Document Type : Case report/ series


1 Department of Orthodontics, Dental School, Mashhad University of Medical Sciences, Mashhad, Iran

2 Dental Research Center, Department of Orthodontics , Mashhad University of Medical Sciences, Mashhad, Iran


Aim: Maxillary transverse deficiencies pose significant challenges in orthodontics, necessitating effective treatment methods. Traditional approaches like rapid maxillary expansion (RME) have demonstrated limitations, especially in skeletally mature patients. Skeletal anchorage-based expansion methods, such as miniscrew-assisted rapid maxillary expansion (MARME), have emerged as viable alternatives, offering advantages in terms of reduced dental side effects and improved stability.
Report of a Case: A 14-year-old female presented with a severely constricted maxillary arch and intricate occlusal issues. This case report details the utilization of MARME as a treatment modality. Miniscrews were strategically placed by an orthodontist specialist, and the expansion process was carefully monitored. Post-treatment outcomes revealed a significant increase in midpalatal suture opening width, showcasing the effectiveness of MARME. Cone beam computed tomography images demonstrated a notable expansion of the transverse dimension, leading to improved occlusal relationships.
Conclusion: Skeletal anchorage-based expansion, particularly MARME, stands out as a preferred method for addressing maxillary constriction in adolescents. This case serves as an illustration of the feasibility and distinctive advantages of Temporary Anchorage Devices (TADs) in the context of maxillary expansion for skeletally mature patients.


Main Subjects

  1. Mommaerts MY. Transpalatal distraction as a method of maxillary expansion. Br J Oral Maxillofac Surg.1999;37(4):268-72. doi:10.1054/bjom.1999.0127 PMID: 10475647.
  2. Bin Dakhil N, Bin Salamah F. The Diagnosis Methods and Management Modalities of Maxillary Transverse Discrepancy.Cureus.2021;13(12):e20482. doi: 10.7759/cureus.20482 PMID: 35047300.
  3. Almuzian M, Short L, Isherwood G, Al-Muzian L, McDonald J. Rapid maxillary expansion: a review of appliance designs, biomechanics and clinical aspects. Orthodontic Update. 2016;9(3):90-95. doi:10.12968/ortu.2016.9.3.90.
  4. Tausche E, Hansen L, Hietschold V, Lagravère MO, Harzer W. Three-dimensional evaluation of surgically assisted implant bone-borne rapid maxillary expansion: a pilot study.Am J Orthod Dentofacial Orthop. 2007;131(4):S92-S9. doi: 10.1016/j.ajodo.2006.07.021 PMID: 17448393.
  5. Rungcharassaeng K, Caruso JM, Kan JY, Kim J, Taylor G. Factors affecting buccal bone changes of maxillary posterior teeth after rapid maxillary expansion. Am J Orthod Dentofacial Orthop.2007;132(4):428.e1-.e8. doi: 10.1016/j.ajodo.2007.02.052 PMID:17920493.
  6. Kim KB, Helmkamp ME. Miniscrew implant-supported rapid maxillary expansion. J Clin Orthod. 2012;46(10):608-12. PMID:23154231.
  7. William R. Proffit, Henry W. Fields Jr, Brent Larson, Sarver DM. Contemporary orthodontics, sixth edition: Elsevier, Inc.2018. 436-7.
  8. Chamberland S. Maxillary expansion in nongrowing patients. Conventional, surgical, or miniscrew-assisted, an update. J World Fed Orthod. 2023 Aug;12(4):173-183. doi: 10.1016/j.ejwf.2023.04.005 PMID:37344295.
  9. Winsauer H, Vlachojannis J, Winsauer C, Ludwig B, Walter A. A bone-borne appliance for rapid maxillary expansion. J Clin Orthod. 2013;47(6):375-81 .PMID: 23863561.
  10. Korbmacher H, Huck L, Merkle T, Kahl-Nieke B. Clinical profile of rapid maxillary expansion--outcome of a national inquiry. J Orofac Orthop. 2005;66(6):455-68. English, German. doi:10.1007/s00056-005-0440-5 PMID: 16331546.
  11. Moon W. Maxillary Expansion in Skeletally Mature Patients with TADs. 2020: 223-32. doi:10.1002/9781119513636.ch24.
  12. Bi WG, Li K. Effectiveness of miniscrew-assisted rapid maxillary expansion: a systematic review and meta-analysis. Clin Oral Investig. 2022;26(6):4509-4523. doi: 10.1007/s00784-022-04415-y PMID: 35211817.
  13. Krüsi M, Eliades T, Papageorgiou SN. Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis.Prog Orthod.2019;20(1):9. doi:10.1186/s40510-019-0261-5 PMID: 30799516.
  14. Krüsi M, Eliades T, Papageorgiou SN. Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis. Prog Orthod. 2019;20(1):9. doi:10.1186/s40510-019-0261-5 PMID: 30799516.