendra Brooks,Won Moon 대한치과교정학회 2023 대한치과교정학회지 Vol.53 No.5

Objective: To analyze the microimplant (MI) displacement pattern on treatment with a maxillary skeletal expander (MSE) using cone-beam computed tomography (CBCT). Methods: Thirty-nine participants (12 males and 27 females; mean age, 18.2 ± 4.2 years) were treated successfully with the MSE II appliance. Their pre- and post-expansion CBCT data were superimposed. The pre- and post-expansion anterior and posterior inter-MI angles, neck and apical inter-MI distance, plate angle, palatal bone thickness at the MI positions, and suture opening at the MI positions were measured and compared. Results: The jackscrew plate was slightly bent in both anterior and posterior areas. There was no significant difference in the extent of suture opening between the anterior and posterior MIs (P > 0.05). The posterior MI to hemiplate line was greater than that anteriorly (P < 0.05). The apical distance between the posterior MIs was greater than that anteriorly (P < 0.05). The palatal thickness at the anterior MIs was significantly greater than that posteriorly (P > 0.01). Conclusions: In the coronal plane, the angulation between the anterior MIs in relation to the jackscrew plate was greater than that between the posterior MIs owing to the differential palatal bone thickness.