Maxillary Bone Fracture Due to a Miniscrew-Assisted Rapid Maxillary Expansion: A Case Report

Area of Science:

• Orthodontics
• Maxillofacial Surgery

Background:

• Miniscrew-assisted rapid palatal expansion (MARPE) is a common nonsurgical treatment for adult maxillary constriction.
• Complications associated with MARPE are infrequently reported in scientific literature.

Observation:

• A rare case of maxillary bone fracture occurred in a 32-year-old patient following MARPE.
• The patient experienced severe pain and infraorbital sensory disturbances five days post-MARPE activation.

Findings:

• CT imaging revealed a maxillary fracture extending from the infraorbital foramen to the alveolar process.
• MARPE-induced fractures may result from stress concentration at the zygomatico-maxillary suture, especially with dense midpalatal sutures and thin bone.

Implications:

• This case underscores the need for meticulous patient selection and preoperative CT evaluation of bone thickness.
• Individualized expansion protocols and consideration of alternative treatments like surgically assisted expansion are vital for high-risk patients.