Effects of rapid maxillary expansion on the midpalatal suture: a systematic review

Liu, ShiYao; Xu, Tianmin; Zou, Wei

doi:10.1093/ejo/cju100

Cited by 105 publications

(96 citation statements)

References 16 publications

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“…First, the method of measuring the borders of separated midpalatal suture was highly time‐dependent and skill‐sensitive . The borders of the midpalatal suture and midsagittal bony landmarks become difficult to be clearly defined over time after expansion due to the immediate surface remodeling and consequent CBCT image blurring . Second, the midpalatal suture was not always fully separated from the ANS to the PNS, in consistence with previous systematic review reporting 14.2% partial separation from the ANS to the transverse palatal suture .…”

Section: Discussionmentioning

confidence: 65%

“…For the time point of post‐expansion evaluation, we decided to take the secondary images at five months after the end of active expansion to investigate overall skeletal alteration involving the possible residual changes during the expander retention period . Since the primary reference of our study was not the midpalatal suture but the anterolateral maxillary walls, interindividual difference (<1 month) of the removal timing of the expander could be accepted in this study.…”

Section: Discussionmentioning

confidence: 99%

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Asymmetric nasomaxillary expansion induced by tooth‐bone‐borne expander producing differential craniofacial changes

Kim

et al. 2019

Orthod Craniofacial Res

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Objectives To evaluate three‐dimensional (3D) craniofacial changes induced by a non‐surgical tooth‐bone‐borne rapid palatal expander (TBB‐RPE) according to the symmetrical pattern of expansion, to investigate the 3D changes between the sides in patients with asymmetric expansion, and to identify the related factors of asymmetric expansion. Setting and sample population Sixty‐six patients (mean age: 19.3 ± 5.7 years) treated with TBB‐RPE were divided into a symmetric expansion group (Group S, n = 46) or asymmetric expansion group (Group A, n = 20). Group S was subdivided into Group Ss (n = 27), with bilateral frontomaxillary suture (FMS) split, and Group Sn (n = 19), with no FMS split. Materials and methods Pre‐ and post‐expansion cone‐beam computed tomography images were superimposed, and the common coordinated system was set. All landmarks were designated as coordinate pairs, and treatment changes were automatically calculated. Analysis of variance was conducted for intergroup comparison of craniofacial changes, and logistic regression analysis was performed to identify the related factors of asymmetric expansion. Results The frequency of asymmetric expansion was 30.3%. Group A with unilateral FMS split showed less craniofacial changes than Group Ss and more changes than Group Sn. Group A exhibited different nasomaxillary displacement between the two halves, showing greater changes in the FMS‐split side. Among the tested six variables (age, gender, Angle's classification, unilateral crossbite, maxillary cant and chin deviation), chin deviation was uniquely associated with asymmetric expansion. Conclusions Tooth‐bone‐borne rapid palatal expander had a risk of asymmetric expansion, especially in facial asymmetric patients with chin deviation, producing different craniofacial changes from symmetric expansion.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Asymmetric nasomaxillary expansion induced by tooth‐bone‐borne expander producing differential craniofacial changes

Kim

et al. 2019

Orthod Craniofacial Res

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“…Midpalatal suture changes after RME were reported to be of great interest [21] since a deeper knowledge of this processes might help in treatment options and modalities. The present case report aimed to investigate immediate histologic changes in midpalatal suture in humans following RME compared to control and was conducted on selected patients who had to perform surgery in the palatal area for other clinical reasons.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, the morphology of the suture at this age (subject 3) presented a parallel orientation of the collagen fibers related to the suture long axis similar to lamellar bone, which is traditionally considered as a stress-strain resistant type of bone. RME performed in pre-pubertal age might avoid fracture of inter-digitations due to immature stages of growth and bone remodeling [21]. Seven days after the end of expansion (subject 1) newly-formed bone with osteoid matrix undergoing mineralization was evident not only on the bone margins, indicating mineralization processes from within the center of the suture, which seemed to be an original finding of the present investigation, as was the peculiar fishbone appearance of the trabecular bone.…”

Section: Discussionmentioning

confidence: 99%

Cellular Midpalatal Suture Changes after Rapid Maxillary Expansion in Growing Subjects: A Case Report

Caprioglio

Fastuca

Zecca

et al. 2017

IJMS

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The present case report aimed to investigate immediate histologic changes in midpalatal suture in humans following rapid maxillary expansion compared to control. Three patients (mean age 8.3 ± 0.9 years) were enrolled in the case report and underwent midpalatal suture biopsy. Two patients underwent treatment before biopsy. The third patient did not show transversal maxillary deficiency and was enrolled as a control. Biopsy samples of midpalatal suture at 7 (subject 1) and 30 days (subject 2) after maxillary expansion as well as of one control (subject 3) were collected and processed for histology. In the control (subject 3) inter-digitations at the palatal suture gap were observed. At 7 days (subject 1) mature bone with small marrow spaces and trabecular bone with the peculiar storiform appearance inside the soft tissue and collagen fibers running parallel only in the central part were present. At 30 days (subject 2), a greater number of newly-formed bone trabeculae with a perpendicular orientation to the long axis of the suture could be seen. At 30 days the fibrous component of bone tissue was less represented compared to the sample at 7 days. Data from the preliminary histological results showed that bone formation was observed in the gap after rapid maxillary expansion, although the healing process was still ongoing.

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“…On the contrary, the density of the midpalatal suture (MPSD) is likelyto be the most important factor determining the necessity for surgical weakening rather than OI. 8,16 Similarly Grünheid et al 14 assured that MPSD ratio has the potential to become a useful clinical predictor of skeletal response to RME.…”

Section: Introductionmentioning

confidence: 99%

Skeletal Age-related Changes of Midpalatal Suture Densities in Skeletal Maxillary Constriction Patients: CBCT Study

Samra

Hadad

2018

The Journal of Contemporary Dental Practice

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Aim:To determine if density measurements of the midpalatal suture and cervical vertebral maturation index (CVMI) are related, and to investigate if CVMI could help in predicting of the developmental status of the midpalatal suture. Materials and methods:Cone-beam computed tomography (CBCT) images of 95 skeletal maxillary constriction patients (aged 8 to 18 years) were examined. The maturational stages of the cervical vertebrae were visually defined, and midpalatal suture density in the anterior region, the middle region, and the posterior region were measured. One-way ANOVA and Fisher's least significant difference (LSD) post-hoc test were used for statistical assessment.Results: Significant differences were found in MPDS: in anterior region between (c1,c2,c3,c4) and (c5,c6) stages, in middle region between (c1,c2,c3) and (c5,c6) stages, and in posterior region between (c1,c2,c3) and (c4,c5,c6) stages. Conclusion:Midpalatal suture densities in all regions increase with skeletal maturation advancement.The significant increase after puberty may have the key role in decreasing the skeletal effects of RME after that age. Clinical significances:It is important to assess the midpalatal suture density to choose between rapid maxillary expansion (RME) and surgically assisted rapid maxillary expansion (SARME). This study revealed a significant increase in the midpalatal suture density after puberty. Thus, it may better to perform RME before puberty.

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Effects of rapid maxillary expansion on the midpalatal suture: a systematic review

Abstract: The majority of the articles were judged to be of low quality. Therefore, we could not draw any accurate conclusion on the basis of evidence in this systematic review.

Cited by 105 publications

References 16 publications

Asymmetric nasomaxillary expansion induced by tooth‐bone‐borne expander producing differential craniofacial changes

Asymmetric nasomaxillary expansion induced by tooth‐bone‐borne expander producing differential craniofacial changes

Cellular Midpalatal Suture Changes after Rapid Maxillary Expansion in Growing Subjects: A Case Report

Skeletal Age-related Changes of Midpalatal Suture Densities in Skeletal Maxillary Constriction Patients: CBCT Study

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