Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: A preliminary study

Abstract

ObjectiveWe sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults.MethodsThe following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification.ResultsIn the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = −0.506, −0.494, and −0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = −0.900, p < 0.05).ConclusionsThe findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

Efficacy of Miniscrew-Assisted Rapid Palatal Expansion (MARPE) in late adolescents and adults: a systematic review and meta-analysis

“…The mean skeletal expansion ranged from 1.11 mm to 4.5 mm and was statistically significant in all five articles ( 28 , 29 , 31 , 32 , 34 ) where the p-value was calculated. One study differentiated between a midpalatal suture separation group and a non-separation group and reported results for both groups separately and combined ( 35 ).…”

“…Different expansion protocols were used across the studies. The mean duration of expansion in those studies with a rapid expansion protocol ranged from 20 to 35 days ( 30 , 32 , 34 , 35 ).…”

“…From the additional outcome measures, duration of expansion was reported in seven studies ( 28 , 30–35 ) and there was a clear association between duration and the expansion protocol that was used. In the majority of studies, a rapid protocol with a speed of 1–2 turns per day was applied and expansion took approximately 3–7 weeks (20–35 days) ( 30 , 32 , 34 , 35 ). Choi et al ( 28 ) and Li et al ( 31 ) applied a slow expansion protocol of 1–2 turns every other day and, consequently, reported the longest duration.…”

Stability of bimaxillary surgery involving intraoral vertical ramus osteotomy with or without presurgical miniscrew-assisted rapid palatal expansion in adult patients with skeletal Class III malocclusion

“…This is because MARPE opens the midpalatal suture, inducing bone formation between the separated sutures that ensures maintenance of the maxillary arch width even after the molars are lingually uprighted due to the intrinsic buccolingual inclination of the brackets during presurgical orthodontics. [18][19][20]26 In several previous studies, [27][28][29] skeletal tissues have been reported to be stable at 6 months after orthognathic surgery. Normally, debonding in cases undergoing presurgical orthodontic treatment is performed within 6 months of surgery.…”

“…This is because MARPE opens the midpalatal suture, inducing bone formation between the separated sutures that ensures maintenance of the maxillary arch width even after the molars are lingually uprighted due to the intrinsic buccolingual inclination of the brackets during presurgical orthodontics. 18 - 20 , 26 …”