Effects of rapid maxillary expansion on the cranial and circummaxillary sutures

• Published in: American journal of orthodontics and dentofacial orthopedics 2011-10, Vol.140 (4), p.510-519
• Main Authors: Ghoneima, Ahmed, Abdel-Fattah, Ezzat, Hartsfield, James, El-Bedwehi, Ashraf, Kamel, Ayman, Kula, Katherine
• Format: Article
• Language: English
• Subjects: Adolescent; Biological and medical sciences; Cephalometry - methods; Child; Cranial Sutures - diagnostic imaging; Cuspid - diagnostic imaging; Dental Arch - diagnostic imaging; Dentistry; Frontal Bone - diagnostic imaging; Humans; Image Processing, Computer-Assisted - methods; Imaging, Three-Dimensional - methods; Incisor - diagnostic imaging; Maxilla - diagnostic imaging; Medical sciences; Molar - diagnostic imaging; Nasal Bone - diagnostic imaging; Orthodontic Appliance Design; Otorhinolaryngology. Stomatology; Palatal Expansion Technique - instrumentation; Palate - diagnostic imaging; Prospective Studies; Sphenoid Bone - diagnostic imaging; Temporal Bone - diagnostic imaging; Tomography, Spiral Computed - methods; Zygoma - diagnostic imaging
• ISSN: 0889-5406; 1097-6752
• DOI: 10.1016/j.ajodo.2010.10.024

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.