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A Three-dimensional Analysis to Investigate the Midface Changes with MSE


Maxillary width deficiencies are a common occurrence in orthodontic patients being one of the most pervasive skeletal problems in the craniofacial region. An early orthodontic treatment can improve a transverse as well as an anteroposterior maxillary discrepancy and it consists of a true skeletal expansion or of an arch development obtained through the orthodontic wire. A pure skeletal expansion can be achieved with conventional appliances when the palatal suture is not completely fused. The introduction of TAD’s in common orthodontic practice has found several implications in the treatment of maxillary transverse deficiency. Using a micro-implants anchorage, the MSE has been proved to be a powerful tool to achieve a pure skeletal expansion even in adult subjects whose midpalatine maxillary suture is already fused.

Studies analyzing 2D measurements conducted on CBCT reported generalized changes in the skeletal structure of patients successfully treated with MSE, evidencing a more parallel expansion compared to the conventional expanders. These findings gave rise to the desire of closely studying the impact of MSE on the entire midface skeletal structure utilizing a pure three-dimensional approach.

Describing the three-dimensional movement that each bone undergoes during MSE is the major purpose of this study. No studies have previously used a pure tridimensional analysis to investigate the impact of MSE on the skeletal structures of the midface.

An innovative method for pure 3D analysis has been developed utilizing modern imaging software proving that Micro-Implant Assisted Maxillary Skeletal Expander (MSE) has a significant impact in the mid-facial bone structures.

The new analysis confirmed the previous finding obtained with 2D measurements and gave a better understanding of effect of MSE on the midfacial structures.

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