Palatal expansion

A patient who would rather not wait several months for the end result achieved by a palatal expander may be able to opt for a surgical separation of the maxilla.

This is often known as "six month retention period" during which the bone fills the gap in the maxilla that was created by the expansion process.

The expansion process usually results in a large gap between the patient's two top front teeth, often known as diastema.

It usually takes a week or two for one to adjust to eating and speaking after first receiving the rapid palatal expander.

In slow expansion technique, a patient is ordered to turn the screw 4 times which amounts of 1mm per week.

Patient is instructed to turn the jackscrew at the same rate for next 8–10 weeks to achieve the desired expansion.

Some studies have reported that diastema in slow type of expansion also happens less due to the interdental fibers having chance to close the space as the maxilla is being expanded.

Mini-implant Assisted Rapid Palatal Expansion (MARPE) involves the forces being applied directly to the maxillary bone instead of the teeth.

This technique involves placing anywhere from 2–4 mini-implants in the palatal vault area of maxilla to anchor the RME appliance to the screws.

In most adults, especially males a surgical assist may be recommended to achieve consistent outcomes, such as a typical SARPE procedure (now SAMARPE) or less invasive techniques.

The orthodontist will then finish the procedure by connecting the palatal expanders band rings to the patients maxillary molars.

In 1889, J. H. McQyillen who was the president of the American Dental Association at that time, opposed Angell's idea regarding arch expansion.

He was also one of the first people to report lowering of mandible with bite opening and increase in nasal width and gain in arch perimeter.