Effects of rapid maxillary expansion on the cranial and circummaxillary sutures

Abstract

Introduction The aim of this study was to determine whether the orthopedic forces of rapid maxillary expansion cause significant quantitative changes in the cranial and the circummaxillary sutures. Methods Twenty patients (mean age, 12.3 ± 1.9 years) who required rapid maxillary expansion as a part of their comprehensive orthodontic treatment had preexpansion and postexpansion computed tomography scans. Ten cranial and circummaxillary sutures were located and measured on one of the axial, coronal, or sagittal sections of each patient’s preexpansion and postexpansion computed tomography scans. Quantitative variables between the 2 measurements were compared by using the Wilcoxon signed rank test. A P value less than 0.05 was considered statistically significant. Results Rapid maxillary expansion produced significant width increases in the intermaxillary, internasal, maxillonasal, frontomaxillary, and frontonasal sutures, whereas the frontozygomatic, zygomaticomaxillary, zygomaticotemporal, and pterygomaxillary sutures showed nonsignificant changes. The greatest increase in width was recorded for the intermaxillary suture (1.7 ± 0.9 mm), followed by the internasal suture (0.6 ± 0.3 mm), and the maxillonasal suture (0.4 ± 0.2 mm). The midpalatal suture showed the greatest increase in width at the central incisor level (1.6 ± 0.8 mm) followed by the increases in width at the canine level (1.5 ± 0.8 mm) and the first molar level (1.2 ± 0.6 mm). Conclusions Forces elicited by rapid maxillary expansion affect primarily the anterior sutures (intermaxillary and maxillary frontal nasal interfaces) compared with the posterior (zygomatic interface) craniofacial structures.

CBCT of skeletal changes following rapid maxillary expansion to increase arch-length with a development-dependent bonded or banded appliance

“…The effect of RME is not limited to the maxillary alveolar process but is also seen on adjacent structures, including the cranial and circummaxillary sutures. 39 In the present study, RME had significant effects at the level of the zygomaticomaxillary suture and nasal bone, but not in the frontozygomatic and frontomaxillary sutures (triangular expansion pattern). Finite element analysis of the stress distribution with RME shows high tensile stress at the zygomaticomaxillary suture, except along its anteromedial surface.…”

“…These appliances are designed to provide more uniform expansion of the palate and to inhibit alveolar tipping. 5,44 Compared to the slight negative expansion (constriction) of the frontomaxillary suture, noted for all groups in the present study (Table 1), Ghoneima et al 39 reported a small but significant increase (0.1 mm) in the width at the frontomaxillary suture with a bonded RME in a group of children with mean age of 12 years (range 8-15 years). However, the magnitude of the difference between the studies is small (,1 mm), so it is relatively insignificant compared to the overall triangular pattern of expansion noted in both studies.…”

Does rapid maxillary expansion induce adverse effects in growing subjects?

“…A meta-analysis was not performed for this reason. Twenty-one studies 3,4,6,8,9,15,[18][19][20][22][23][24][25][26][28][29][30][31][32][33][34] were retrospective, five studies 7,11,12,16,17 were prospective, and four studies 5,10,21,27 were prospective and randomized. Six studies 10,18,[22][23][24]33 compared the results with a control group of the same age, and eight studies 4,6,10,12,22,[32][33][34] analyzed the long-term effects of RME.…”

“…Application of the inclusion and exclusion criteria and follow-up on the referred studies identified 30 relevant publications (Figure 1). [3][4][5][6][7][8][9][10][11][12][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] Heterogeneity of the results of the investigations with similar technique of maxillary expansion was high (.85%). A meta-analysis was not performed for this reason.…”

Evaluation and comparison of root resorption between tooth-borne and tooth-tissue borne rapid maxillary expansion appliances: A CBCT study

“…Expansion occurs when the force applied to the teeth and maxilla exceeds the limits needed for tooth movement. 1 The applied force causes widening and gradual opening of the midpalatal suture, bending of the alveolar processes, and dental tipping.…”