title: Rapid maxillary expansion in adults: Can multislice computed tomography help choose between orthopedic or surgical treatment?
abstract: BACKGROUND
  The aim of this study was to evaluate the accuracy of Multislice Computed Tomography (MSCT) in the detection resistance areas on the midpalatal suture (MPS) and thus to evaluate if MSCT could be a help in the kind of maxillary expansion to be used (pure orthodontic or surgically-aided) for the correction of transverse maxillary deficiencies in adults.
  
  
  METHODS
  Ten MSCT were obtained from 10 MPS removed from fresh corpses (mean age: 79.4; extreme: 70-86). Three standardized radiological regions of interest (ROI) were identified on each MPS and were classified into "open" (group 1) or "closed" (group 2) by 3 independent radiologists. The 30 ROI were then histologically analyzed according to 3 criteria: mean suture width (MSW), obliteration index (OI) and interdigitation index (Ii).
  
  
  RESULTS
  Nine ROI were classified in group 1 (closed) and 21 in group 2 (open). On the histological examination, the mean MSW was 396.9μm in group 1 and 227.1μm in group 2. OI was 3.098% and 9.309% and Ii was 1.25 and 1.34 respectively. Statistically significant difference between the 2 groups was only found for the MSW. We conclude that MSCT allows for the evaluation of the width of the MPS, but not for the evaluation of the other possible parameters of resistance we used. Therefore, it cannot predict precisely the amount of résistance in the MPS and is not suited for the choice between pure orthodontic or surgically-aided expansion.
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France. Electronic address: gueutier.alexandre@hotmail.fr.
authors.forename: A
authors.initials: A
authors.lastname: Gueutier
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Paré
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France.
authors.forename: A
authors.initials: A
authors.lastname: Joly
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France.
authors.forename: B
authors.initials: B
authors.lastname: Laure
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Pathology, Tours, France.
authors.forename: G
authors.initials: G
authors.lastname: de Pinieux
authors.affiliation: CHU Trousseau, University Francois-Rabelais, Department of Maxillo Facial and Facial Plastic Surgery, Tours, France.
authors.forename: D
authors.initials: D
authors.lastname: Goga
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002102:Cadaver; D002508:Cephalometry / Q000379:methods; D006801:Humans; D008310:Malocclusion / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008437:Maxilla / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods; D057909:Orthognathic Surgery / Q000379:methods; D019637:Orthopedic Procedures / Q000379:methods; D010155:Palatal Expansion Technique; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity
keywords: Expansion maxillaire; Histologie; Histology; Maxillary expansion; Multidetector computed tomography; Scanner