Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 17 Apr 2025

Rotational fulcrum and dentoskeletal changes after rapid palatal expansion with tooth-bone-borne (MARPE) and tooth-borne appliances in post-pubertal patients

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DOI: 10.2319/111224-931.1
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ABSTRACT

Objectives

To identify the rotational fulcrum (RF) and to evaluate the skeletal and dentoalveolar effects after rapid palatal expansion (RPE) with tooth-borne and tooth-bone-borne (MARPE) appliances.

Materials and Methods

31 patients were selected (MARPE group: n = 14, age 16.2 ± 2 years; hyrax group: n = 17, age 14.7 ± 0.8 years) with RPE indication and having cone-beam computed tomography before (T1) and after RPE (T2) and after 6 months of retention (T3).

Results

In the MARPE group, the RF was at or above the frontozygomatic suture (FZS), whereas in the hyrax group, it was at or below the FZS. The skeletal response rates were 70% (2°) and 33% (1.09°); alveolar response rates, 18% (0.52°) and 20% (0.68°); and dental response rates, 12% (0.35°) and 47% (1.54°) in the MARPE and hyrax groups, respectively, with a significant difference between groups in skeletal (P = .005) and dental (P < .001) regions. After retention, no significant difference was found between groups.

Conclusions

Although MARPE resulted in a higher RF in the coronal view, both techniques effectively corrected transverse discrepancies with similar stability. Considering the between-group differences in relation to skeletal and dentoalveolar response, MARPE should be used for cases in which minimal compensatory tooth movement is desired.

Copyright: © 2025 by The EH Angle Education and Research Foundation, Inc.

Contributor Notes

 PhD Student, Department of Orthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
 Adjunct Professor, Graduate Program in Orthodontics, Pontifical Catholic University of Minas Gerais, Belo Horizonte, Brazil.
 PhD Student, Department of Oral Biology, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo, NY, USA.
 Researcher, Technology Research Center, University of Mogi das Cruzes, Mogi das Cruzes, Sao Paulo, Brazil.
 Professor and Chair, Department of Orthodontics, School of Dentistry, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Corresponding author: Luciana Quintanilha Pires Fernandes, Boulevard 28 de Setembro, 157 Vila Isabel, Rio de Janeiro, RJ 20551-030, Brazil (e-mail: lqpfernandes@hotmail.com)
Received: 12 Nov 2024
Accepted: 08 Mar 2025
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