Midpalatal suture density ratio: A novel predictor of skeletal response to rapid maxillary expansion.
BACKGROUND
During adolescence, increasing interdigitation of the midpalatal suture increases resistance to rapid maxillary expansion (RME); this decreases its skeletal effect. In this study, we aimed at determining whether a novel measure of midpalatal suture maturity, the midpalatal suture density ratio, can be used as a valid predictor of the skeletal response to RME.


METHODS
The midpalatal suture density ratio, chronologic age, cervical vertebral maturation, and the stage of midpalatal suture maturation were assessed before treatment for 30 patients (ages, 12.9 ± 2.1 years) who underwent RME as part of comprehensive orthodontic treatment. Measurements on cone-beam computed tomography scans were used to determine the proportions of prescribed expansion achieved at the greater palatine foramina, the nasal cavity, and the infraorbital foramina.


RESULTS
There was a statistically significant negative correlation between the midpalatal suture density ratio and both the greater palatine foramina and the infraorbital foramina (r = -0.7877 and -0.3647, respectively; P <0.05). In contrast, chronologic age, cervical vertebral maturation, and stage of midpalatal suture maturation were not significantly correlated to any of the assessed measures of skeletal expansion (r range, -0.2209 to 0.0831; P >0.05).


CONCLUSIONS
The midpalatal suture density ratio has the potential to become a useful clinical predictor of the skeletal response to RME. Conversely, chronologic age, cervical vertebral maturation, and stage of midpalatal suture maturation cannot be considered useful parameters to predict the skeletal effects of RME.
Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn. Electronic address: tgruenhe@umn.edu.
Thorsten
T
Grünheid
Private practice, Rochester, Minn.
Chad E
CE
Larson
Division of Orthodontics, School of Dentistry, University of Minnesota, Minneapolis, Minn.
Brent E
BE
Larson
D000293:Adolescent; D000365:Age Determination by Skeleton; D002574:Cervical Vertebrae / Q000254:growth & development*; D002648:Child; D015331:Cohort Studies; D054893:Cone-Beam Computed Tomography; D003393:Cranial Sutures / Q000000981:diagnostic imaging / Q000254:growth & development*; D005260:Female; D005544:Forecasting; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D010155:Palatal Expansion Technique; D010159:Palate / Q000000981:diagnostic imaging / Q000254:growth & development*; D012189:Retrospective Studies; D013997:Time Factors