Maxillary Expansion Decisions for Everyday Dentistry

Maxillary transverse skeletal deficiency is often one of the first issues to address in a developing malocclusion. Although maxillary expansion is a familiar and widely used treatment, there is still confusion and debate about when to intervene, which appliance to choose, and what expansion can realistically achieve in both the short and long term. One area that needs to be highlighted is that opening the midpalatal suture is closely connected to the wider circummaxillary suture system, and patients can respond very differently depending on age, skeletal maturity, and individual suture development.

This presentation will review the best available evidence from prospective clinical trials and long-term studies to provide practical guidance for maxillary skeletal expansion. Drawing on clinical experience, including successes and failures, we will discuss ideal timing, age-appropriate appliance selection, and how to differentiate indications and outcomes between conventional expansion and mini-screw-supported expansion. We will also address common misconceptions, such as whether expansion can reliably prevent extractions, resolve airway obstruction, or improve sleep-related breathing issues, and review what long-term data suggest about stability, especially when expansion is primarily dental rather than skeletal.

1. Acknowledge the differences between expansion protocols based on suture maturation and the patient's developmental stage.
2. Make an informed decision regarding the appropriate protocol to follow based on clinical and scientific evidence.
3. Learn how to troubleshoot in complicated cases and/or resort to alternative approaches.

Presenter

Sercan Akyalçin, DDS, MS, PhD

Sercan Akyalcin, DDS, MS, PhD, is a globally recognized orthodontist and Head of Orthodontics at the Harvard School of Dental Medicine (HSDM). He completed his specialty training in orthodontics at the University of Texas Health Science Center at Houston, where he also served as a faculty member and researcher. Dr. Akyalcin has authored or co-authored more than 70 peer-reviewed publications, contributed numerous book chapters, and co-edited orthodontic textbooks, including Mosby’s Orthodontic Review. His research focuses on 3D imaging, digital orthodontics, biomechanics, machine learning applications in orthodontics, and craniofacial growth and development. He is a frequent invited speaker at national and international orthodontic and dental meetings. He serves on editorial boards for leading journals, including AJO-DO, JERD, and The Angle Orthodontist. His work has earned multiple honors, including the 2019 Edward H. Angle Research Prize. He is currently the President of the Northeast Society of Orthodontists and Secretary-Treasurer of Angle-East Society.