Relationship between the efficacy of micro-implant-assisted rapid maxillary arch expansion and maturation of the midpalatal sutures
DOI:
https://doi.org/10.2340/aos.v85.45902Keywords:
Midpalatal suture, mini-screw, rapid maxillary expansion, cone beam computed tomographyAbstract
Objective: To investigate the relationship between the efficacy of micro-implant-assisted rapid palatal expansion (MARPE) and the degree of midpalatal suture (MBT) fusion.
Methods: Forty patients with maxillary transverse hypoplasia from Hengshui People’s Hospital from January 2022 to August 2024 were recruited for MARPE treatment. These patients were divided into unfused (stages B and C, n = 18), initiation fusion (stage D, n = 10), and complete fusion groups (stage E, n = 12) according to the degree of MBT fusion based on the staging method for palatal sutures. Cone beam computed tomography (CT) and gypsum models were created before and on the day after arch expansion. The differences in maxilla, alveolar bone, tooth, and bony arch expansion efficiency between the three groups were measured and compared.
Results: The success rates of arch expansion in the unfused, initial fusion, and complete fusion groups were 100%, 100%, and 83.3%, respectively. Expansion of the MBT in the first molar position was 4.11 ± 1.10 mm, 4.07 ± 0.42 mm, and 2.18 ± 0.66 mm in the unfused, initial fusion, and complete fusion groups, respectively (P < 0.05). The corresponding bony arch expansion efficiency was 58.82 ± 6.56%, 54.58 ± 8.65%, and 37.88 ± 4.36%, respectively, without statistical difference (P > 0.05).
Conclusion: Patients with different degrees of MBT confluence and treated with MARPE had significant differences. Observation of the degree of MBT fusion before arch expansion predicts MARPE efficacy.
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Oliveira PLE, Campos V, de Andrade RM, de Souza Araújo MT, Pithon MM, Sant’Anna EF. Deformation of the circummaxillary sutures during acute micro-implant assisted rapid palatal expansion and tooth-supported expansion: an ex vivo study. Orthod Craniofac Res. 2021;24(3):396–404. DOI: https://doi.org/10.1111/ocr.12450
Lo Giudice A, Barbato E, Cosentino L, Ferraro CM, Leonardi R. Alveolar bone changes after rapid maxillary expansion with tooth-born appliances: a systematic review. Eur J Orthod. 2018;40(3):296–303. DOI: https://doi.org/10.1093/ejo/cjx057
Reyneke JP, Conley RS. Surgical/orthodontic correction of transverse maxillary discrepancies. Oral Maxillofac Surg Clin North Am. 2020;32(1):53–69. DOI: https://doi.org/10.1016/j.coms.2019.08.007
Lagravère MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop. 2010;137:304.e1–12: discussion 304–5. DOI: https://doi.org/10.1016/j.ajodo.2009.09.016
Jia H, Zhuang L, Zhang N, Bian Y, Li S. Age-dependent effects of transverse maxillary deficiency treated by microimplant-assisted rapid palatal expansion: a prospective cone-beam computed tomography study. Am J Orthod Dentofacial Orthop. 2022;161(4):557–73. DOI: https://doi.org/10.1016/j.ajodo.2020.10.029
Başal E, Acar YB. Relationship between circummaxillary and intramaxillary suture densities and skeletal effects of rapid maxillary expansion. Turk J Orthod. 2024;37(2):72–8. DOI: https://doi.org/10.4274/TurkJOrthod.2023.2022.191
Ferrillo M, Daly K, Pandis N, Fleming PS. The effect of vertical skeletal proportions, skeletal maturation, and age on midpalatal suture maturation: a CBCT-based study. Prog Orthod. 2024;25(1):4. DOI: https://doi.org/10.1186/s40510-023-00504-0
Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop. 2008;134(1):8–9. DOI: https://doi.org/10.1016/j.ajodo.2007.11.024
Reis LG, Ribeiro RA, Vitral RWF, Reis HN, Devito KL. Classification of the midpalatal suture maturation in individuals older than 15 years: a cone beam computed tomographic study. Surg Radiol Anat. 2020;42(9):1043–9. DOI: https://doi.org/10.1007/s00276-020-02518-3
Sayar G, Kılınç DD. Rapid maxillary expansion outcomes according to midpalatal suture maturation levels. Prog Orthod. 2019;20(1):27. DOI: https://doi.org/10.1186/s40510-019-0278-9
Qiu TY, Li Y, Xu J, Yifan YF, Bao XF, Hu M. [Effect of micro-implant assisted rapid palatal expansion in patients with different radiographic stages of mid-palatal suture maturation]. Zhonghua Kou Qiang Yi Xue Za Zhi. 2021;56(8):777–784.
Angelieri F, Cevidanes LH, Franchi L, Gonçalves JR, Benavides E, McNamara JA Jr. Midpalatal suture maturation: classification method for individual assessment before rapid maxillary expansion. Am J Orthod Dentofacial Orthop. 2013;144(5):759–69. DOI: https://doi.org/10.1016/j.ajodo.2013.04.022
Salmoria I, de Souza EC, Furtado A, Franzini CM, Custodio W. Dentoskeletal changes and their correlations after micro-implant -assisted palatal expansion (MARPE) in adults with advanced midpalatal suture ossification. Clin Oral Investig. 2022;26(3):3021–31. DOI: https://doi.org/10.1007/s00784-021-04284-x
Zong C, Tang B, Hua F, He H, Ngan P. Skeletal and dentoalveolar changes in the transverse dimension using microimplant-assisted rapid palatal expansion (MARPE) appliances. Semin Orthod. 2019;25(1):46–59. DOI: https://doi.org/10.1053/j.sodo.2019.02.006
Li N, Wang W, Jia L, Wang X, Ning R, Guo J. The detoskeletal effects of mini-implant assisted maxillary expansion on young adults with transvers maxillary deficiencies. Chin J Orthod. 2019;26(3):121125.
Li Y, Qiu TY, Bao XF, Hu M. Evaluation on expansion efficiency of microimplant-assisted rapid palatal expansion in treatment of maxillary transverse deficiency in adolescents with CBCT. J Jilin University (Medicine Edition). 2020;46(5):1050–5.
Jesus AS, Oliveira CB, Murata WH, Suzuki SS, Santos-Pinto AD. Would midpalatal suture characteristics help to predict the success rate of miniscrew-assisted rapid palatal expansion? Am J Orthod Dentofacial Orthop. 2021;160(3):363–73. DOI: https://doi.org/10.1016/j.ajodo.2020.04.035
Naveda R, Dos Santos AM, Miranda F, da Cunha Bastos JC, Garib D. Immediate dentoskeletal and periodontal effects of miniscrew-assisted rapid palatal expansion: comparison between young vs middle-aged adults. Am J Orthod Dentofacial Orthop. 2023;164(3):416–22. DOI: https://doi.org/10.1016/j.ajodo.2023.02.014
Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. Korean J Orthod. 2017;47(5):313–22. DOI: https://doi.org/10.4041/kjod.2017.47.5.313
Cantarella D, Dominguez-Mompell R, Moschik C, Mallya SM, Pan HC, Alkahtani MR, et al. Midfacial changes in the coronal plane induced by microimplant-supported skeletal expander, studied with cone-beam computed tomography images. Am J Orthod Dentofacial Orthop. 2018;154(3):337–45. DOI: https://doi.org/10.1016/j.ajodo.2017.11.033
Ouldyerou A, Mamboleo E, Gilchrist L, Alsharif K, Ngan P, Merdji A, et al. In-silico evaluation of orthodontic miniscrew-assisted rapid palatal expanders for patients with various stages of skeletal maturation. Am J Orthod Dentofacial Orthop. 2024;166(6):561–71. DOI: https://doi.org/10.1016/j.ajodo.2024.07.018
Nie X, Zhang X, Liu Y, Yan S, Men Y, Yu J, et al. Evaluation of palate-related factors of the effectiveness of microimplant-assisted rapid palatal expansion in late adolescents and adults. Clin Oral Investig. 2023;27(7):3531–44. DOI: https://doi.org/10.1007/s00784-023-04967-7
Ngan P, Nguyen UK, Nguyen T, Tremont T, Martin C. Skeletal, dentoalveolar, and periodontal changes of skeletally matured patients with maxillary deficiency treated with microimplant-assisted rapid palatal expansion appliances: a pilot study. APOS Trends Orthod. 2018;8:71–85. DOI: https://doi.org/10.4103/apos.apos_27_18
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