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Transverse discrepancies treatment in adults: Orthodontic and orthopedic alternatives rationale

Marcos Janson, Francisco Honório da Silva Neto

The need for treatment of transverse deficiencies in patients with craniofacial growth has grown in recent years due to the increase in the demand of adult patients searching for better facial and dental aesthetics. The transverse problem is commonly characterized by posterior crossbite, but is also very common in Class II malocclusions, as a compensation for the relationship of the maxilla with the narrower portion of the mandible, even when crossbite is not present. Some studies show that approximately 9.4% of the entire population and almost 30% of adult orthodontic patients present the problem. This amount is relatively high and also critical, due to the controversies related to non-surgical treatment in adults, the difficulty in treating them in the period of complete skeletal maturation, the consequent lack of stability in the posttreatment period, and also because not all patients have the financial means to undergo surgical treatment or even are willing to do so. The present work aims at demonstrating the classic orthodontic and orthopedic possibilities for treating transverse discrepancies in adults and the changes in treatment plan and prognosis that result from the incorporation of the most recent expansion method (MARPE, Miniscrew-Assisted Rapid Palatal Expansion), as well as describing the technique for installation and activation of the appliance in this technique and discuss the pros, cons and indications of each modality.

Keywords: Adult orthodontics. Rapid maxillary expansion. Slow maxillary expansion. MARPE. Dentoalveolar compensation. Transverse discrepancies in adults.

How to cite: Janson M, Silva Neto FH. Tratamento das discrepâncias transversais em adultos: racionalização das alternativas ortodônticas e ortopédicas. Rev Clín Ortod Dental Press. 2016 Dez-2017 Jan;15(6):56-89. DOI: http://dx.doi.org/10.14436/1676-6849.15.6.056-089.art

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