Dentoalveolar Effects Following Maxillary Expansion: Comparison Between Dental and Skeletal Anchorage


  • Francesca Cremonini
  • Patrizia Pieralli
  • Paolo Albertini
  • Mario Palone


Orthodontics, Malocclusion, Palatal Expansion Technique


Objective: To compare the dento-alveolar effects between dental and skeletal anchored expansion devices to achieve maxillary expansion in different groups of patients: pure dental anchorage was used in growing patients and skeletal anchorage in adult patients. Linear, angular and volumetric parameters have been analysed. Material and Methods: 22 patients has been selected from the total archive of patients treated in the Orthodontics Department of the University of Ferrara, Italy, divided into 3 groups according to the appliance used to obtain the transversal maxillary correction. Digital files of the upper arch were obtained from scans performed using an intro-oral scanner before treatment (T0) and at the end of expansion (T1). Therefore, linear, angular and volumetric measurements have been performed. Results: There is a highly significant statistic variation of the 3-3, 4-4 and 6-6 diameter as a function of time. There was a statistically significant variation of the palatal vault angle and of the 6-6 distance at the cusp level as a function of time. Moreover, it appears that these parameters are reduced in the group with skeletal anchored expander. No tooth considered have encountered a statistically significant change in tip and torque values, no matter the type of RPE and the treatment time. For all patients, we have recorded the superimposition of the maxillary dental cast before and after treatment. Conclusion: In all patients, we obtained a resolution of the maxillary transverse deficit. Patients treated by pure skeletal anchored devices have recorded a less variations of palatal vault angle and the distance between first molar cusps, as if the expansion was gained more parallel. The expansion obtained showed reduced dental side effects, as tip and torque values haven’t changed in a statistically significant way.


Kutin G, Hawes RR. Posterior cross-bites in the deciduous and mixed dentitions. Am J Orthod 1969; 56(5):491-504.

Manfredini D, Stellini E, Gracco A, Lombardo L, Nardini LG, Siciliani G. Orthodontics is temporomandibular disorder-neutral. Angle Orthod 2016; 86(4):649-54.

Kurol J, Berglund L. Longitudinal study and cost-benefit analysis of the effect of early treatment of posterior cross-bites in the primary dentition. Eur J Orthod 1992; 14(3):173-9.

Gracco A, Luca L, Cozzani M, Siciliani G. Assessment of palatal bone thickness in adults with cone beam computerised tomography. Aust Orthod J 2007; 23(2):109-13.

McNamara JA. Maxillary transverse deficiency. Am J Orthod Dentofacial Orthop 2000; 117(5):567-70.

Baccetti T, Mucedero M, Leonardi M, Cozza P. Interceptive treatment of palatal impaction of maxillary canines with rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2009; 136(5):657-61.

Cozzani M, Rosa M, Cozzani P, Siciliani G. Deciduous dentition-anchored rapid maxillary expansion in crossbite and non-crossbite mixed dentition patients: reaction of the permanent first molar. Prog Orthod 2003; 4:15-22.

Cappellette Jr. M, Alves FEMM, Nagai LHY, Fujita RR, Pignatari SSN. Impact of rapid maxillary expansion on nasomaxillary complex volume in mouth-breathers. Dental Press J Orthod 2017; 22(3):79-8.

Caprioglio A, Meneghel M, Fastuca R, Zecca PA, Nucera R, Nosetti L. Rapid maxillary expansion in growing patients: correspondence between 3-dimensional airway changes and polysomnography. Int J Pediatr Otorhinolaryngol 2014; 78(1):23-7.

Gracco A, Malaguti A, Lombardo L, Mazzoli A, Raffaeli R. Palatal volume following rapid maxillary expansion in mixed dentition. Angle Orthod 2010; 80(1):153-9.

Eichenberger M, Baumgartner S. The impact of rapid palatal expansion on children's general health: a literature review. Eur J Paediatr Dent 2014; 15(1):67-71.

Di Fazio D, Lombardo L, Gracco A, D'Amico P, Siciliani G. Lip pressure at rest and during function in 2 groups of patients with different occlusions. Am J Orthod Dentofacial Orthop 2011; 139(1):e1-6.

Arreghini A, Trigila S, Lombardo L, Siciliani G. Objective assessment of compliance with intra- and extraoral removable appliances. Angle Orthod 2017; 87(1):88-95.

Lombardo L, Toni G, Stefanoni F, Mollica F, Guarneri MP, Siciliani G. The effect of temperature on the mechanical behavior of nickel-titanium orthodontic initial archwires. Angle Orthod 2013; 83(2):298-305.

Zhang W, Qu HC, Yu M, Zhang Y. The effects of maxillary protraction with or without rapid maxillary expansion and age factors in treating class III malocclusion: a meta-analysis. PLoS One 2015; 10(6): e0130096.

Lopez MA, Andreasi Bassi M, Confalone L, Gaudio RM, Lombardo L, Lauritano D. Clinical outcome of 215 transmucosal implants with a conical connection: a retrospective study after 5-year follow-up. J Biol Regul Homeost Agents 2016; 30(2 Suppl 1):55-60.

Lopez MA, Andreasi Bassi M, Confalone L, Gaudio RM, Lombardo L, Lauritano D. Retrospective study on bone-level and soft-tissue-level cylindrical implants. J Biol Regul Homeost Agents 2016; 30(2 Suppl 1):43-8.

Brunetto DP, Sant'Anna EF, Machado AW, Moon W. Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE). Dental Press J Orthod 2017; 22(1):110-25.

Gracco A, Lombardo L, Cozzani M, Siciliani G. Quantitative cone-beam computed tomography evaluation of palatal bone thickness for orthodontic miniscrew placement. Am J Orthod Dentofacial Orthop 2008; 134(3):361-9.

Lee RJ, Moon W, Hong C. Effects of monocortical and bicortical mini-implant anchorage on bone-borne palatal expansion using finite element analysis. Am J Orthod Dentofacial Orthop 2017; 151(5):887-97.

Lopez MA, Andreasi Bassi M, Confalone L, Gaudio RM, Lombardo L, Lauritano D. The influence of conical plus octagonal internal connection on implant survival and success rate: a retrospective study of 66 fixtures. J Biol Regul Homeost Agents 2016; 30(2 Suppl 1):49-54.

Maino G, Paoletto E, Lombardo L, Siciliani G. MAPA: a new high-precision 3D method of palatal miniscrew placement. European Journal of Clinical Orthodontics 2015; 3(2):41-7.

Liou EJ. Effective maxillary orthopedic protraction for growing Class III patients: a clinical application simulates distraction osteogenesis. Prog Orthod 2005; 6(2):154-71.

Huanca Ghislanzoni LT, Lineberger M, Cevidanes LH, Mapelli A, Sforza C, McNamara JA Jr. Evaluation of tip and torque on virtual study models: a validation study. Prog Orthod 2013; 14:19.

Handelman CS, Wang L, BeGole EA, Haas AJ. Nonsurgical rapid maxillary expansion in adults: report on 47 cases using the Haas expander. Angle Orthod 2000; 70(2):129-44.

Mosleh MI, Kaddah MA, Abd ElSayed FA, ElSayed HS. Comparison of transverse changes during maxillary expansion with 4-point bone-borne and tooth-borne maxillary expanders. Am J Orthod Dentofacial Orthop 2015; 148(4):599-607.

Lombardo L, Carinci F, Martini M, Gemmati D, Nardone M, Siciliani G. Quantitive evaluation of dentin sialoprotein (DSP) using microbeads - a potential early marker of root resorption. Oral Implantol 2016; 9(3):132-42.

Perrini F, Lombardo L, Arreghini A, Medori S, Siciliani G. Caries prevention during orthodontic treatment: In-vivo assessment of high-fluoride varnish to prevent white spot lesions. Am J Orthod Dentofacial Orthop 2016; 149(2):238-43.

Choi SH, Shi KK, Cha JY, Park YC, Lee KJ. Nonsurgical miniscrew-assisted rapid maxillary expansion results in acceptable stability in young adults. Angle Orthod 2016; 86(5):713-20.

Lagravère MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2010; 137(3):304.e1-12; discussion 304-5.

Kartalian A, Gohl E, Adamian M, Enciso R. Cone-beam computerized tomography evaluation of the maxillary dentoskeletal complex after rapid palatal expansion. Am J Orthod Dentofacial Orthop 2010; 138(4):486-92.

Kim KB, Helmkamp ME. Miniscrew implant-supported rapid maxillary expansion. J Clin Orthod 2012; 46(10):608-12.

Arreghini A, Lombardo L, Mollica F, Siciliani G. Torque expression capacity of 0.018 and 0.022 bracket slots by changing archwire material and cross section. Prog Orthod 2014; 15(1):53.

Cantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod 2017; 18(1):34.




How to Cite

Cremonini, F. ., Pieralli, P. ., Albertini, P. ., & Palone, M. . (2021). Dentoalveolar Effects Following Maxillary Expansion: Comparison Between Dental and Skeletal Anchorage. Pesquisa Brasileira Em Odontopediatria E Clínica Integrada, 21, e0022. Retrieved from



Original Articles