DOME

What is DOME?

DOME or Distraction Osteogenesis Maxillary Expansion is a modern method that gently and gradually widens the upper jaw. The aim is to open the nasal passages and promote the stability of the airways. This improves breathing - especially during sleep - and can reduce problems such as snoring or interrupted breathing (sleep apnea)."

Visualization of the goals of DOME treatment - improved nasal breathing and widened jaw arch

How does DOME work?

DOME works by gradually expanding the upper jaw using a custom-made expander that is anchored directly into the jawbone. New bone is created in the center, filling the space created. This process ensures a stable and lasting improvement in jaw structure and nasal breathing.

Comparison of two palates with maxillary expander - illustration before and after maxillary expansion

Why is it important?

You may have experienced this yourself: when your nose is blocked, it is difficult to breathe. This becomes even more stressful during sleep because the body then often switches to mouth breathing. This leads to snoring, poor sleep quality and can make you tired and unable to concentrate during the day. For people with permanently narrow nasal passages, this is a daily challenge - and this is exactly where DOME comes in.

Illustration of facial development before and after jaw augmentation. Focus on esthetics and symmetry

Which is right for me: DOME, MARPE, MASPE, SARPE?

All acronyms describe the same principle: the skeletal expansion of the upper jaw using slightly different techniques. Treatment should be tailored to your individual needs and circumstances, which is why Dr. Pinter likes to use the term DOME. According to the author of this concept, Dr. Stanley Liu, DOME focuses on the RESULT for the patient rather than the technique. It means transforming a high, narrow palate into a functional dome-shaped palate that provides enough room for the tongue and improves nasal breathing.

Advantages

By widening the upper jaw, DOME improves nasal breathing, promotes restful sleep and at the same time contributes to respiratory health and an improved quality of life. In addition, the position of the teeth and bite can be corrected, which brings aesthetic and functional benefits.

Relaxed woman on the sofa with her eyes closed - symbolic image for well-being after successful maxillary expansion

Am I suitable for DOME?

An upper jaw that is too narrow and the associated difficulty in nasal breathing should ideally be corrected at a young age, as the treatment becomes more complex with increasing age. However, DOME is also possible for adults - often even without surgical bone cuts.

Adults who:

want to improve their nasal breathing,
want a wider, more esthetic smile,
want to alleviate sleep-related breathing disorders such as snoring or sleep apnea,
are looking for an alternative to CPAP therapy or a snoring splint.

Whether DOME is suitable for you will be clarified by a comprehensive assessment and diagnosis, usually in close consultation with specialists relevant to the treatment.

Presentation of the positive effects of DOME therapy on breathing, smile and tooth alignment

Frequently asked questions

The actual stretching of the upper jaw is usually perceived as pressure or slight traction, but is not painful in most cases. If discomfort occurs, this can be alleviated with painkillers, but severe pain is rare.
The insertion of the anchors for the expander is generally well tolerated. During the procedure itself, a local anesthetic is used so that there is no pain. Afterwards, there may be a slight feeling of pressure or a headache, but this subsides quickly and can be relieved with painkillers.
Thanks to the expander being anchored directly in the upper jaw bone, the upper jaw can be expanded slowly and in a controlled manner. At the same time, transparent aligners are used to move the teeth into the area where new bone has already formed. In this way, the teeth remain together at the front and there is no large gap.
The expansion of the upper jaw usually takes 4 to 8 months. This is followed by a phase in which the bite (occlusion) is precisely adjusted and optimized to ensure optimum jaw function and stability. A total treatment time of approx. 2 years can be assumed (may vary from case to case).
It is not always possible to reliably predict whether bone cuts will be necessary. After the pubertal growth spurt, the bony sutures of the maxilla are often fused, but the degree of fusion varies from person to person. In some cases, targeted stimulation of the bony sutures (e.g. by polycyclic activation of the expander) can achieve an opening without bone cuts.
After the anchors have been inserted, you should relax for the rest of the day and avoid strenuous activities. If bone cuts have been made, you should follow your doctor's recommendations. Depending on the effort involved, most patients are fully operational again the next day.
After successful expansion, the expander usually remains in the mouth for a further 9 to 12 months until the newly formed bone is completely mineralized. This prevents recurrence and ensures that the upper jaw remains stable.