EXPANDERS

Maxillary (Palatal) Expansion

Maxillary (palatal) expanders are one of the most commonly used tools in orthodontics. Expanders often help address jaw, teeth, and bite problems. They come in a variety of designs, and can have different effects depending on how and when they are used.

How do expanders work?

Expanders are most predictable in kids when they are growing. This is because the upper jaw starts with a split (suture) down the middle. This split is OPEN during childhood, and becomes FUSED during puberty. Fusion of this suture makes widening the upper jawbone difficult (often impossible) to achieve after puberty, without additional procedures or surgery.

Expanders are most predictable in kids when they are growing. This is because the upper jaw starts with a split (suture) down the middle. This split is OPEN during childhood, and becomes FUSED during puberty. Fusion of this suture makes widening the upper jawbone difficult (often impossible) to achieve after puberty, without additional procedures or surgery.

Child holding a maxillary palatal expanders retainer in focus, smiling and standing indoors from Godley Family Orthodontics in Zionsville, Indiana.

Who can benefit from an expander?

Palatal expanders are particularly effective in children, especially between the ages of 6 and 12, when the jaw is still growing and developing. Common dental conditions that may indicate a need for palatal expansion include:

Severe crowding
Crossbite
Narrow upper jaw
Impacted teeth (teeth are blocked out)
Certain sleep disordered breathing condition
Malocclusion (underbite, overbite, cross bite, open bite)

Early diagnosis and intervention are key benefits of using palatal expanders as they can address orthodontic issues before they become more severe. By expanding the palate during childhood or adolescence, it can create additional space in the mouth, allowing permanent teeth to erupt properly, as well as correct breathing issues. It also reduces the need for more invasive treatments in adulthood.

COMMON TYPES OF MAXILLARY EXPANDERS

Rapid Palatal Expander

The RPE (rapid palatal expander) or RME (rapid maxillary expander) is the most common type of expander. It is bonded to the teeth and remains in place for at least six months. The RPE is activated according to your orthodontist‘s prescription with a turn key to gradually expand the jaw.

Bonded Expander

The bonded expander is similar in mechanism to the RPE (rapid palatal expander), however it is designed to have acrylic that covers the teeth. This expander is typically used for severe open bites.

Hass Expander

The Haas expander works similar to the RPE, though this type is made of acrylic. The acrylic plate pushes against the area of the palate to distribute the forces evenly.

Quad Helix Expander

The quad helix expander is bonded to the back molars, but does not require turns. This expander starts compressed and expands on its own over time.

Bone Anchored Expander

A bone anchored expander, sometimes called MSE (maxillary skeletal expander) or MARPE (maxillary anchored RPE), is supported by small temporary anchorage devices (miniature implants) and is most often used for adults whose jaw bones are done developing.

A Godley Family Orthodontic palatal expander is displayed on a white plaster model of upper teeth from Godley Family Orthodontics in Zionsville, Indiana. Perfect for kids needing gentle orthodontic adjustments.

Do expanders work on the lower jaw?

Without surgery, lower jaw expansion is physically and anatomically impossible. This is because the mandible (lower jaw) is not split down the middle. The reason an expander is effective on the upper jaw is that the bones of the palate are separated by a split or suture that runs down the center. If the suture is still open, these bones can be separated. The lower jaw, however, cannot be expanded. The lower jaw is one solid bone and does not have a suture running through the center of it.

However, expanders might still be used to move and upright the lower TEETH. This might be necessary to fix a misaligned bite and create space for crowding. There are some expansion appliances that can be placed on the lower arch, but these appliances are NOT meant to expand the bones of the lower jaw. They simply help to move and upright the lower teeth.

EXPANSION FOR ADULTS

Maxillary Skeletal Expanders (MSE)

In adult cases where the permanent teeth have emerged and the upper jaw has fused, typical palatal expander treatment could cause the teeth to flare outward, or protrude. In order to prevent this, adults typically require additional accessories to be used for expansion. The MSE (maxillary skeletal expander) appliance provides non-surgical palatal expansion for adults. With MSE treatment, we can help prevent the unwanted flaring of teeth and avoid invasive surgery (surgically-assisted rapid palatal expansion) that may otherwise be required to widen the jaws.

Who needs maxillary skeletal expansion?

The MSE appliance is suited for for skeletally matured patients. This refers to adults and older teens whose teeth and jaws are done developing, yet they have a narrow maxilla (upper jaw).

How does MSE treatment work?

If Dr. Godley determines that maxillary skeletal expander treatment is best for your case, we will walk you through the process. This expander requires four small temporary anchors to support the appliance. These mini screws are typically placed by a different specialist and implanted into the roof of the mouth. The expander can then be activated by inserting a special key into the center and turning it (once or twice a day, depending on your treatment protocol).

Each time the device is activated, it will expand slightly, which also expands the jaw bone. Expansion is gradual. The MSE appliance will remain in place for at least six months in order to solidify and retain your results.

During activation of the MSE, it’s normal for the teeth to spread out a little and create spaces as the jaw is wider and now able to accommodate all teeth when straightened out. A full treatment of braces or Invisalign typically follows MSE treatment to align the teeth and perfect the smile.

Questions about expanders?

Our team is here to answer any questions you may have and we want you to know your options! Please don’t hesitate to reach out to us at any time. Dr. Godley and our orthodontic staff are here to guide you, so you can have a positive treatment experience.

Ready to get started? Call or book online to reserve a complimentary orthodontist consultation at our convenient Zionsville office located close to Carmel and Indianapolis, IN.

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