Purely bone-borne rapid palatal expansion with bracket plates and replaceable expansion screw assembly

Abstract

Tooth-bone-borne rapid palatal expansion (RPE) often results in unwanted buccal tipping of anchor teeth, particularly in cases where midpalatal suture expansion is not successful. This report presents a novel approach to treating transverse maxillary deficiency through purely bone-borne RPE using bracket plates. The method involves strategically placing four mini-implants in the palate before inserting the RPE screw. Subsequently, right and left bracket plates are fixed over the mini-implant heads to connect two anteroposterior mini-implants. The RPE screw is then attached to the bracket plates, securing the RPE connecting arms into 0.032 × 0.040-inch slot brackets on the bracket plates. The primary advantage of this method is that the RPE screw is replaceable and adjustable. This enhances the freedom in selecting mini-implant placement sites, ensuring better skeletal anchorage on the palatal bone compared to tooth-bone-borne RPE, where mini-implant placement sites are limited to the periphery of the RPE screw. This report presents two cases in which midpalatal suture expansion was successfully achieved using purely bone-borne RPE without incurring any dental side effects.