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Updated: Apr 12, 2026

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Dentoalveolar Changes in the Premolar Region After Two Maxillary Expansion Protocols.

Jaqueline Peter1, Fabiane Azeredo1, Susana Maria Deon Rizzatto1

  • 1Department of Orthodontics, School of Health and Life Sciences (Dental Program), Pontifical Catholic University of Rio Grande Do Sul, Porto Alegre, Brazil.

Orthodontics & Craniofacial Research
|April 11, 2026
PubMed
Summary

Both rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) protocols similarly affected upper first premolars, reducing alveolar bone thickness. Alt-RAMEC showed a tendency for greater tooth inclination.

Keywords:
cone‐beam CTorthodonticspalatal expansion techniquepremolars

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Area of Science:

  • Orthodontics
  • Dentofacial Orthopedics
  • Craniofacial Biology

Background:

  • Maxillary expansion is a common orthodontic procedure.
  • Understanding dentoalveolar effects is crucial for treatment planning.

Purpose of the Study:

  • To compare the dentoalveolar effects of rapid maxillary expansion (RME) and alternate rapid maxillary expansion and constriction (Alt-RAMEC) on upper first premolars.
  • To evaluate changes before and 6 months after treatment.

Main Methods:

  • Cone-Beam Computed Tomography (CBCT) evaluated 20 patients treated with Hyrax appliance.
  • Measurements included tooth length, alveolar bone level, and thickness at the premolar region.
  • Statistical analyses used Shapiro-Wilk and Student's t-tests.

Main Results:

  • Both RME and Alt-RAMEC significantly increased interpremolar distances (coronal and radicular).
  • Greater coronal than root distance increase was observed, more pronounced with Alt-RAMEC.
  • Alveolar thickness showed an average reduction of 0.54 mm post-expansion.

Conclusions:

  • RME and Alt-RAMEC yielded similar effects on upper first premolars, reducing alveolar thickness.
  • Alt-RAMEC showed a tendency towards greater tooth inclination and root reduction.