Skeletal Transversal Expansion Using Modified RME Appliance in Adult Patient

Objective: In this study, rapid maxillary expansion without corticotomy with the use of a miniscrew-supported appliance in an adult patient is presented. Case: As a result of the clinical examination of an 18-year-old Caucasian female patient, she had a bilateral posterior crossbite. The upper midline was coincident with the facial midline, whereas there was a deviation to the right in the lower midline. Angle's Class II molar relationship on the right and Angle's Class I on the left were observed. Arch-length deficiency values were -2 mm in the upper and -3 mm in the lower. Overjet was 7.5 mm and overbite was 0 mm. It was determined by the hand-wrist radiograph that the patient's growth was ceased. It was planned to expand maxilla non-surgically prior to any other orthodontic interventions. After 55 quarter-turns of activation the appliance was left in mouth passively for 3 months. Her fixed treatment is continuing. Results: With RME SNB angle did not change and SNA angle increased by approximately 1 degree. 1-SN decreased by approximately 6 and IMPA by 1 degrees. Inclinations of the upper first molar teeth were not significantly changed as confirmed by postero-anterior radiograph. Overjet increased from 7.5 to 9 mm while the amount of overbite remained as 0 mm. It was determined by the model analysis that the increase in intermolar was 6.18 mm and intercanine widths was 5.21 mm. There was no significant change in lower teeth in model measurements. Conclusions: It is seen that the presented appliance can achieve sutural expansion without any corticotomy in adult patients. Key Words: Modified RME, Appliance, Adult patient, Corticotomy, MARPE