The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Effect of bone-borne maxillary skeletal expanders on cranial and circummaxillary sutures: A cone-beam computed tomography study

  • Bin Xu (Department of Orthodontics, School of Dentistry, Kyung Hee University) ;
  • Jung-Jin Park (Department of Orthodontics, School of Dentistry, Kyung Hee University) ;
  • Jin Bai (Department of Orthodontics, School of Dentistry, Kyung Hee University) ;
  • Seong-Hun Kim (Department of Orthodontics, School of Dentistry, Kyung Hee University)
  • Received : 2024.08.09
  • Accepted : 2024.09.26
  • Published : 2024.11.25
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Abstract

Objective: Miniscrew-assisted maxillary expansion devices are frequently used for patients with calcified midpalatal sutures. This study aimed to evaluate the effects of two bone-borne maxillary expansion appliances on the cranial and circummaxillary sutures by comparing cone-beam computed tomography (CBCT) images before and after transverse maxillary expansion. Methods: A total of 81 patients (women = 58, men = 23) were treated with either a C-expander (n = 44) or an ATOZ expander (n = 37). CBCT images were obtained before (T0) and after (T1) maxillary expansion, and the widths of 10 circummaxillary sutures were measured in the sagittal, coronal, and axial planes. The Wilcoxon signed-rank test was used to compare the changes in suture width between the C-expander and ATOZ groups, and statistical significance was set at P < 0.05. Results: The frontonasal, frontomaxillary, pterygomaxillary, nasomaxillary, internasal, intermaxillary, and midpalatal suture widths increased significantly after maxillary expansion in both the ATOZ and C-expander groups (both P < 0.05). The frontozygomatic, zygomaticomaxillary, and temporozygomatic suture widths decreased in the C-expander group (P < 0.05), whereas the frontozygomatic suture width increased significantly in the ATOZ group (P < 0.05). The width changes of the frontozygomatic, zygomaticomaxillary, temporozygomatic, pterygomaxillary, internasal, intermaxillary, and midpalatal sutures differed significantly between the two groups (P < 0.05). Conclusions: Both the C- and ATOZ expanders affected the suture width in the naso-maxillozygomatic region. The C-expander decreased the circum-zygomatic suture widths, whereas the ATOZ expander widened the frontozygomatic suture with no effect on other circummaxillary sutures.

Keywords

Acknowledgement

The authors thank Dr. Heon Jae Cho, CEO of 3DONS Company, and Sung-Chul Moon, Clinical Adjunct Professor of the Department of Orthodontics, Seoul National University, School of Dentistry, Seoul for editing during the article preparation.

References

  1. Lagravere MO, Carey J, Heo G, Toogood RW, Major PW. Transverse, vertical, and anteroposterior changes from bone-anchored maxillary expansion vs traditional rapid maxillary expansion: a randomized clinical trial. Am J Orthod Dentofacial Orthop 2010;137:304.e1-12; discussion 304-5. https://doi.org/10.1016/j.ajodo.2009.09.016
  2. Gautam P, Valiathan A, Adhikari R. Stress and displacement patterns in the craniofacial skeleton with rapid maxillary expansion: a finite element method study. Am J Orthod Dentofacial Orthop 2007;132:5. e1-11. https://doi.org/10.1016/j.ajodo.2006.09.044
  3. Gardner GE, Kronman JH. Cranioskeletal displacements caused by rapid palatal expansion in the rhesus monkey. Am J Orthod 1971;59:146-55. https://doi.org/10.1016/0002-9416(71)90046-7
  4. Garrett BJ, Caruso JM, Rungcharassaeng K, Farrage JR, Kim JS, Taylor GD. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2008;134:8-9. https://doi.org/10.1016/j.ajodo.2008.06.004
  5. Baer MJ. Patterns of growth of the skull as revealed by vital staining. Hum Biol 1954;26:80-126. https://pubmed.ncbi.nlm.nih.gov/13191803/
  6. Starnbach H, Bayne D, Cleall J, Subtelny JD. Facioskeletal and dental changes resulting from rapid maxillary expansion. Angle Orthod 1966;36:152-64. https://pubmed.ncbi.nlm.nih.gov/4956318/
  7. Ghoneima A, Abdel-Fattah E, Hartsfield J, El-Bedwehi A, Kamel A, Kula K. Effects of rapid maxillary expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop 2011;140:510-9. https://doi.org/10.1016/j.ajodo.2010.10.024
  8. Baydas B, Yavuz I, Uslu H, Dagsuyu IM, Ceylan I. Nonsurgical rapid maxillary expansion effects on craniofacial structures in young adult females. A bone scintigraphy study. Angle Orthod 2006;76:759-67. https://doi.org/10.1043/0003-3219(2006)076[0759:Nrmeeo]2.0.Co;2
  9. Leonardi R, Sicurezza E, Cutrera A, Barbato E. Early post-treatment changes of circumaxillary sutures in young patients treated with rapid maxillary expansion. Angle Orthod 2011;81:36-41. https://doi.org/10.2319/050910-250.1
  10. Leonardi R, Cutrera A, Barbato E. Rapid maxillary expansion affects the spheno-occipital synchondrosis in youngsters. A study with low-dose computed tomography. Angle Orthod 2010;80:106-10. https://doi.org/10.2319/012709-56.1
  11. Jin B, Choi JY, Kim SH. The design of bone-borne maxillary expander affects the different dentoalveolar inclination and expansion pattern: a CBCT study. Semin Orthod 2024. [Epub ahead of print] https://doi.org/10.1053/j.sodo.2024.05.002
  12. Braun S, Bottrel JA, Lee KG, Lunazzi JJ, Legan HL. The biomechanics of rapid maxillary sutural expansion. Am J Orthod Dentofacial Orthop 2000;118:257-61. https://doi.org/10.1067/mod.2000.108254
  13. Park JJ, Park YC, Lee KJ, Cha JY, Tahk JH, Choi YJ. Skeletal and dentoalveolar changes after miniscrew-assisted rapid palatal expansion in young adults: a cone-beam computed tomography study. Korean J Orthod 2017;47:77-86. https://doi.org/10.4041/kjod.2017.47.2.77
  14. Jafari A, Shetty KS, Kumar M. Study of stress distribution and displacement of various craniofacial structures following application of transverse orthopedic forces-a three-dimensional FEM study. Angle Orthod 2003;73:12-20. https://pubmed.ncbi.nlm.nih.gov/12607850/
  15. Sun Z, Hueni S, Tee BC, Kim H. Mechanical strain at alveolar bone and circummaxillary sutures during acute rapid palatal expansion. Am J Orthod Dentofacial Orthop 2011;139:e219-28. https://doi.org/10.1016/j.ajodo.2009.12.029
  16. Hartono N, Soegiharto BM, Widayati R. The difference of stress distribution of maxillary expansion using rapid maxillary expander (RME) and maxillary skeletal expander (MSE)-a finite element analysis. Prog Orthod 2018;19:33. https://doi.org/10.1186/s40510-018-0229-x
  17. Mao JJ. Mechanobiology of craniofacial sutures. J Dent Res 2002;81:810-6. https://doi.org/10.1177/154405910208101203
  18. Isaacson RJ, Ingram AH. Forces produced by rapid maxillary expansion: II. forces present during treatment. Angle Orthod 1964;34:261-70. https://pubmed.ncbi.nlm.nih.gov/14331018/ 1018/
  19. Prado GP, Furtado F, Aloise AC, Bilo JP, Masako Ferreira L, Pereira MD. Stability of surgically assisted rapid palatal expansion with and without retention analyzed by 3-dimensional imaging. Am J Orthod Dentofacial Orthop 2014;145:610-6. https://doi.org/10.1016/j.ajodo.2013.12.026
  20. de Oliveira CB, Ayub P, Ledra IM, Murata WH, Suzuki SS, Ravelli DB, et al. Microimplant assisted rapid palatal expansion vs surgically assisted rapid palatal expansion for maxillary transverse discrepancy treatment. Am J Orthod Dentofacial Orthop 2021;159:733-42. https://doi.org/10.1016/j.ajodo.2020.03.024
  21. Ahmida A, Mehta S, Amelemah E, Bashir R, Vich ML, Tadinada A, et al. Short-term and long-term effects of miniscrew-assisted and conventional rapid palatal expansion on the cranial and circummaxillary sutures. Am J Orthod Dentofacial Orthop 2023;163:e115-26. https://doi.org/10.1016/j.ajodo.2023.01.007
  22. Kim JW, Park JJ, Kim SH. Comparison of geometric changes in basal arch form after maxillary expansion between pure bone-borne and tissue-boneborne appliance. Semin Orthod 2024. [Epub ahead of print] https://doi.org/10.1053/j.sodo.2024.08.004
  23. Choi JY, Choo H, Oh SH, Park JH, Chung KR, Kim SH. Finite element analysis of C-expanders with different vertical vectors of anchor screws. Am J Orthod Dentofacial Orthop 2021;159:799-807. https://doi.org/10.1016/j.ajodo.2020.02.024
  24. Cho AR, Park JH, Moon W, Chae JM, Kang KH. Short-term effects of microimplant-assisted rapid palatal expansion on the circummaxillary sutures in skeletally mature patients: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2022;161:e187-97. https://doi.org/10.1016/j.ajodo.2021.01.023
  25. Isaacson RJ, Wood JL, Ingram AH. Forces produced by rapid maxillary expansion: I. design of the force measuring system. Angle Orthod 1964;34:256-60. https://meridian.allenpress.com/angle-orthodontist/article/34/4/256/55749/Forces-Produced-By-RapidMaxillary-ExpansionI
  26. Kopher RA, Mao JJ. Suture growth modulated by the oscillatory component of micromechanical strain. J Bone Miner Res 2003;18:521-8. https://doi.org/10.1359/jbmr.2003.18.3.521
  27. Storey E. Tissue response to the movement of bones. Am J Orthod 1973;64:229-47. https://doi.org/10.1016/0002-9416(73)90017-1
  28. Dibbs RP, Ferry AM, Sarrami SM, Abu-Ghname A, Dempsey RF, Buchanan EP. Distraction osteogenesis: mandible and maxilla. Facial Plast Surg 2021;37:751-8. https://doi.org/10.1055/s-0041-1727248
  29. Park JJ, Park KH, Kim SH, Ahn HW. Critical issues concerning miniscrew-assisted rapid palatal expanders: a narrative review. Semin Orthod 2024. [Epub ahead of print] https://doi.org/10.1053/j.sodo.2024.04.003
  30. Choo H, Moon SC. Growth of the maxillary apical base in post-adolescents with craniofacial dysmorphism using ATOZTM orthodontic distraction osteogenesis. Semin Orthod 2024. [Epub ahead of print] https://doi.org/10.1053/j.sodo.2024.06.005
  31. Castello JR, Olaso AS, Chao JJ, McCarthy JG, Molina F. Craniofacial shortening by contraction osteogenesis: an experimental model. Plast Reconstr Surg 2000;105:617-25; discussion 626-7. https://doi.org/10.1097/00006534-200002000-00021
  32. Roberts WE, Huja SS. Bone physiology, metabolism, and biomechanics in orthodontic practice. In: Graber LW, Vanarsdall RL, Vig KWL, Huang GJ, eds. Orthodontics: current principles and techniques. 6th ed. St. Louis: Elsevier; 2017. p. 100-49. https://search.worldcat.org/ko/title/951917299