Maxillary transverse expansion in adults: Rationale, appliance design, and treatment outcomes  Kee-Joon Lee, Sung-Hwan Choi, Tae-Hyun Choi, Kyung-Keun.

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Maxillary transverse expansion in adults: Rationale, appliance design, and treatment outcomes  Kee-Joon Lee, Sung-Hwan Choi, Tae-Hyun Choi, Kyung-Keun Shi, Byeong-Tak Keum  Seminars in Orthodontics  Volume 24, Issue 1, Pages 52-65 (March 2018) DOI: 10.1053/j.sodo.2018.01.006 Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 1 Simulation of treatment outcome using setup model. (A) Initial cast with severe transverse problem, (B) setup model with insufficient transverse correction, and (C) setup model with sufficient basal bone expansion. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 2 Clinical manifestation of transverse problems. (A) Ideal buccal occlusion, (B) insufficient buccal overjet, (C) transverse compensation, and (D) open lingual occlusion. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 3 Maxillomandibular dental arch widths in a 16-year-old female. (A) PA ceph showing 30mm difference, indicating severe transverse discrepancy and (B) axial computed tomography view showing similar basal bone widths. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 4 Maxillomandibular transverse difference15. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 5 Initial intraoral photographs. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 6 Three-dimensional rendering of initial model indicating relatively narrow maxillary basal bone. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 7 Maxillary arch expansion and alignment. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 8 Final intraoral photographs. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 9 Final extraoral photographs and cephalometric superimposition showing almost identical facial profile. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 10 Three-dimensional rendering of final model indicating adequate transverse correction in both crown and basal bone levels. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 11 Finite element models for conventional (C-RPE), bone-borne (B-RPE), and MARPE. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 12 Stress distribution by each expander at respective circummaxillary, buccal place, and suture areas. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 13 Purely bone-borne RPE for a 11-year-old boy. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 14 Application of MARPE in the middle age. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 15 Intraoral photographs before and after treatment with correction of distinct buccal crossbite on the left side. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 16 Initial intraoral photographs showing remarkable posterior open-bite and transverse discrepancy, orthopedic expansion with MARPE and subsequent alignment using lingual braces. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 17 Initial PA and CBCT view showing facial asymmetry. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

Figure 18 Final intraoral and extraoral view in comparison to initial extraoral view. Seminars in Orthodontics 2018 24, 52-65DOI: (10.1053/j.sodo.2018.01.006) Copyright © 2018 Elsevier Inc. Terms and Conditions

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