Mini-implants are successfully used with palatal expanders to work as anchors and to achieve more efficient skeletal expansion while decreasing undesired dental effects. Mini-implant Assisted Rapid Palatal Expander (MARPE) shows distribution of stress throughout the palate while preventing unwanted rotation and tipping of the maxillary anchor teeth. Most patients prefer a short orthodontic treatment time. Over the past decade, the Regional Acceleratory Phenomenon (RAP) induced by surgical trauma has thus gained emphasis for reducing orthodontic treatment time. This has lead to the evolution of minimally invasive surgical procedures for inducing RAP for eg. micro osteoperforation, low level laser therapy etc. Treixeira et al. have shown that biological principles can be activated to accelerate bone remodelling using Micro osteoperforation (MOP). In MOP, minute perforations are created within the bone. Micro osteoperforation increases local levels of inflammatory cytokine activity around a tooth, which increases bone remodelling by stimulating osteoclastic activity and causing transient osteopenia. Micro osteoperforation yields very little discomfort to the patient, can be performed chair side in a few minutes and can be used in conjunction with any treatment modality including TADs, aligners, etc. There are sporadic suggestions that MOP can be used in cases where palatal split is not occurring within first few days of expander activation. Thus, in this proposed study, we are performing micro osteoperforation, a minimally invasive technique of accelerated orthodontics in the mid palatal suture region for Rapid Maxillary Expansion (RME) using mini–implants for skeletal anchorage. The study intends to compare efficacy of rapid maxillary expansion using mini–implants with MARPE done with and without MOP. The rationale of this study is that it would guide clinicians to select the appropriate treatment protocol and achieve optimum results for their patients |