Abstract
ObjectiveThe purpose of this study was to assess the palatal suture opening and the pterygopalatine suture disarticulation pattern in the tomographic axial plane after treatment with midfacial skeletal expander (MSE).Materials and methodsPre- and post-expansion CBCT records of 50 subjects (20 males, 30 females, mean age 18 ± 3 years) who were treated with MSE (Biomaterials Korea, Seoul, Korea) appliance were superimposed and compared using OnDemand software. Reference planes were identified and the angulation of the midpalatal suture opening after expansion was calculated as well as the frequency of the pterygopalatine suture split.ResultsAfter MSE treatment, the mean palatal suture opening angle (SOA) was 0.57°. (− 0.8° to 1.3°). There was no significant difference between males and females in terms of the palatal suture opening pattern (P > 0.05). Only 3 out of 50 (6%) subjects presented SOA above 1 degree. Also, 3 out of 50 (6%) patients presented a negative SOA value. With regard to the pterygopalatine suture split, 84 sutures out of 100 (84%) presented openings between the medial and lateral pterygoid plates on both right and left sides. Partial split was detected with 8 patients (5 females, 3 males). Five patients had split only in the medial pterygoid plates of both pterygomaxillary sutures, and 3 patients exhibited disarticulation on the right side only. No significant differences were found in the frequency of suture opening between males and females (P = 1.000).ConclusionsMSE appliance performed almost parallel expansion in the axial view. Remarkably, this study shows that pterygopalatine suture can be split by MSE appliance without the surgical intervention; the disarticulation of pterygopalatine suture was visible in most of the patients.
Highlights
Maxillary transverse deficiency is a common problem in daily orthodontic practice [1, 2]
No significant differences were found between males and females in terms of the suture opening angle (SOA) mean, as shown in Table 2.With regard to the pterygopalatine suture split, eighty-four
There are many reports on the effects of rapid palatal expansion (RPE) [4, 13, 19], very few studies exist in the literature about the midpalatal suture opening pattern after treatment with micro-implant-assisted rapid palatal expansion (MARPE) appliances [11]
Summary
Maxillary transverse deficiency is a common problem in daily orthodontic practice [1, 2]. Treatment options consist of orthodontic, non-surgical orthopedic and surgical correction. Orthodontists traditionally use rapid palatal expansion (RPE) to manage transverse maxillary deficiency in young patients, but interlocking of the palatal suture after puberty [3] can cause unwanted side effects with RPE treatment, such as dental tipping and alveolar bone bending, causing limited skeletal movement and poor long-term stability [4, 5]. The surgically assisted rapid palatal expansion (SARPE) is often applied; surgical morbidity should be considered. Orthodontists developed the micro-implant-assisted rapid palatal expansion (MARPE) in order to avoid the unwanted side effects and complexity, as discussed above
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