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Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT

Authors :
Fernanda Angelieri
Lorenzo Franchi
Lucia H. S. Cevidanes
Bruno Bueno-Silva
James A. McNamara Jr.
Source :
Dental Press Journal of Orthodontics, Vol 21, Iss 6, Pp 115-125
Publisher :
Dental Press Editora.

Abstract

ABSTRACT Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically.

Details

Language :
English, Portuguese
ISSN :
21776709
Volume :
21
Issue :
6
Database :
Directory of Open Access Journals
Journal :
Dental Press Journal of Orthodontics
Publication Type :
Academic Journal
Accession number :
edsdoj.7f9680fdd57a48cfb875533db870b31b
Document Type :
article
Full Text :
https://doi.org/10.1590/2177-6709.21.6.115-125.sar