CLINICAL GUIDELINES FOR THE USE OF RAPID MAXILLARY EXPANDER IN GROWING PATIENTS

Transverse Maxillary Deficiency (TMD) is a common disorder in the clinical practice of every orthodontist, affecting patients of all age groups. Rapid Maxillary Expansion is an effective and common method applied for orthopedic correction of TMD.
Aim:
The purpose of this presentation is to provide the components of elaborated clinical protocol and guidelines for rapid maxillary expansion treatment.
Materials and methods:
The guidelines are based on a study involving 74 patients, among whom 51 girls and
23 boys, of mean age 13.2 years (± 2.24). An analysis of the changes in the maxillary arch recorded before and after using a Hyrax appliance for rapid maxillary expansion in patients with malocclusions combined with maxillary transverse deficiency is performed. Patients' skeletal age assessment was performed on lateral cephalograms through changes in cervical vertebral development by combining the method proposed by Lamparski with the modified method of Bacchetti, Franchi and Mc Namara.
Results:
The protocol consists of four part. First and Second part contains the results that are of particular importance for the development of an optimal successful treatment plan. Third and fourth parts contains general prognostic values, algorithms, and the most influential factors that should be considered in planning rapid expansion treatment with the Hyrax expander.
Conclusions:
The guidelines focus the clinician's attention on the individual maturation of adolescent patients and help the clinician to quickly choose a treatment approach. The information is synthesized and logically ordered to optimally aid the clinician in choosing a suitable treatment approach and a subsequent retention plan. The use of the protocol on prognosis of treatment and the factors influencing the outcome of the treatment with rapid maxillary expansion provide confidence to the clinician for the predictability of the results."


Keywords: rapid maxillary expansion, guidelines

Maria Stoilova-Todorova

DDS, MSD, PhD, Assistant professor, Orthodontics Department, Faculty of Dental Medicine, Medical University– Plovdiv, Bulgaria