MAXILLARY TRANSVERSE DISORDERS IN ADULT PATIENTS: CURRENT APPROACHES TO DIAGNOSIS AND TREATMENT (LITERATURE REVIEW)
DOI:
https://doi.org/10.35220/2523-420X/2026.3.16Keywords:
MARPE, SARPE, midpalatal suture, miniscrew anchorage, expansionAbstract
Maxillary transverse deficiency in adults is a complex skeletal and dentoalveolar condition, and its diagnosis and selection of the optimal treatment method remain relevant issues in contemporary orthodontics. Materials and methods. A review of scientific literature published between 2016 and 2026 was conducted using the PubMed/MEDLINE and Google Scholar databases. Systematic reviews, meta-analyses, and clinical studies focusing on the diagnosis of maxillary transverse deficiency and the use of miniscrew-assisted and surgically assisted expansion in adults were included in the analysis. Results. It was established that the clinical manifestations of transverse deficiency may be partially masked by dentoalveolar compensation; therefore, the absence of posterior crossbite does not exclude the presence of an underlying skeletal deficiency. Conventional measurements on dental casts primarily characterize dental arch width and do not allow sufficiently reliable differentiation between skeletal and dentoalveolar components. Cone-beam computed tomography is the most informative method for three-dimensional assessment of transverse relationships, as it enables evaluation of basal and alveolar width, inclination of posterior teeth, the condition of the midpalatal suture, bone thickness, and anatomical conditions for miniscrew placement. Chronological age has been shown not to be an absolute criterion of midpalatal suture maturation, although with increasing age the predictability of successful suture opening decreases. MARPE provides clinically significant skeletal expansion in adults; however, the treatment effect is formed by skeletal, alveolar, and dental components simultaneously. Treatment effectiveness depends on the morphology of the midpalatal suture, the condition of the posterior structures of the maxillary complex, palatal bone thickness, and appliance design. SARPE remains an effective method in cases of pronounced skeletal deficiency and high resistance of the bony structures, although it is associated with greater invasiveness and a risk of complications. Conclusions. The contemporary choice of treatment method should be based on individualized threedimensional diagnostics rather than on the patient’s age alone. Promising directions include personalization of miniscrew-assisted appliances, standardization of CBCT analysis, and development of prognostic criteria for successful skeletal expansion in adults
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