Indications and Types of Palatal Expansion
- Maxillary expansion indicated when the width of upper jaw to lower jaw difference is 4 mm or greater
- Measurement done from width of outside first molars in upper jaw compared to lower jaw
- Rapid palatal expansion used in cleft palate repair
- Rapid palatal expansion used to gain room for teeth in patients with moderate crowding in upper jaw
- Types of expansion include rapid palatal expansion (RPE), slow expansion, implant-supported expansion, and surgically assisted rapid palatal expansion (SARPE)

Rapid Palatal Expansion (RPE)
- RPE achieved by turning a key in the expander
- RPE typically remains in patient's mouth for 3-6 months
- RPE can be tooth supported, bone supported, or both
- RPE relieves posterior crossbite by achieving daily expansion of 0.5mm to 1mm
- RPE results in a gap between the two top front teeth, which may require braces
- Adjustment to eating and speaking may take a week or two after receiving RPE
- Patients turn the expansion screw themselves to widen the expander
- Bionator appliance may be an alternative for lower jaw expansion not managed by the patient

Implant-Supported Expansion
- Mini-implant assisted rapid palatal expansion (MARPE) applies forces directly to the maxillary bone
- MARPE involves placing 2-4 mini-implants in the palatal vault area to anchor the RME appliance
- MARPE allows palatal expansion in young adults with fused palatal suture
- Surgical assist may be recommended in adults for consistent outcomes
- Expansion at the PNS and nasal aperture critical in treating Obstructive sleep apnea

Surgically Assisted Rapid Palatal Expansion (SARPE)
- SARPE used when patient's palate halves or intermaxillary suture fuses together
- Palatal expander surgically inserted onto mid-palatal suture by oral-maxillofacial surgeon
- Orthodontist connects palatal expanders band rings to maxillary molars
- SARPE allows expansion in patients with matured palate
- Surgical procedure required for SARPE

Definition, Purpose, and Effects of Palatal Expansion
- Palatal expansion is a dental procedure that aims to widen the upper jaw.
- It is commonly used to correct issues such as crossbite, overcrowding, and narrow arches.
- The procedure involves applying pressure to the midpalatal suture to stimulate bone growth.
- Palatal expansion can improve breathing, speech, and facial aesthetics.
- It is often performed during childhood or adolescence when the bones are still growing.
- Palatal expansion techniques include rapid maxillary expansion (RME), surgically assisted rapid maxillary expansion (SARME), distraction osteogenesis maxillary expansion (DOME), endoscopically-assisted surgical expansion (EASE), and implant-supported palatal expansion.
- Benefits of palatal expansion include improved breathing, corrected crossbite, improved dental occlusion, enhanced speech articulation, and improved facial aesthetics.
- Palatal expansion is most effective when performed during the growth phase, and the success and relapse rates of different techniques have been investigated.
- Notable figures in the field of palatal expansion include Charles J. Burstone, Thomas M. Graber, Robert M. Ricketts, David L. Turpin, and Charles H. Tweed.