Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging

Abstract Background Mini-implant-assisted rapid palatal expansion (MARPE) appliances have been developed with the aim to enhance the orthopedic effect induced by rapid maxillary expansion (RME). Maxillary Skeletal Expander (MSE) is a particular type of MARPE appliance characterized by the presence o...

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Main Authors: Daniele Cantarella, Ramon Dominguez-Mompell, Sanjay M. Mallya, Christoph Moschik, Hsin Chuan Pan, Joseph Miller, Won Moon
Format: Article
Language:English
Published: SpringerOpen 2017-11-01
Series:Progress in Orthodontics
Subjects:
Online Access:http://link.springer.com/article/10.1186/s40510-017-0188-7
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author Daniele Cantarella
Ramon Dominguez-Mompell
Sanjay M. Mallya
Christoph Moschik
Hsin Chuan Pan
Joseph Miller
Won Moon
author_facet Daniele Cantarella
Ramon Dominguez-Mompell
Sanjay M. Mallya
Christoph Moschik
Hsin Chuan Pan
Joseph Miller
Won Moon
author_sort Daniele Cantarella
collection DOAJ
description Abstract Background Mini-implant-assisted rapid palatal expansion (MARPE) appliances have been developed with the aim to enhance the orthopedic effect induced by rapid maxillary expansion (RME). Maxillary Skeletal Expander (MSE) is a particular type of MARPE appliance characterized by the presence of four mini-implants positioned in the posterior part of the palate with bi-cortical engagement. The aim of the present study is to evaluate the MSE effects on the midpalatal and pterygopalatine sutures in late adolescents, using high-resolution CBCT. Specific aims are to define the magnitude and sagittal parallelism of midpalatal suture opening, to measure the extent of transverse asymmetry of split, and to illustrate the possibility of splitting the pterygopalatine suture. Methods Fifteen subjects (mean age of 17.2 years; range, 13.9–26.2 years) were treated with MSE. Pre- and post-treatment CBCT exams were taken and superimposed. A novel methodology based on three new reference planes was utilized to analyze the sutural changes. Parameters were compared from pre- to post-treatment and between genders non-parametrically using the Wilcoxon sign rank test. For the frequency of openings in the lower part of the pterygopalatine suture, the Fisher’s exact test was used. Results Regarding the magnitude of midpalatal suture opening, the split at anterior nasal spine (ANS) and at posterior nasal spine (PNS) was 4.8 and 4.3 mm, respectively. The amount of split at PNS was 90% of that at ANS, showing that the opening of the midpalatal suture was almost perfectly parallel antero-posteriorly. On average, one half of the anterior nasal spine (ANS) moved more than the contralateral one by 1.1 mm. Openings between the lateral and medial plates of the pterygoid process were detectable in 53% of the sutures (P < 0.05). No significant differences were found in the magnitude and frequency of suture opening between males and females. Correlation between age and suture opening was negligible (R 2 range, 0.3–4.2%). Conclusions Midpalatal suture was successfully split by MSE in late adolescents, and the opening was almost perfectly parallel in a sagittal direction. Regarding the extent of transverse asymmetry of the split, on average one half of ANS moved more than the contralateral one by 1.1 mm. Pterygopalatine suture was split in its lower region by MSE, as the pyramidal process was pulled out from the pterygoid process. Patient gender and age had a negligible influence on suture opening for the age group considered in the study.
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spelling doaj.art-c0a5028c7c5749d28981e5b6114032c62022-12-21T23:43:12ZengSpringerOpenProgress in Orthodontics2196-10422017-11-0118111210.1186/s40510-017-0188-7Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imagingDaniele Cantarella0Ramon Dominguez-Mompell1Sanjay M. Mallya2Christoph Moschik3Hsin Chuan Pan4Joseph Miller5Won Moon6Division of Oral Biology and Medicine, School of Dentistry, Center for Health Science, University of CaliforniaDivision of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of CaliforniaDivision of Diagnostic and Surgical Sciences, Section of Oral and Maxillofacial Radiology, School of Dentistry, Center for Health Science, University of CaliforniaDivision of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of CaliforniaDivision of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of CaliforniaDivision of Integrative Anatomy, Department of Pathology and Laboratory Medicine, Geffen School of Medicine, Center for Health Science, University of CaliforniaDivision of Growth and Development, Section of Orthodontics, School of Dentistry, Center for Health Science, University of CaliforniaAbstract Background Mini-implant-assisted rapid palatal expansion (MARPE) appliances have been developed with the aim to enhance the orthopedic effect induced by rapid maxillary expansion (RME). Maxillary Skeletal Expander (MSE) is a particular type of MARPE appliance characterized by the presence of four mini-implants positioned in the posterior part of the palate with bi-cortical engagement. The aim of the present study is to evaluate the MSE effects on the midpalatal and pterygopalatine sutures in late adolescents, using high-resolution CBCT. Specific aims are to define the magnitude and sagittal parallelism of midpalatal suture opening, to measure the extent of transverse asymmetry of split, and to illustrate the possibility of splitting the pterygopalatine suture. Methods Fifteen subjects (mean age of 17.2 years; range, 13.9–26.2 years) were treated with MSE. Pre- and post-treatment CBCT exams were taken and superimposed. A novel methodology based on three new reference planes was utilized to analyze the sutural changes. Parameters were compared from pre- to post-treatment and between genders non-parametrically using the Wilcoxon sign rank test. For the frequency of openings in the lower part of the pterygopalatine suture, the Fisher’s exact test was used. Results Regarding the magnitude of midpalatal suture opening, the split at anterior nasal spine (ANS) and at posterior nasal spine (PNS) was 4.8 and 4.3 mm, respectively. The amount of split at PNS was 90% of that at ANS, showing that the opening of the midpalatal suture was almost perfectly parallel antero-posteriorly. On average, one half of the anterior nasal spine (ANS) moved more than the contralateral one by 1.1 mm. Openings between the lateral and medial plates of the pterygoid process were detectable in 53% of the sutures (P < 0.05). No significant differences were found in the magnitude and frequency of suture opening between males and females. Correlation between age and suture opening was negligible (R 2 range, 0.3–4.2%). Conclusions Midpalatal suture was successfully split by MSE in late adolescents, and the opening was almost perfectly parallel in a sagittal direction. Regarding the extent of transverse asymmetry of the split, on average one half of ANS moved more than the contralateral one by 1.1 mm. Pterygopalatine suture was split in its lower region by MSE, as the pyramidal process was pulled out from the pterygoid process. Patient gender and age had a negligible influence on suture opening for the age group considered in the study.http://link.springer.com/article/10.1186/s40510-017-0188-7Cone beam computed tomography (CBCT)Midpalatal suturePalatal expansionPterygopalatine suture
spellingShingle Daniele Cantarella
Ramon Dominguez-Mompell
Sanjay M. Mallya
Christoph Moschik
Hsin Chuan Pan
Joseph Miller
Won Moon
Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
Progress in Orthodontics
Cone beam computed tomography (CBCT)
Midpalatal suture
Palatal expansion
Pterygopalatine suture
title Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
title_full Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
title_fullStr Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
title_full_unstemmed Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
title_short Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging
title_sort changes in the midpalatal and pterygopalatine sutures induced by micro implant supported skeletal expander analyzed with a novel 3d method based on cbct imaging
topic Cone beam computed tomography (CBCT)
Midpalatal suture
Palatal expansion
Pterygopalatine suture
url http://link.springer.com/article/10.1186/s40510-017-0188-7
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