What goes wrong with MARPE? Audrey Yoon

orthodontics In summary

Το περιεχόμενο παρέχεται από το Farooq Ahmed. Όλο το περιεχόμενο podcast, συμπεριλαμβανομένων των επεισοδίων, των γραφικών και των περιγραφών podcast, μεταφορτώνεται και παρέχεται απευθείας από τον Farooq Ahmed ή τον συνεργάτη της πλατφόρμας podcast. Εάν πιστεύετε ότι κάποιος χρησιμοποιεί το έργο σας που προστατεύεται από πνευματικά δικαιώματα χωρίς την άδειά σας, μπορείτε να ακολουθήσετε τη διαδικασία που περιγράφεται εδώ https://el.player.fm/legal.

1+ y ago 7:16

MP3•Αρχική οθόνη επεισοδίου

What goes wrong with MARPE? Audrey Yoon

Join me for a lecture summary from this years AAO by Audrey Yoon. Don’t Make the Same Mistake I Did/ MARPE Complication.

Success MARPE

Overall separation: 87.8% Success rate of sutural separation: (Jeon 2021)

· 61.05% in male

· 94.17% in female

· Average expansion: 7.8 ± 2.4 mm.

Variation with age and gender

MARPE efficacy = Achieved Vs planned expansion

· Greater negative correlation with age in general

o More male than female

o Planned Vs achieved

a. 20 years old = 1:1 M:F

b. 30 years old = 0.5:1 : 0.8:1

c. 40 years old = 0! : 0.6:1 BUT NO DATA – extrapolation

No relationship with bicortical engagement

Asymmetric expansion

· = 50% of cases ANS level greater than 1mm

· 27% Greater than 2mm at ANS

· Severe: Similar to tripod fracture

· Causes of asymmetry Kim 2019

· Nasal-maxillary suture opening / remain closed

· 30% of case unilateral opening of suture

SARPE = 3-13% asymmetric expansion Williams 2012, Smeets 2020

Pain

· 45% report pain

· 19% Around band of 1st maxillary molar band

· 10% headaches

Gingival inflammation

· 83.9% of patients

· Design = flush

o Change to 1mm from palate and arms 3mm from palate = reduce

· Greater inflammation in retention

o Possibly due to palatal vault relapse and therefore TADs imbed in palate

Breakages

· 10%

· Usually guide rod / arm

Rare:

Loss of vitality 2%

· Required RCT maxillary incisors (SARPE 4.5%)

Fractures - potential tripod fracture

Infra-orbital numbness

· Temporary numbness 6 weeks

· 3 cases

· Management

· Turn backwards slowly

· Facial massage / myofascial

· Folate, Vit b – aid nerve regeneration

Hearing loss

· Zygomatic arch = hearing loss temporary, tetanus, trismus

Unexplained tears

· Lateral orbital rim = sagging eyeball, lacrimal gland

Popping in the ear

Lateral pterygoid fracture

· Click and popping to the ear – cheek shooting pain

· Lateral pterygoid plate fracture – asymmetric expansion

Consent

Audrey Yoon – youtube patient instruction video / leaflet

Growing consent

Audrey Yoon paper AJODO clinical companion – open access

A retrospective analysis of the complications associated with miniscrew-assisted rapid palatal expansion` Audrey Yoon 2022

112 επεισόδια

#Podcasting Education #Farooq Ahmed