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Palatal expansion vs dental arch expansion  

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Jelly
Eminent Member

If you expand your dental arches a bit with braces/Invisalign, are you expanding your palate as well? Or do ony specific palatal expanders do this?

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Posted : 19/11/2019 9:11 am
DrMario
Eminent Member

Braces (traditional and Invisalign) only shift and move teeth on the alveolar bone, which does not result in palatal changes or changes to the craniofacial structure. Only palate expanders are able to accomplish such craniofacial changes like expanding the palate, which is maxillary bone and prevent relapse given that you continue to wear the expander for months until new bone is created during the expansion period. The most suitable type of palate expander depends on your age. 

 

Ages below around 8 will benefit from a tooth-borne palate expander and see craniofacial results as the child is still developing and are impressionable to drastic changes in a short period of time. Example of a tooth-borne expander would be the Hyrax appliance.

 

Ages around 9 to 15 can benefit from tooth-borne and bone-borne expanders but a trained orthodontist will prefer bone-borne to maximize the chance of seeing favorable results. Example of a bone-borne expander would be the MSE (Maxillary Skeletal Expander).

 

Ages beyond 16 and anyone in adulthood should get a bone-borne expander because it's almost impossible to see positive skeletal changes since development is nearing or has ended around this age.

 

Braces do the grunt work of moving teeth around for favorable occlusion, but to generate more physical real estate for the tongue to be seated properly, improve nasal breathing due to maxillary atresia and provide your face with a more optimal facial structure, a palate expander, especially a bone-borne one will accomplish this. Once room is generated by the expander, you follow it up with braces to tie things up. You will end up with a broader smile, better breathing, more room for the tongue and enough room for teeth to be straightened since your maxilla was physically expanded.

 

Hope this helps.

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Posted : 20/11/2019 10:42 am
Jelly
Eminent Member

@drmario

Thank you very helpful! Do you know if correct tongue posture causes palatal expansion or only dental arch expansion? It seems to me like the force is too small and the change too slow to cause palatal expansion in adults. Then again, the pressure extends to below the teeth.

Also, what if your upper dental arch isn't super narrow? A bit V shaped, but not extreme. Very little crowding, a tilted incisor being the only noticable misaligned tooth at first glance.. Can you still use a palatal expander then?

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Posted : 20/11/2019 2:08 pm
DrMario
Eminent Member

@jelly

Please, I encourage you to look at my post detailing what happened in my experience. You might be surprised at what the tongue can do.

https://the-great-work.org/community/case-discussions/progress-photos-with-proper-tongue-posture/

To immediately answer your question: yes, the tongue can definitely expand the palate but to an extent. To an extent meaning that there does need to exist a significant amount of force to split and separate the midpalatal suture. It's not as easy as a job to accomplish as it would be if you were below age 10 where the craniofacial structure is impressionable to change.

A palate expander, like the one I have installed I illustrate in my post will accomplish this. It's a skeletal expander that will further expand the palate by the bone and not just teeth. Expanders that are exclusively attached to teeth will likely result in very unfavorable outcomes resulting to relapse, bone loss and dental tipping for adult patients.

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Posted : 22/11/2019 3:16 pm
Jelly
Eminent Member

@drmario

Do you know some names of expanders that split the suture and expand the maxilla (bone borne I understand)? 

Could this type of expander (acrylic plate) do that you think? https://www.bracesshop.net/en/active-plates/23/modified-stretching-plate

And where the hell do you get it done? In my whole country (The Netherlands), I found two orthodontists who even do any type of expansion, one uses a Hyrax (tooth borne) and the other uses an acrylic plate, but only for the upper dental arch (he thinks the lower arch will follow, I don't believe it).

It seems like a lot of adult maxilla expansion happens surgically in some way or another. 

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Posted : 21/12/2019 10:03 am