Haas AJ. The Treatment of Maxillary Deficiency by Opening the Midpalatal Suture. The Angle Orthod. 1965; 35:200-217;2
Baccetti T, Sigler LM, McNamara JA An RCT on treatment of palatally displaced canines with RME and/or a transpalatal arch. Eur J Orthod. 2011; 33:601-607
Angell EC. Treatment of irregularities of the permanent or adult teeth. Dental Cosmos. 1860; 1:540-544
Timms DJ. The dawn of rapid maxillary expansion. Angle Orthod. 1999; 69:247-250;2
Inchingolo AD, Ferrara I, Viapiano F, Netti A, Campanelli M, Buongiorno S Rapid maxillary expansion on the adolescent patient: systematic review and case report. Children (Basel). 2022; 9
Norton NS. Netter's head and neck anatomy for dentistry, 3rd edN. Philadelphia (PA): Elsevier, Health Sciences Division; 2021
Whitaker RH, Borley NR. Instant Anatomy, 4th edn. Chichester (UK): Wiley-Blackwell; 2010
Chaconas SJ, Caputo AA. Observation of orthopedic force distribution produced by maxillary orthodontic appliances. Am J Orthod. 1982; 82:492-501
Bishara SE, Staley RN. Maxillary expansion: clinical implications. Am J Orthod Dentofacial Orthop. 1987; 91:3-14
Kokich VG. Age changes in the human frontozygomatic suture from 20 to 95 years. Am J Orthod. 1976; 69:411-430
Melson B. Palatal growth study on human autopsy material: A histologic microradiographic study. Am J Orthod. 1975; 68:42-54
Isaacson RJ, Ingram A. Forces produced by rapid maxillary expansion. II. Forces present during treatment. Angle Orthod. 1964; 34:261-270;2
Haas AJ. Palatal expansion: just the beginning of dentofacial orthopedics. Am J Orthod. 1970; 57:219-255
Adkins MD, Nanda RS, Currier GF. Arch perimeter changes on rapid palatal expansion. Am J Orthod Dentofacial Orthop. 1990; 97:194-199
Sigler LM, Baccetti T, McNamara JA Effect of rapid maxillary expansion and transpalatal arch treatment associated with deciduous canine extraction on the eruption of palatally displaced canines: A 2-center prospective study. Am J Orthod Dentofacial Orthop. 2011; 139:E235-244
Vaughn GA, Mason B, Moon H-B, Turley PK. The effects of maxillary protraction therapy with or without rapid palatal expansion: A prospective, randomized clinical trial. Am J Orthod Dentofacial Orthop. 2005; 128:299-309
Almuzian M, Short L, Isherwood G, Al-Muzian L, Mcdonald J. Rapid maxillary expansion: a review of appliance designs, biomechanics and clinical aspects. Orthodontic Update. 2016; 9:90-95
Schütz-Fransson U, Kurol J. Rapid maxillary expansion effects on nocturnal enuresis in children. Angle Orthod. 2008; 78:201-208
Gray LP. Results of 310 cases of rapid maxillary expansion selected for medical reasons. J Laryngol Otol. 1975; 89:601-614
Bahammam SA. Rapid maxillary expansion for obstructive sleep apnea among children – systematic review and meta-analysis. Sleep Sci. 2020; 13:70-77
Laptook T. Conductive hearing loss and rapid maxillary expansion: report of a case. Am J Orthod. 1981; 80:325-331
Bazargani F, Feldmann I, Bondemark L. Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: a systematic review. The Angle Orthodontist. 2013; 83:1074-1082
Krüsi M, Eliades T, Papageorgiou SN. Are there benefits from using bone-borne maxillary expansion instead of tooth-borne maxillary expansion? A systematic review with meta-analysis. Prog Orthod. 2019; 20
Yacout YM, Abdalla EM, El Harouny NM. Skeletal and dentoalveolar effects of slow vs rapid activation protocols of miniscrew-supported maxillary expanders in adolescents: A randomized clinical trial. Angle Orthod. 2022; 92:579-588
Liou EJ-W, Tsai W-C. A new protocol for maxillary protraction in cleft patients: repetitive weekly protocol of alternate rapid maxillary expansions and constrictions. Cleft Palate Craniofac J. 2005; 42:121-127
Suri L, Taneja P. Surgically assisted rapid palatal expansion: a literature review. Am J Orthod Dentofacial Orthop. 2008; 133:290-302
Needleman HL, Hoang CD, Allred E, Hertzberg J, Berde C. Reports of pain by children undergoing rapid palatal expansion. Pediatr Dent. 2000; 22:221-226
Greenbaum KR, Zachrisson BU. The effect of palatal expansion therapy on the periodontal supporting tissues. Am J Orthod. 1982; 81:12-21
Barber AF, Sims MR. Rapid maxillary expansion and external root resorption in man: a scanning electron microscope study. Am J Orthod. 1981; 79:630-652
Sandikçiolu M, Hazar S. Skeletal and dental changes after maxillary expansion in the mixed dentition. Am J Orthod Dentofacial Orthop. 1997; 111:321-327
Lanigan DT, Mintz SM. Complications of surgically assisted rapid palatal expansion: review of the literature and report of a case. J Oral Maxillofac Surg. 2002; 60(1):104-10

Rapid maxillary expansion: a clinical insight for the general dental practitioner

From Volume 16, Issue 4, October 2023 | Pages 197-202


Jack Slaymaker

BDS Pg Dip (Resto)

General Dental Practitioner, Cambridge

Articles by Jack Slaymaker

Email Jack Slaymaker

Julian Woolley


Dental Core Trainee 1, King's College Dental Hospital

Articles by Julian Woolley

Sunil Hirani

BDS, BSc, FDS RCS(Eng), MSc, MOrth, FDS(Orth)

Consultant Orthodontist, Luton and Dunstable Hospital, Bedfordshire

Articles by Sunil Hirani


Rapid maxillary expansion is an orthodontic treatment approach for corrections of transverse discrepancies, such as crossbites. Rapid maxillary expansion expands the palate by applying forces to the teeth and surrounding tissues to separate the mid-palatal suture, allowing for the correction of the indicated malocclusions. A general dental practitioner should be aware of the indications, treatment strategy and play an important role in the timely referral of patients for orthodontic assessment. This article offers a comprehensive overview of rapid maxillary expansion, expansion protocols, and an in-depth analysis of the prevalent characteristics associated with expansion, along with evidence-based recommendations for effective management.

CPD/Clinical relevance: This paper aims to give the general dental practitioner clinical insight into rapid maxillary expansion, the devices used and the indications for use.


Rapid maxillary expansion (RME) is an orthodontic treatment used to expand the maxilla in the transverse plane. It can be used to correct posterior crossbites, relieve dental crowding and create space for impacted canines and in the correction of class III malocclusions.1,2.

RME involves using a specially designed appliance secured to the patient's maxillary teeth or palate. The appliance gradually widens the maxilla by exerting high forces on the bones that make up the palate. Over time, this force results in the separation of the mid-palatal suture leading to bony remodelling across the newly created space.

When seeing their regular patients, dentists may come across RME in either the active treatment or retention phases. For this reason, general dentists should have a clinical awareness of this procedure, particularly to communicate with patients and their relatives regarding the indications and observed effects of treatment. This article offers a comprehensive overview of RME, encompassing the history, anatomy, indication, various appliance options, expansion protocols and evidence-based recommendations for troubleshooting and management.

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