title: Three-dimensional assessment of transverse skeletal changes after surgically assisted rapid maxillary expansion and orthodontic treatment: a prospective computerized tomography study.
abstract: BACKGROUND
  The aim of this prospective longitudinal study was to evaluate transverse skeletal changes after surgically assisted rapid maxillary expansion. The changes were registered by using a 3-dimensional computerized tomography technique based on superimposition on the anterior base of the skull.
  
  
  METHODS
  The subjects comprised 35 patients (mean age, 19.7 years; range, 16.1-43.9 years). Low-dose, helical computerized tomography images were taken at treatment start and after orthodontic treatment. The 3-dimensional models were registered and superimposed at the anterior cranial base.
  
  
  RESULTS
  Surgically assisted rapid maxillary expansion had a significant transverse skeletal treatment effect, significantly greater posteriorly than anteriorly. The expansion was parallel anteriorly, but posteriorly there was significant transverse tipping. Although there was no statistically significant difference between the changes at the corresponding landmarks, the range of standard deviations was marked.
  
  
  CONCLUSIONS
  The results showed that, for registering transverse skeletal changes after surgically assisted rapid maxillary expansion, 3-dimensional superimposition is a reliable method, circumventing projection and measurement errors. Surgically assisted rapid maxillary expansion had a significant but nonuniform skeletal treatment effect. Despite careful surgical separation, pronounced posterior tipping occurred. No correlation was found between the severity of tipping and the patient's age.
authors.affiliation: Department of Orthodontics, Institute for Postgraduate Dental Education, Jönköping, Sweden. anders.magnusson@lj.se
authors.forename: Anders
authors.initials: A
authors.lastname: Magnusson
authors.forename: Krister
authors.initials: K
authors.lastname: Bjerklin
authors.forename: Hyungmin
authors.initials: H
authors.lastname: Kim
authors.forename: Peter
authors.initials: P
authors.lastname: Nilsson
authors.forename: Agneta
authors.initials: A
authors.lastname: Marcusson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008297:Male; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000601:surgery; D009971:Orthodontics, Corrective; D010155:Palatal Expansion Technique; D019047:Phantoms, Imaging; D011446:Prospective Studies; D011859:Radiography; D019291:Skull Base / Q000000981:diagnostic imaging; D055815:Young Adult