THE USE OF MARPE IN THE CORRECTION OF MAXILLARY ATRESIA IN PATIENTS WITH ADVANCED SUTURAL MATURATION: AN INTEGRATIVE REVIEW
DOI:
https://doi.org/10.56238/arev7n10-213Keywords:
Malocclusion, Mini Dental Implants, Palatal Expansion TechniqueAbstract
Maxillary atresia is an orthodontic condition characterized by narrowing of the upper arch, classified as a transverse malocclusion. It has a multifactorial origin and may involve harmful oral habits and genetic factors. It is a common orthodontic problem that leads to several clinical implications and is often associated with unilateral or bilateral posterior crossbite. Rapid maxillary expansion (REM) is considered the gold standard in the treatment of this condition, being effective in therapies started early. However, in adult patients, the prognosis is uncertain due to increased interdigitation of the maxillary sutures and stiffness of the bone structures. In these situations, surgery is recommended, but risks and costs can be obstacles to acceptance. As an alternative to surgical treatment, the rapid maxillary expander assisted by orthodontic mini-implant (MARPE) emerged. Therefore, the objective of this work is to carry out an integrative review of the literature about the particularities involved in the success of maxillary disjunction performed through MARPE in patients with advanced suture maturation. To this end, a literature search was carried out through the PubMed, BIREME and Scopus databases, in which the descriptors “Malocclusion AND Mini Dental Implants, AND Palatal Expansion Technique” were used. By applying the search strategy, a total of 25 articles were found, of which 12 were located in the PubMed database, along with 7 studies found in the BIREME database and 6 in the Scopus database. After applying the inclusion and exclusion criteria, 8 articles were selected. MARPE is a bone support RME device connected to the palate through four mini orthodontic screws installed parallel to the median palatal suture, allowing the expansion force to impact directly on the jaw bone. In the literature there is evidence of the success of MARPE during the treatment of maxillary transverse deficiencies. When compared to other conventional expander devices, this expander increased skeletal effects and decreased dental inclinations of the posterior teeth. Furthermore, it showed reduced costs and morbidity compared to surgically assisted disjunction. Based on the results observed, it can be concluded that the use of MARPE expanded the age range for non- surgical maxillary expansion, becoming an effective alternative in the treatment of transverse maxillary deficiencies in patients with advanced sutures.
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