The adults achieved 18% of their transmolar expansion at the height of the palate and the remainder with buccal displacement of the alveolus. The mandibular plane and lower facial height were unchanged. Rapid maxillary expansion in adults flared the molars buccally only 3° per side. If the expander was properly fabricated, and turned no more than once a day, the procedure was well-tolerated. In the adults, transarch expansion and the correction of the posterior crossbites were stable following discontinuance of retainers (mean 5.9 years). The mean transarch width increase was similar in adults and children who had RME 4.6 ± 2.8 compared to 5.7 ± 2.4 mm for the molars and 5.5 ± 2.4 compared to 5.7 ± 2.5 mm for the second premolars. Students’ t-test, and the analysis of variance followed by the Scheffé test were used to determine if there were significant differences among time periods and among the 3 study groups. A control group of 52 adult orthodontic patients who did not require RME was also studied. Rapid maxillary expansion using a Haas expander was examined in 47 adults and 47 children. The purpose of this paper is to study the efficacy of nonsurgical RME, and to determine the incidence of complications such as relapse of the expansion, pain and tissue swelling, tipping of the molars, opening rotation of the mandible and gingival recession. Rapid maxillary expansion (RME) in the adult is thought to be an unreliable procedure with several adverse side effects and, consequently, surgically assisted RME is considered the preferred procedure. Nonsurgical Rapid Maxillary Expansion in Adults: Report on 47 Cases Using the Haas ExpanderĬhester S. Visit the Adult Orthodontics section to learn more about adult treatment SUPPORTING ARTICLES: (All evidence-based) Interestingly, most adults that undergo surgically assisted jaw expansion do not need a surgery to solve their crossbite! They do not need “jaw expansion.” They often only need “dental expansion.”Īdults should carefully select their orthodontist to avoid unnecessary procedures. This involves a surgery that cuts down the center of the upper jaw.

As such, many orthodontists only expand adults with crossbites using “surgically assisted” jaw expansion. Treating adults with crossbites can be different than treating children with crossbites. Additionally, crossbites of children results in TMJ problems over time.Įxpanding the upper jaw of a child is straight-forward, because the upper jaw is soft and formable before the age of 16 years.Īdults with crossbites should also be treated, but some level of TMJ damage will be apparent on the jaw joints (sometimes debilitating damage). AGE AND JAW EXPANSION:Ĭhildren with crossbites should be treated as early as reasonable (generally not earlier than 5 years old if possible). Since children are growing, crossbites tend to force the jaw into non-centered positions, and the jaw can grow off center during childhood growth. Additionally, both jaws will be unstable and have a tendency to collapse back to their original position after treatment is complete. Widening of the lower jaw has a tendency to develop TMJ problems. Therefore, the lower jaw must be expanded to fit the widened upper jaw. Why not broaden? If no crossbites exist, and you expand the upper jaw, the upper jaw becomes too wide for the lower jaw. In fact, the literature would advise against “broadening.” While some doctors try to “broaden” the smile via expansion, this “broadening” is not supported by the literature in orthodontics. As circumference increases, the dental arch perimeter increases. An enlarged arch perimeter allows crowded teeth to align along the greater perimeter.īroadening the Smile – A dubious treatment:Įxpansion for any reason other than Posterior Crossbites or Crowding is dubious.

As such, the upper jaw is widened until it fits around the lower jaw.Įxpansion can also resolve crowding by enlarging the circumference in the are of the front teeth. WHEN TO EXPAND:Įxpansion is generally utilized when the upper jaw is too narrow to fit around the lower jaw. Most patients are less than perfect in their cooperation. Expanders can be fixed (glued in) or removable.įixed expanders are generally preferred over removable appliances, because removable appliances require patient cooperation to be successful. Expansion of the lower jaw is occasionally utilized, but a very unusual and dubious treatment. The upper jaw is usually the one undergoing expansion. As such, the upper jaw should be “wider” than the lower jaw. In general, the upper set of teeth should fit around (outside) the lower set of teeth. The term jaw expansion refers to “widening” of the back teeth.

Andrew schwartz orthodontist