MSE and the face: what actually changes
Micro‑implant‑supported maxillary skeletal expansion (MSE) applies orthopedic forces through palatal mini-implants to split the midpalatal suture, yet its soft‑tissue effects have been less clear than its skeletal outcomes
This study used 3D stereophotogrammetry to quantify facial soft‑tissue changes immediately after expansion and at one‑year retention, revealing significant, stable changes localized to the paranasal region, upper lip, and both cheeks.
🔹 Protocol
- Appliance: MSE with 4 palatal mini-implants
- Activation: 0.25 mm turns, 1–2/day (per Cantarella protocol)
- Monitoring: Midline diastema + CBCT confirmation
🔹 Soft Tissue Effects (3D Analysis)
- Paranasal area → mean displacement 1.3–1.5 mm
- Cheeks → greater displacement (R: 2.4 mm, L: 2.9 mm)
- Direction: forward + lateral (dominant anterior)
- Stable at 1-year retention
🔹 Clinical Pearls
✅ Changes most visible around cheeks and paranasal areas
✅ Facial symmetry can vary → expansion often slightly asymmetric
✅ 3D scans are superior to 2D photos for monitoring changes
✅ No significant relapse after 1 year
🔹 Quick Comparison
| Expander | Effect | Notes |
|---|---|---|
| Tooth-borne (Hyrax/Haas) | Dentoalveolar tipping | Risk of root resorption |
| Bone-borne (MSE) | True skeletal expansion | Stable soft tissue changes |
Bottom line
MSE produces significant, forward‑lateral soft‑tissue enhancement centered on the paranasal/upper lip and cheeks, with the cheeks showing the largest and most clinically perceptible displacements that remain stable at one year
Dentowesome 