Orthodontic and orthopedic expansion of the transverse dimension: A four decade perspective  James A McNamara, Lorenzo Franchi, Laurie McNamara McClatchey  Seminars in Orthodontics  Volume 25, Issue 1, Pages 3-15 (March 2019) DOI: 10.1053/j.sodo.2019.02.002 Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure1 Bonded acrylic splint expander that is made from 3 mm thick Splint Biocryl. Brackets also have been placed on the maxillary incisors for alignment. Copyright Needham Press, used with permission. Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure2 Removable lower Schwarz appliance that is activated once per week. Copyright Needham Press, used with permission. A. Pre-expansion B. Post-expansion. Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure3 Acrylic maintenance plate with ball clasps, oblique view. Copyright Needham Press, used with permission. Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure4 Transpalatal arch made from 0.036″ stainless steel wire. Copyright Needham Press, used with permission. Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure5 Lower lingual arch made from 0.036″ stainless steel wire. Copyright Needham Press, used with permission. Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure6 Change in molar relationship from T1 to T2, an interval of 4years. In the untreated Class II group, the molar relationship on average did not change. In the expansion group, however, the molar relationship improved in 92% of the sample, with 48% improving 2 mm or more. Adapted from Guest et al., 2010.5 Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions

Figure7 Stages of maturation of the midpalatal suture as observed with CBCT images. Stage A is seen in this patient as a relatively straight high-density line at the midline. Stage B is observed as one scalloped, high density line at the midline. Stage C is visualized as two parallel, scalloped, high density lines that are close to each other and separated in some areas by small low-density spaces. Stage D is visualized as two scalloped, high-density lines at the midline on the maxillary portion of the palate, while the midpalatal suture cannot be visualized in palatine bone. At stage E, sutural fusion has occurred in the maxilla. From Angelieri et al., 2013.25 Seminars in Orthodontics 2019 25, 3-15DOI: (10.1053/j.sodo.2019.02.002) Copyright © 2019 Elsevier Inc. Terms and Conditions