Mini-screw-assisted rapid palatal expansion (MARPE) has become a popular approach for arch expansion in cases with maxillary transverse deficiency. Minimal high-quality studies were found regarding MARPE. There was a great degree of heterogeneity among the studies with regards to age of use, expansion protocol, appliance design and mini-screw dimensions and placement. There is a suggestion that MARPE is best performed on those under the age of 30. The literature suggests the degree of buccal tipping of teeth is comparable to that of rapid maxillary expansion (RME) and surgically assisted rapid palatal expansion (SARPE). However, other side effects included root resorption, periodontal damage and loss of buccal alveolar bone height. Studies on upper airway volume suggested there may be a positive correlation between MARPE and upper airway volume, but future clinical studies are required to make more definitive conclusions about MARPE. CPD/Clinical Relevance: A review of the literature regarding mini-screw-assisted rapid palatal expansion is reported and includes design protocols and clinical considerations.

Orthodontic training in the UK is evolving to address workforce shortages and meet increasing demand. A new curriculum, effective from September 2024 emphasizes evidence-based practice. Despite these advancements, challenges persist, including competitive recruitment, financial constraints and an uneven distribution of services. Possible areas for future development include the integration of primary care experience into training; and the revision of orthodontic commissioning in the NHS. Any measures introduced should aim to improve training pathways, ensure equitable service delivery, and maintain high standards of care. Addressing these issues is vital for developing a sustainable orthodontic workforce capable of meeting future healthcare needs. CPD/Clinical Relevance: This article reviews current developments in UK orthodontic training, assessment, workforce challenges, and NHS service provision, providing essential context for trainees, educators, and clinicians preparing for future practice.

Cleidocranial dysplasia, linked to a mutation in the RUNX2 gene, is characterized by defective endochondral and intra-membranous bone formation. General features include a combination of aplasia or hypoplasia of one or both clavicles, a short skull, delayed ossification of the fontanelles and short stature. Dental anomalies include delayed exfoliation of primary teeth, multiple supernumerary teeth and multiple impacted teeth. The dental management of such cases is complicated. This review summarizes the multiple treatment strategies for the dental management of cleidocranial dysplasia. Combined orthodontic and surgical approaches, as well as prosthetic rehabilitation, are discussed. CPD/Clinical Relevance: To highlight the importance of a multidisciplinary, individualized approach to the dental management of patients with cleidocranial dysplasia.

Treating patients with prognathic maxillae is a multifaceted process, especially when dealing with thalassaemia complications. This case study addresses the issue of severe maxillary protrusion in a woman living with β-thalassaemia major who had presented with pronounced maxillary protrusion, lip incompetence and an everted upper lip. Following initial alignment and levelling using the 0.018inch standard edgewise system, the patient underwent a Le Fort I osteotomy procedure. Segmental osteotomy was ruled out owing to the heightened risk of excessive bleeding. The outcomes demonstrated successful management of the thalassaemic patient through presurgical orthodontics, LeFort I osteotomy, and subsequent post-surgical orthodontics and periodontics. The patient exhibited improved facial aesthetics after an active treatment period of 4 years. CPD/Clinical Relevance: Orthodontic treatment for patients with β-thalassaemia major and skeletal Class II malocclusion with prognathic maxillae requires a multidisciplinary approach, including Le Fort I osteotomy and careful management of elevated bleeding risks

Clinical relevance: Adjustments to the MIA removable quadhelix demonstrate how to derotate an upper right first molar.

Cone beam computed tomographic imaging has increasingly become an important adjunct to our diagnostic toolbox in orthodontics. This article provides some practical tips to clinicians for the viewing and interpretation of cone beam computed tomography in orthodontics, particularly in relation to root resorption. CPD/Clinical relevance: This article informs the orthodontic team on the applications of cone beam computed tomography and provides practice tips for viewing and interpreting images in practice, with particular regard to root resorption.

Rapid maxillary expansion is an orthodontic treatment approach for corrections of transverse discrepancies, such as crossbites. Rapid maxillary expansion expands the palate by applying forces to the teeth and surrounding tissues to separate the mid-palatal suture, allowing for the correction of the indicated malocclusions. A general dental practitioner should be aware of the indications, treatment strategy and play an important role in the timely referral of patients for orthodontic assessment. This article offers a comprehensive overview of rapid maxillary expansion, expansion protocols, and an in-depth analysis of the prevalent characteristics associated with expansion, along with evidence-based recommendations for effective management. CPD/Clinical relevance: This paper aims to give the general dental practitioner clinical insight into rapid maxillary expansion, the devices used and the indications for use.