Point of View Column – Rapid maxillary expansion: a controversial technique or revolutionary advance in orthodontics?

Vol. 16 – Number 62 – 2023 Point of View Column Page 8-11 Rapid maxillary expansion: a controversial technique or revolutionary advance in orthodontics? Orlando Tanaka1 Gerson Luiz Ulema Ribeiro2 Gil Guilherme Gasparello3 Carlos Henrique Camilo Marchesan4 Matheus Melo Pithon5 Introduction Rapid maxillary expansion (RME), also known as lateral maxillary expansion by separating the midpalatal suture, was first described by Angell¹ (1860). Two curious aspects can be highlighted in relation to this technique. The first is that, in Angell’s original publication¹ (1860), the initial of his middle name was erroneously referenced with the letter “H” instead of “C”. The second aspect is that the illustration of the technique, which showed a diastema between the maxillary central incisors, eventually became the focus of attention and controversy at the time (Figure 1). A 14-year-old patient with palatoversion of the lateral incisor and maxillary left premolar, in addition to lack of space for the canine, received an expander appliance fitted with two counter-rotating screws positioned in the left and right hemimaxilla. The appliance was neither cemented nor fitted, but controlled by the pressure of the screws, with the guidance to keep it as evenly tight as possible. To this end, the screws were rotated to keep them in contact with the palatal cervical face of the teeth. After two weeks of maxillary separation, successful correction was achieved. However, unfortunately, the author of the report provided little other clinical information, merely mentioning the clinically visible diastema between the maxillary central incisors². The editor of Dental Cosmos, at the time the RME technique was described, expressed his belief that it would be impossible to separate the hemimaxillae, given the anatomical relationships existing between these structures and the other facial bones with which they articulate. According to this view, such a result would be totally unlikely to occur and republished the photo of the model without the diastema². 1 Full Professor – PPGO – PUCPR – School of Medicine and Life Sciences, Diplomate of the Brazilian Board of Orthodontics and Facial Orthopedics, Postdoctoral Fellow at The Center for Advanced Dental Education at Saint Louis University – Saint Louis – MO-USA. 2 Professor of undergraduate and graduate courses – UFSC, Full Professor of Orthodontics at UFSC, PhD in Orthodontics from UFRJ, Postdoctoral Fellow at Baylor College of Dentistry – Dallas – Tx – USA, Specialist in Orofacial Harmonization, Diplomate of the Brazilian Board of Orthodontics and Facial Orthopedics. 3 PhD student in Dentistry-Orthodontics – PUCPR – School of Medicine and Life Sciences. 4 Dental Surgeon – UFSM/RS, Specialist in Dental Prosthesis – Orbis Institute/SC. 5 Professor of Orthodontics – UESB, Director of the Brazilian Board of Orthodontics – BBO. DOI: 10.24077/2023;1662-pov230612348