Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion

Abstract

Objective: To test the null hypothesis that circumaxillary sutures do not show bony displacement in response to rapid maxillary expansion (RME) therapy. Materials and Methods: Subjects consisted of eight growing patients (two male and six female) with Angle Class I malocclusion, bilateral posterior crossbite, transverse maxillary deficiency, deep palatal vault, and dental crowding at the start of the treatment. A Hyrax palatal expander was used for each patient, and activation protocol required the screw to be turned three times per day (0.25 mm per turn) for an average of 18 days for all subjects. Multislice computed tomography (CT) scans were performed before rapid palatal expansion (time T0) and again at the end of the active expansion phase (time T1) without removing the expander. Measurements were carried out directly on the CT image using the OsiriX Imaging software program. Data were analyzed statistically by using the Wilcoxon signed rank test. Results: All linear measurements showed an increase between T0 and T1 and RME determined a widening of suture; however, sutures far from the maxilla showed a smaller degree of disarticulation. Conclusions: The hypothesis is rejected. Early treatment with RME produced a significant bony displacement by circumaxillary suture opening. The amount of changes of sutures depends on different factors relating to the subjects and varies between different sutures, showing that sutures that articulate directly with the maxilla face a greater influence by the RME compared with those located further away. (Angle Orthod. 2011;81:36-41.)

Three-dimensional analysis of effects of rapid maxillary expansion on facial sutures and bones: A systematic review

“…11 The involvement of both the circummaxillary sutures and the sphenooccipital synchondrosis can have some important clinical implications and may explain the forward and downward displacement of the maxilla after RME treatment, which can be beneficial in Class III corrections in young patients. 9 These findings are, however, a manifestation of the immediate effects of RME, and a systematic review of the long-term effects and critical analysis of longitudinal studies are essential.…”

“…9 The following sutures were reported to be affected: zygomaticofrontal, zygomaticomaxillary, frontomaxillary, zygomaticotemporal, nasomaxillary, frontonasal, and internasal. The changes in these sutures were overall small, ie, between 0.30 and 0.45 mm.…”

“…Measurements of changes in midpalatal suture width during RME were presented in six studies, 9,12,14,[20][21][22] and five of them presented data for both the anterior and posterior region. The mean expansion changes in the midpalatal suture in the posterior region ranged from 1.6 to 4.33 mm, which corresponded to 22%-53% of the total screw expansion.…”

Condyle fossa relationship associated with functional posterior crossbite, before and after rapid maxillary expansion

“…27,28 Briefly, patients were examined with a multidetector helical CT scanner (Lightspeed Ultra, GE Medical Systems, Giles, UK). The scanning parameters were 80 kV, 10 mA (low dose), 0.625 mm collimation, pitch 1, and gantry tilt 0u.…”

Recombinant human bone morphogenetic protein-2 stimulates bone formation during interfrontal suture expansion in rabbits

“…8,18,19 Ideal suture expansion methods would include rapid expansion and accelerated consolidation. The use of optimal tensional force combined with an appropriate concentration of rhBMP-2 might make this method possible.…”