Abstract
ABSTRACTIntroduction: In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). Description: Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. Results: The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. Conclusions: Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.
Highlights
In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning
Individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME)
Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MS maturation (MSM)
Summary
In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. Individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. In rapid maxillary expansion (RME), the skeletal effect is expected to be greater than the dental one; the maxillary arch width increase must be achieved by opening the midpalatal suture (MS), and not by the inclination of posterior teeth.[3,4]. There is a consensus that RME in patients up to 14 years of age is predictable, but individual variations in MS fusion process must be analyzed based on the definition of its maturation stage (MSM)[7,9] and density (MSD).[10]. Suture images can be obtained from cone beam computed tomography (CBCT), and that approach has been increasingly used in orthodontics.[11]
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