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ePaper created 2016-04-19, 11:44:05 | version 1.38.0
| industry report rapid maxillary expansion 42 ortho 1 2016 Rapid maxillary expansion: small details make the difference Author: Gabriele Scommegna, Italy Nowadays,rapidmaxillaryexpansion(RME)isaquite popular orthodontic therapy since maxillary defi- ciency is probably the most recurrent problem that can be detected among patients. Thehistoryofthistherapygoesbackto1860when DrEmersonC.Angellwrote,andDentalCosmos published, an article where he reported a caseofa14-year-oldgirlwithaunilateral cross bite, treated by means of a jack- screwinordertowidenthepalate.The complete expansion was achieved in onlytwoweeksandthepatientshowed aninterincisordiastema(Figs.1a&b). Dr Angell was a real pioneer in dentofacial orthopaedics, and faced great criticism among the dental community even if, 35 years be- forethepossibilityofprovingitby the use of X-ray, his palatal wid- ening therapy was successfully and clearly proven today; in 1860 he defined the gold standard for actualmaxillaryexpansiontherapy. Aninterestingfacttoknowbuttrueaswellaslittle sad,DrAngellbecamefrustratedwithhiscolleagues’ opinions, so he decided to leave the orthodontic dis- cipline, as well as San Francisco, ending his profes- sional carrier as a medical doctor in the US. ManyyearsafterDrAngell’sfuturisticvision,inthe 1970s,DrHaasreintroducedthistherapybymeansof anupdateddesignofarapidpalatalexpansor,theso- called Haas expansor1 (Fig. 2). From that time, RME has been investigated several timesbymanyauthorsfocusingontheindications, the right timing, the various clinical proce- dures, initial outcomes and long-term sta- bility,aswellasregardingtheinfluenceof different appliance designs. Todaythe‘hygienicRME’,socalleddue totheabsenceofacryliccontactingwith the palatal mucosa that facilitates oral hygiene,islargelymorepopularthanthe Haasone(Figs.3a&b). Leone, as one of the few orthodontic screw manufactures in the world, has playedanimportantroleinthisdevelop- ment since the very beginning: in the early ‘70s, Leone started the production of the first RME dedicated screw, fully made of stainless steel with four integrated arms (Figs. 4 and 5). Since then, Leone has continuously improved the quality of the material, the production technology as well as widening the expansor range in order to give the orthodontist the best tools to fit their various Fig.1a Fig.1b Fig.2 Fig.3a Fig.3b Fig.5 Fig.4 Fig.6 Fig.7 12016