Dental Medicine and Orthodontics

Rapid maxillary expansion is a useful strategy in the treatment of malocclusion. It is applicable for correcting posterior crossbites (unilateral and bilateral), narrow maxillary arches, mandibular functional shift and dental crowding. This technique was first described by Angell and then, a number of banded loops or helices, jackscrew devices and spring-loaded devices have been incorporated in fixed or removable appliances to achieve widening of the maxillary arch. RME increases the upper arch transverse dimensions mainly by separation of the two maxillary halves (orthopedic effect), followed by buccal movement of the posterior teeth and alveolar processes (orthodontic effect). The effect of the appliance on the midpalatal suture has also been reported to vary with age. A greater response to RPE has been reported in younger subjects, whereas in older subjects the appliance becomes increasingly less effective, to the point where no sutural expansion takes place. This has been correlated with the increase with age of bony intercalations along the midpalatal suture line. It is thought that this osseous interlocking, and perhaps synostosis of the midpalatal suture, causes a mechanical resistance to the actions for the expansion device. The aim of this study will be to analyze the benefits of an early treatment of the anterior and posterior crossbite. It will be explained when it´s the correct time to treat a patient with anterior/posterior crossbite. It will be shown different appliances for this purpose. It will be also clarified when it’s the best time to refer a child for an orthodontic assessment by a general dentist.