From Volume 9, Issue 3, July 2016 | Pages 90-95
Rapid maxillary expansion (RME) is an orthopaedic procedure that utilizes heavy forces to correct transverse maxillary arch discrepancies. There is a substantial body of literature relating to the various designs of RME devices and their clinical indications.
Rapid maxillary expansion (RME) is not a new concept; it was first described and used, 150 years ago, on a 14-year-old female patient, utilizing heavy forces to correct a transverse maxillary arch discrepancy.1 The efficacy of the procedure has, however, been questioned and challenged over the years. It was originally thought that separation of the mid-palatal suture was either impossible, due to the buttressing effect of the circum-maxillary sutures or, if successful, it was considered to be a dangerous procedure.2,3 This paper will discuss in detail the biomechanics, clinical considerations, differing designs, expansion and retention regimens, as well as highlight potential problems encountered with RME.
The dentition and the craniofacial bones are constrained bodies by the periodontium and the sutures, respectively. The biomechanical principles involving tooth movement can be applied to the craniofacial bones using RME,4 however, the magnitude of the forces required to separate the mid-palatal suture is approximately 900–4500 grammes, which is very different from that required to move teeth, about 10–150 grammes. The theoretical principle behind substantial force application is to disarticulate the circum-maxillary suture with resultant orthopaedic expansion before teeth respond.5,6
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