title: Effects of rapid maxillary expansion on the cranial and circummaxillary sutures.
abstract: BACKGROUND
  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.
authors.affiliation: Department of Orthodontics, Faculty of Dental Medicine, Al-Azhar University, Cairo, Egypt. aghoneim@iupui.edu
authors.forename: Ahmed
authors.initials: A
authors.lastname: Ghoneima
authors.forename: Ezzat
authors.initials: E
authors.lastname: Abdel-Fattah
authors.forename: James
authors.initials: J
authors.lastname: Hartsfield
authors.forename: Ashraf
authors.initials: A
authors.lastname: El-Bedwehi
authors.forename: Ayman
authors.initials: A
authors.lastname: Kamel
authors.forename: Katherine
authors.initials: K
authors.lastname: Kula
mesh_terms: D000293:Adolescent; D002508:Cephalometry / Q000379:methods; D002648:Child; D003393:Cranial Sutures / Q000000981:diagnostic imaging*; D003481:Cuspid / Q000000981:diagnostic imaging; D003724:Dental Arch / Q000000981:diagnostic imaging; D005624:Frontal Bone / Q000000981:diagnostic imaging; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods; D007180:Incisor / Q000000981:diagnostic imaging; D008437:Maxilla / Q000000981:diagnostic imaging*; D008963:Molar / Q000000981:diagnostic imaging; D009295:Nasal Bone / Q000000981:diagnostic imaging; D016382:Orthodontic Appliance Design; D010155:Palatal Expansion Technique / Q000295:instrumentation; D010159:Palate / Q000000981:diagnostic imaging; D011446:Prospective Studies; D013100:Sphenoid Bone / Q000000981:diagnostic imaging; D013701:Temporal Bone / Q000000981:diagnostic imaging; D036542:Tomography, Spiral Computed / Q000379:methods; D015050:Zygoma / Q000000981:diagnostic imaging