A YouTube video (Hallie Bulkin) discussing clinical decision-making for maxillary expansion in children. The speaker recommends a screw-retained appliance around age 10–11 because the midpalatal suture begins to fuse and interdigitate with age; presence of retained primary teeth and unerupted second/first molars supports using a regular pediatric expander instead.
Like an Average, on average 10, 11 years old is like a cutoff point when I would rather go with a screw retained appliance rather than the regular expander. Not because the suture is fully developed, but the suture starts fusing. And that fusing is still linear. So it's just a tangent. The two halves of the maxilla, they just touch in linear fashion. The more mature we become, the more interdigitations we develop between the two halves of the maxilla. So that becomes way, way more complicated in an adult. If I see that a child still ret retains their baby teeth, the second molars, and even the first molars, which are supposed to be lost by 9, 10, 10 years old, then I feel like we can still try to go with a with a regular, I would say pediatric type of expander, not screw retained.
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