Transverse maxillary deficiency is relatively prevalent in orthodontic patients. This article reports the use of a Miniscrew-Assisted Rapid Palatal Expansion (MARPE) device for the correction of transverse skeletal maxillary constriction in an adult patient. The patient was a 20-year-old girl with a transverse maxillary deficiency and bilateral posterior crossbite. A MARPE device was positioned on her palate using 4 miniscrews. The activation protocol was one-quarter turn per day every other day, with a total activation duration of 10 weeks following with a 3-month retention period. Pre-MARPE and post-MARPE cone-beam computed tomography cross sections presented a skeletal expansion of maxilla. This report confirms the effective treatment of a mature patient with severe maxillary constriction, highly deep palate, and posterior crossbite using a custom-made modification of MARPE

Statement of the Problem: Refractory nocturnal enuresis possesses a heavy psychosocial burden for the affected child. Only a 15% spontaneous annual cure rate is reported.Purpose: This patient-level meta-analysis aimed to evaluate the efficacy of rapid palatal expansion to treat nocturnal enuresis among children.Materials and Method: A sensitive search of electronic databases of PubMed (since 1966), SCOPUS (containing EMBASE, since 1980), Cochrane Central Register of Controlled Trials, CINAHL and EBSCO till Jan 2014 was performed. A set of regular terms was used for searching in data banks except for PubMed, for which medical subject headings (MeSH) keywords were used. Children aged at least six years old at the time of recruitment of either gender who underwent rapid palatal expansion and had attempted any type of pharmacotherapy prior to orthodontic intervention were included.Results: Six non-randomized clinical trials were found relevant, of which five studies had no control group. Eighty children were investigated with the mean age of 118 (28.12) months ranged from 74 to 185 months. The median time to become completely dry was 2.87 months [confidence interval (CI) 95% 2.07-2.93 months]. After one year, the average rate of becoming complete dry was 31%. The presence of posterior cross bite [relative risk (RR): 0.31, CI 95%: 0.12-0.79] and signs of upper respiratory obstruction during sleep (RR: 5.1, CI 95%: 1.44-18.04) significantly decreased and increased the chance of improvement, respectively. Meanwhile, the other predictors did not significantly predict the outcome after simultaneous adjustment in Cox regression model.Conclusion: Rapid palatal expansion may be considered when other treatment modalities have failed. The 31% rate of cure is promising when compared to the spontaneous cure rate. Though, high-level evidence from the rigorous randomized controlled trials is scarce (Level of evidence: C).

Background: Rapid maxillary expansion (RME) is an important method for correcting maxillary transverse deficiency. Objectives: The aim of this study was to assess the variations of the palatal plane in the anteroposterior and vertical directions after RME observed under cone-beam computed tomography. Methods: The images using the cone-beam computed tomography were obtained from the skull of 15 patients (10 males, 5 females) with ages from 7 to 14 years, at the specialization course in orthodontics of the School of Dentistry at UFBA before (T0) and after (T1) RME using the Haas-type expander. The sagittal slices were obtained with Dolphin imaging program, premium version 11. 0, in order to visualize the most anterior and posterior extremities of the maxillary bone and the following points: Sella (S), nasion (N), anterior nasal spine (ANS) and posterior nasal spine (PNS). The distances between points S and PNS (L1) and between N and ANS (L2) and the angles formed by the intersection of line SN with the palatal plane (angle 1) and line SN with line N-ANS (angle 2) were measured. Results: The values obtained were statistically analyzed using Students t-test. At the time intervals assessed, no statistically significant difference was found in the linear measurements L1 and L2 (P = 0. 296 and P = 0. 674, respectively). No statistical significance was found when assessing angles 1 and 2 (P = 0. 673 and P = 0. 589, respectively). Conclusions: RME using the Haas-type expander does not cause any alterations in the vertical or sagittal position of the maxilla.

Introduction: Crossbite is a common malocclusion with a 7-23% prevalence rate. Treatment is based on the expansion of the mid-palatal suture (MPS) with Rapid Palatal Expansion(RPE) followed by a retention period to reach new bone maturation, enough to maintain the results stable. This systematic review was conducted to evaluate the effectiveness of low-level laser therapy (LLLT) in increasing bone formation in MPS. Methods: This article was written by the PRISMA checklist. Electronically, 3 databases, namely PubMed, Scopus, and Embase, were searched with the keywords selected based on PICO. Time (2010-2021) and language restrictions were performed. Results: 528 articles, out of which 374 studies were screened, were found, and 9 full-text articles were subsequently included considering these inclusion criteria: randomized clinical trial (RCT) that examines the efficacy of LLLT in rapid palatal expansion (RPE), age under 15 years, non-surgical RPE with a tooth-supported appliance, and low-intensity laser application. Finally, 4 articles were appraised by Cochrane version 5. 2. 0 with 7 domains. 3 of 4 articles showed LLLT has a significant impact on bone formation. One of them showed no significant difference in pain perception and bone density between the laser and non-laser groups. Conclusion: While many studies have assessed the effect of LLLT on bone formation in animal models, high-quality clinical trials are missing in this regard. The available clinical trials suggest a positive effect of LLLT on sutural bone formation after RPE.

Introduction: This study was performed to compare the effects of single and multiple irradiations of low-level laser therapy (LLLT) on bone regeneration in a mid-palatal suture following rapid palatal expansion (RPE). Methods: In this animal study, 40 male Wistar rats underwent RPE for 7 days and were divided into 4 groups including A: single LLLT on day 7, B: Multiple LLLT on days 7, 9, 11, 13 and 15, C: control (no LLLT), and D: sacrificed on day 7. Animals in group D were used to determine the amount of suture expansion. LLLT was done by a diode laser set at an 808 nm wavelength with a useful power output of 100 mW and duration of 0. 1 ms. LLLT was applied to three points. After three weeks of retention, the rats were sacrificed and beheaded and the maxilla was evaluated by occlusal radiography, µ-CT, and histomorphometric analyses. A comparison of the mean measurements between the groups was performed using ANOVA and the Tukey post hoc test. Results: Based on occlusal radiography and µ CT, bone density in group B was significantly higher than group A and group C (P < 0. 05). There was no significant difference in bone density between group A and group C (P > 0. 05). Mean suture width (MSW) in group B was significantly lesser than the control group (P = 0. 027) while there was no significant difference between MSWnin groups A and B (P = 0. 116) and groups A and C (P = 0. 317). Conclusion: It may be concluded that multiple low-power laser irradiation improves bone regeneration after RPE while single irradiation does not have a positive effect.