Skeletal expansion of the upper jaw in adults: current state of the problem

Abstract

The article presents literature data on skeletal expansion of the maxilla in adults.
The historical development of this method, approaches to orthodontic treatment, correction
methods and long-term results are considered.
Purpose. To analyze the methods of skeletal expansion of the maxilla in adults, their
effectiveness, and to identify aspects that require further resolution.
Research methods: analytical, comparative, semantic, method of systematization of scientific
knowledge.
Research results. In adults, maxillary expansion can be difficult due to excessive buccal
root resorption and gingival recession. To overcome these difficulties, SARME — surgical
rapid maxillary expansion was introduced.
Important factors during rapid maxillary expansion are the speed of expansion, the shape
of the appliance, the age and gender of the patient, the degree of discrepancy between the
upper and lower jaws, the degree of crossbite and the level of molar angulation, the physical
availability of space for expansion, the presence of concomitant diseases and metabolic
disorders, the condition of the periodontium and gingival mucosa.
It was found that skeletal expanders are divided into those that are attached to the palatal
arch (transpalatal distractors) and devices with bone fixation of the tooth. Rapid skeletal
expansion is presented in the literature with different designs regarding the number and
length of mini-screws, the number of fixed teeth and the position of the device along the
palate. However, all of them were characterized by clinically comparable effectiveness in
terms of dentoalveolar, skeletal and nasal effects.
It has been proven that the use of rapid expansion of the upper jaw is possible at any age, and
the differences between the indicators of adolescence, young and mature age are irrelevant.
Conclusions. The method of rapid skeletal expansion in adult orthodontics is quite effective
and is considered the method of choice in situations of transverse deficiency of the upper
jaw. Studies have proven comparable effectiveness of different methods of rapid expansion
of the upper jaw, but the evaluation remains an urgent issue.