Can surgically assisted rapid palatal expansion (SARPE) be recommended over orthodontic rapid palatal expansion (ORPE) for girls above the age of14? : Acone-beam CT study on midpalatal suture maturation.

Abstract

For patients with amaxillary transversal deficiency (MTD), various treatment options are available, partly based on the practitioner's experience. This study aimed to determine acut-off age for decision making between surgically assisted rapid palatal expansion (SARPE) over orthodontic rapid palatal expansion (ORPE) based on skeletal maturation in afemale population. A total of 100 cone beam computed tomography (CBCT) images of young females were analyzed on maturation of the pterygomaxillary (PMS), zygomaticomaxillary (ZMS), transpalatal (TPS), and midpalatal (MPS) sutures. Based on the maturation of these four junctions, four independent observers had to determine whether they would prefer ORPE or SARPE to widen the maxilla. For the PMS, the results show aclosure of 83-100% from 13to 17years. As for the TPS, aclosure of 78-85% was observed from 15years of age. For the 15- to 17-year-old females, aclosed ZMS was present in 32-47%. Regarding MPS, closed sutures presented in 61% (stagesD andE) of the 15-year-old females. The cut-off age at which SARPE was recommended was 15.1years for the orthodontist observers and 14.8years for the maxillofacial surgeon observers. Significant maturation of MPS was reached at the age of15 in afemale population. The PMS, TPS, MPS, and ZMS closed sequentially. Acomprehensive diagnostic approach is necessary for choosing the appropriate treatment. When in doubt, age could assist decision making in afemale population, with acut-off age of 15years in favor of SARPE based on this study.