C-expander: An efficient MARPE approach without dental support

The present study aims to present the step-by-step process of a simpler and more efficient design of a toothless MARPE appliance (also called bone-borne RME), called the C-expander. A virtual planning of the insertion of mini-screws, using a guide, is also described, seeking to perform a more precise insertion of the mini-screws, minimizing errors and encouraging the use of the appliance by orthodontists with greater safety. Our study focuses on a 45-year-old female patient with periodontal issues. A Cone-Beam Computed Tomography (CBCT) and intraoral scanning were performed, and a guide was used to facilitate the insertion of mini-screws. The C-expander was used to correct the transverse maxillary constriction. We present another clinical (pre-surgical case) in other to confirm the indications of the C expander appliance. An accurate insertion of the mini-screws was performed using the guide. After 80 days of activation, once per day, significant opening of the midpalatal suture was achieved on both cases. The C-expander seems to be a simpler, more efficient, and low-cost type of MARPE appliance in adult patients. In more complex cases, a guide can be used to facilitate mini-screw insertion and to improve the accuracy of the procedure.