A longitudinal study of skeletal side effects induced by rapid maxillary expansion

Orthopedic expansion of the maxillary arch--rapid maxillary expansion (RME)--is a commonly used treatment technique that has become increasingly popular during the last 25 years. During this time, however, clinicians routinely have imputed a variety of undesirable side effects to RME, particularly bite opening. Whereas there have been many explanations as to the mechanisms underlying such RME-related effects as bite opening, few studies have considered the long-term effects of RME in the vertical and sagittal dimensions of the face. The purpose of this investigation was to examine cephalometrically the long-term effect that the Haas-type rapid maxillary expansion may have on bite opening and on the anteroposterior position of the maxilla. The sample consisted of 25 patients who had undergone RME with the Haas-type expander, followed by standard edgewise therapy. This RME sample was compared with a group of 25 patients who had standard edgewise treatment (SET) only and with a control (CTRL) group of 23 subjects. Mean initial form and mean age at start of treatment for the RME, SET, and CTRL groups were similar. Statistically significant among-group differences were documented for only 2 of 10 cephalometric variables sensitive to anteroposterior and vertical skeletal changes. These differences, however, were not clinically significant. The current investigation implies therefore that RME therapy with the Haas-type expander has little long-term (more than 6 years after treatment) effect on either the vertical dimensions or the anteroposterior dimensions of the face.