title: Prediction of rapid maxillary expansion by assessing the maturation of the midpalatal suture on cone beam CT.
abstract: Rapid maxillary expansion (RME) primarily involves the mechanical opening of the midpalatal suture of the maxillary and palatine bones. The fusion of the midpalatal suture determines the failure of RME, a common event in late adolescents and young adults. Recently, the assessment of the maturation of midpalatal suture as viewed using cone beam computed tomography (CBCT) has been introduced. Five maturational stages of the midpalatal suture have been presented: Stage A = straight high-density sutural line, with no or little interdigitation; Stage B = scalloped appearance of the high-density sutural line; Stage C = two parallel, scalloped, high-density lines that lie close to each other, separated in some areas by small low-density spaces; Stage D = fusion of the palatine bone where no evidence of a suture is present; and Stage E = complete fusion that extends also anteriorly in the maxilla. At Stage C, less skeletal response would be expected than at Stages A and B, as there are many bony bridges along the suture. For patients at Stages D and E, surgically assisted RME would be necessary, as the fusion of the midpalatal suture already has occurred either partially or totally. This diagnostic method can be used to estimate the prognosis of the RME, mainly for late adolescents and young adults for whom this procedure is unpredictable clinically.
authors.affiliation: Assistant Professor, Guarulhos University, Guarulhos, Brazil; and Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI.
authors.forename: Fernanda
authors.initials: F
authors.lastname: Angelieri
authors.affiliation: Research Associate, Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy; and Thomas M. Graber Visiting Scholar, Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, MI.
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Franchi
authors.affiliation: Assistant Professor, Department of Orthodontics and Pediatric Dentistry, School of Dentistry The University of Michigan, Ann Arbor, MI.
authors.forename: Lucia H S
authors.initials: LH
authors.lastname: Cevidanes
authors.affiliation: Instructor Professor, Guarulhos University, Guarulhos, Brazil.
authors.forename: Bruno
authors.initials: B
authors.lastname: Bueno-Silva
authors.affiliation: Thomas M. and Doris Graber Endowed Professor Emeritus (Active), Department of Orthodontics and Pediatric Dentistry, School of Dentistry. Professor Emeritus of Cell and Development Biology, School of Medicine; and Research Professor Emeritus, Center of Human Growth and Development, The University of Michigan, Ann Arbor, MI.
authors.forename: James A
authors.initials: JA
authors.lastname: McNamara
mesh_terms: D000293:Adolescent; D054893:Cone-Beam Computed Tomography / Q000379:methods; D003393:Cranial Sutures / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D016910:Orthodontic Brackets; D010155:Palatal Expansion Technique; D010159:Palate / Q000000981:diagnostic imaging* / Q000601:surgery; D055815:Young Adult