Do the miniscrews of the prefabricated systems for the “appliance first” protocol of miniscrew-assisted rapid palatal expansion have lengths that meet the palatal thickness of patients?

• Published in: American journal of orthodontics and dentofacial orthopedics Vol. 163; no. 6; pp. e152 - e161
• Main Authors: Alves, Arthur César de Medeiros, de Carvalho, Nathália Oliveira, Cunha, Ângela Cristina Pinto de Paiva, Rabelo, Sergei Godeiro Fernandes, Pereira, Hallissa Simplício Gomes
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-06-2023
• Subjects: Adult; Bone Screws; Cone-Beam Computed Tomography - methods; Female; Humans; Male; Maxilla; Orthodontic Anchorage Procedures; Palatal Expansion Technique; Palate - diagnostic imaging; Palate - surgery
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2023.03.012

In the “appliance first” protocol of miniscrew-assisted rapid palatal expansion, the prefabricated shape of the expanders limits the potential locations for miniscrew placement. Considering the influence of palatal thickness on the selection of the optimal length of miniscrews, this study aimed to evaluate the thickness of both bone and mucosa of the palate of patients aged 6-65 years and suggest optimal lengths of miniscrews for this approach.
Two hundred and eighty-two cone-beam computed tomography of patients of both sexes were divided into 3 groups according to age. The thicknesses of bone and mucosa were measured in the anterior and posterior regions of the palate.
Males showed a greater thickness of palatal bone than females. The thickness of both bone and mucosa was greater in the anterior region of the palate. The young patients showed greater bone thickness than adults and mature adults. The mature adults showed thinner bone thickness in the posterior region of the palate and greater mucosal thickness along the palate than young patients and adults. Development of miniscrews with longer thread lengths is necessary. Miniscrews with a 3-mm thread length would prevent excessive extravasation in the posterior region of the palate.
The thickness of both bone and mucosa of the palate is variable and influenced by sex and age. Manufacturing additional miniscrews with different lengths of thread is suggested to achieve bicortical anchorage in patients undergoing the “appliance first” protocol of miniscrew-assisted rapid palatal expansion.
•The thickness of both bone and mucosa is greater in the anterior region of the palate.•Young patients have greater bone thickness than mature adults.•Mature adults have greater mucosal thickness than young and adult patients.•Males have greater palatal bone thickness than females.•Manufacturing miniscrews for MARPE with greater variation of lengths is needed.