Transverse maxillary expansion

[Xplorer]

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For the wire-bending brains out there: Transverse maxillary expansion is most physiologc and effective when performed throughout adolescence, and up to age 15, this is a fact. However some texts speak about performing palatal expansion in older patients. What is the age limit (Or is there one) to non-surgical palatal expansion? Any cons to expanding patients older than 15? Just curious.

 

[IHO]

the age limit is fusion of the palatal suture. Unfortunately variable, and no great clinical indicator for when it has occured. If you try to perform palatal expansion in a patient with a fused palatal suture, you wind up getting lots of orthodontic tooth movement and minimal to no actual skeletal expansion. In some cases you can actually push tooth roots through the buccal plate.

Surgically assisted palatal expansion solves this problem nicely and your local OMS can help you out.

Good luck!

 

[Xplorer]

Thanks for the quick reply. It is also recommended to perform rapid palatal expansion (several turns per day for the first 2-3 days) in these older patients in order to disrupt the sutural fusion. If in 2-3 days the patient does not feels a "pop" across the palate, supposedly the expansion is futile. It is very difficult to cause dehiscence or fenestration through Buccal plates, any idea what it would take to do this (in an effort to prevent it)? Excessive force/incorrect mechanics, patient selection, combination of any of the above?

 

[IHO]

It is very difficult to cause dehiscence or fenestration through Buccal plates, any idea what it would take to do this (in an effort to prevent it)? Excessive force/incorrect mechanics, patient selection, combination of any of the above?

generally, I would think any of the above. An orthodontist could probably provide a more sophisticated answer 🙂