• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.63-70
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• 2004

The midpalatal suture area has some advantages for supporting miniscrews : it has no specific anatomical structure, it is composed of thick cortical bone, and covered with attached gingiva. So it is suitable area for inserting miniscrews. However, the midpalatal suture area appears thinner when seen in ceph. As a result, Clinicians can misunderstand that inserting miniscrews cause the problem, both the risk of perforation and the decrease of stability. The purpose of this article is measuring the vertical bone thickness of the midpalatal suture area for inserting miniscrews. The total of 25patient (male : 13, female : 12), who are in their twenties, were taken CT. The vertical bone thickness of the midpalatal suture area was measures from the transverse section of CT. As a result, We reached a conclusion from the differences of each area. It is as follows: 1. There is no significant difference between the thickness of male group and that of female group. 2. In coronal section, Bone thickness becomes thinner from the midpalatal suture to Left & Right side, in sagittal section, Bone thickness becomes thinner from incisive foramen to PNS. 3. The area that is within 3mm of left and right from the midpalatal suture area transversely and within 25mm backward from the incisive foramen sagittaly is enough for inserting miniscrews.

• The korean journal of orthodontics
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• v.29 no.3 s.74
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• pp.375-381
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• 1999

The purpose of this study was to evaluate whether the basal bone of maxilla was expanded transversely by rapid palatal expansion through the posteroanterior cephalome- tric analysis. Thirty patients with the maxillary deficiency were utilized in this study. The posteroanterior cephalometric X-ray film were taken twice, before and after rapid palatal expansion. logram The obtained results were as follows; 1. There was a significant increase of the maxillary width by rapid palatal expansion in male and female. (P<0.001) 2. There was no significant difference between the male and female in the expansion of the maxillary width by rapid palatal expansion. 3. There was a significant increase of the maxillary width by rapid palatal expansion in the both of before and after the puberty. 4. There was no significant difference between before and after the puberty in the expansion of the maxillary width by rapid palatal expansion.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.31-41
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• 2021

The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman's correlation coefficient, ϒ_S = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒ_S = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒ_S = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

• The korean journal of orthodontics
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• v.26 no.2 s.55
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• pp.153-162
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• 1996

Rapid maxillary expansion is widely used for the correction of anteroposterior discrepancies, constriction of the maxillary arch, etc. This experiment was undertaken to examine the serial changes in the osteogenesis as well as the collagen fiber bundles in the intermaxillary suture during the rapid maxillary expansion treatment. Four young female dogs aged 6 to 8 months old and not showing menarche yet were used for the experiment. The maxillary impression of dogs were taken, expansion device cast and Hyrax screw soldered at the midline in the 1st premolar area. RME device was delivered to the dogs and the activation of 0.25 mm per quarter-turn was done 2 times per day for 10 days until 5 mm separation was made. Separation of the maxilla was confirmed by X-ray. The animals were sacrificed on 0, 15, 30, 60 days from the finish of maxillary separation and preparations for light microscopy and surface electron microscopy were made. The sutures were cut into frontal serial sections for examination of the histological reactions. The following results were obtained and the conclusions made. 1. The edges of the two palatal plates bordering the midpalatal suture which at the beginning of the retention period were mainly composed of compact bone, underwent extensive resorption followed by new bone formation and gradually became spongy bone rich in bone marrow which in the 60 day retention animal became the compact bone with short intermaxillary suture space. During this transformation, newly formed trabecular bone tissues were added to the original margin. 2. Throughout the expansion period, the collagen fibers underwent successive changes such as stretching, loss of polarity, and finally fibrillogenesis. Towards the end of the expansion procedure, sharpey's fiber formation in newly formed bones were observed. 3. Bony spicules were found in the initial stage of retention on occlusal topographic X-rays, which later were confirmed to have ossified. 4. Judging from the histological changes occuring during the experimental expansion, excessive expansion will cause an excessive bleeding, and retard the remodeling of intermaxillary suture. According to the above results, the bone remodeling after rapid maxillary expansion was preceded by the migration of migratory cells into the intermaxillary suture area. The bone remodeling phenomena were on-going during the 2 months retention sample.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.85-97
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• 1998

The purpose of this study was to observe the effects of sodium fluoride on the bony repair and regeneration processes after the rapid palatal expansion in the growing dogs. Eighteen dogs were divided into experimental and control groups. They were in the late mixed dentition. The rapid Palatal expansion was undertaken in all the animals($180^{\circ}$ turn/day) for ten days. The animals were sacrificed on 0, 15 and 45 days after the finish of expansion. One mg NaF/kg of body weight/day were given orally to the experimental group. Blood samples were drawn before and after expansion and the se겨m calcium, phosphate and alkaline phosphatase level were measured. The undecalcified bone section of midpalatal suture area was made, and observed under the light microscopy The results were as follows ; 1. The day after expansion, the infiltration of inflammatory cells were prominent and the new bone formation started at the edges of the two palatal plates bodering the midpalatal suture in both groups. Especially, the newly formed osteoid were very extensive and the osteoblasts lining the osteoid were very active in the experimental group. 2. At fifteen days after expansion, the active osteoblasts lining the osteold at the surface of trabecular bony spicules and active new bone formation were observed in the both groups. However, the cellular activity and new bone formation were more prominent In the experimental group. 3. At forty five days after expansion, the continuous osteoid and new bone formation and active osteoblasts were observed in the experimental group. But these phenomena were not observed in the control group. In the control group, the numerous osteoclasts were adjacent midpalatal suture and the bony remodeling process was begun. The serum alkaline phosphatase level was maintained highly in the experimental group, but decreased in the control. According to the above results, the author reached the conclusion that sodium fluoride has the stimulation effects on the osteoid production of the osteoblasts during the healing process after the rapid Palatal expansion more continuously.

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.391-399
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• 1997

Rapid palatal expansion(RPE) is a method of inducing the new bone formation in the palate by separation of the midpalatal suture, which can be done conveniently by placing heavy force across the maxillary dental arch. This experiment was undertaken to examine the histologic changes after RPE and during retention period. Four young adult dogs(a control dog, three experimental dogs) aged 4 to 6 months old were used for this experiment. Expansion screw($Hyrax^{\circledR}$, Dentarum Inc.) was delevered to the palate and fumed 180 degrees every morning and evening for 8 days, giving a total expansion of 7.2mm. A control dog was sacrified at the starting point of this study without any treatment and three experimental dogs were sacrified after RPE, 14-day retention, and 28-day retention in each. Thereafter, those samples were observed with hematoxylin-eosin(H-E) stain, ground section(Villanueva stain), alkaline phosphatase(ALP) stain, tartrate-resistant acid phosphatase(TRA) stain. The results were as followings: 1. After RPE, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts were flattened-inactive state and also, a little osteoid tissues was observed. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 2. After 14-day retention, collagen fiber bundles were stretched along the midpalatal suture and few osteoblasts which had ALP-positive activity in their cytoplasm were seen. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. 3. After 28-day retention, collagen fiber bundles were arranged like those of control dog and osteoblasts which showed a lot of immature bone formation were cuboidal shape and exhibited ALP-positive activity in their cytoplasm. Few multinucleated osteoclasts which had TRAP-positive activity in their cytoplasm were seen in horizontal section, whereas a few osteoclasts were seen in frontal section, especially in the nasal floor side of palatal bone. According to the above results, the new bone formation after rapid palatal expansion was examined after 14-day retention and significantly increased after 28-day retention.

• The korean journal of orthodontics
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• v.30 no.3 s.80
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• pp.317-333
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• 2000

The purpose of this study was to determine the proliferative activity of the osteoblasts and fibroblasts in the midpalatal area and to investigate the adjacent periodontal tissues of individual tooth following rapid expansion of the palate. Ten young adult dogs, aged approximately ten months, were used in the experiment. The experimental design was consisted of 1 week expansion group(Group E1, 3 dogs), 2 week expansion group(Group E2, 3 dogs), 2 week expansion and 2 week retention group(Group E3, 3 dogs), and control group(Group C, 1 dog). For each group, expansion screw was activated one time per day(1/4 turn;$90^{\circ}$) following Hyrax-screw application. The experimental animals in each group were sacrificed at 1, 2 and 4 weeks following palatal expansion. Maxillary tissue blocks were obtained and prepared ior the histomorphologic and immunohistochemical studies. Light mcroscope, polarizing microscope, and soft X-ray apparatus were used in this study, and following results were obtained. 1. In polarizing microscopic study, the expansion groups(E1 & E2) showed blue color representing bone resorption and new bone formation in midpalatal suture area. E3 groups skewed less blue color compared to the E1 and E2 group. But yellow color increased by calcification in the E3 groups. 2. Immunohistochemical study revealed that positive responses of the osteoblasts to PCNA and undifferentiated fibroblasts to EGF in E1 group were somewhat increased. Positive response to PCNA and EGF were increased in fibroblasts and the osteoblasts forming new bone in E2 group. In E3 group, the positive response cell concentrated the periphery of edge of palatal process in both PCNA and EGF. 3. Throughout the expansion period(E1 & E2), light microscopic study showed the edges of the extensive resorption and new palatal processes, indicating bone remodeling within the suture. E3 group exhibited less remodeling of midpalatal suture area. E2 group and E3 group showed cementum formation and resorption at the apex of 3rd premolar and 1st molar E3 group exhibited extensive hyalinized zone on the cervical portion of buccal side of 1st molar. 4. Soft X-ray analysis of E1 group showed hypomineralized defect and microfractures in various parts of the suture areas when compared with control animals. There was no significant difference in the degree of mineralization in the midpalatal suture region between the C and E3 groups. Tooth axis showed tipping of 3rd premolar and 1st molar in the E2 group and E3 group. Based upon these experimental results, it is concluded that the undifferentiated mesenchymal cells always presented in midpalatal suture area following RPE. Differentiated osteoblasts and fibroblasts possess proliferating cellular activity until the 2 week retention period. The posterior teeth are tend to tip buccally as RPE force applied. Retention group exhibited irreversible response with severe hyalinized zone on the buccal surface of the first molar.

• Journal of Dental Rehabilitation and Applied Science
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• v.25 no.1
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• pp.61-71
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• 2009

Anchorage control is important in orthodontic treatment. Recently miniscrew is widly used as maximum anchorage in orthodontic treatment, and then it is important to install miniscrew safely without damaging adjacent anatomic structure. In a view of Miniscrew's stability, maxilla is unfavorable than mandible, and moreover maxillary soft buccal bone has disadvantage on stability. so palatal area comes into notice for installation area. We measured distance between palatal roots and bone thickness at midpalatal area using 3D computed tomography, and have found following results. 1. On the comparison of distance between palatal roots, the distance between 2nd premolar and 1st molar was significantly longest and the distance between premolars was significantly shortest. 2. Going toward lateral area from midpalatal suture and posterior area from zero point, bone thickness significantly became shorter and shorter. And 5.0mm palatal sagittal plane has more significance decrease of bone thickness than 2.5mm palatal sagittal plane. According to these results, we can conclude that the palatal installation of miniscrew between 2nd premolar and 1st molar is safest. And it is more safe that comes closer to midpalatal suture and to anterior area in regard to incisive canal.

• The korean journal of orthodontics
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• v.37 no.2 s.121
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• pp.98-113
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• 2007

Objective: The purpose of this study was to evaluate the displacement pattern and the stress distribution shown on a finite element model 3-D visualization of a dry human skull using CT during the retraction of upper anterior teeth. Methods: Experimental groups were differentiated into 8 groups according to corticotomy, anchorage (buccal: mini implant between the maxillary second premolar and first molar and second premolar reinforced with a mini Implant, palatal: mini implant between the maxillary first molar and second molar and mini implant on the midpalatal suture) and force application point (use of a power arm or not). Results: In cases where anterior teeth were retracted by a conventional T-loop arch wire, the anterior teeth tipped more postero-inferiorly and the posterior teeth moved slightly in a mesial direction. In cases where anterior teeth were retracted with corticotomy, the stress at the anterior bone segment was distributed widely and showed a smaller degree of tipping movement of the anterior teeth, but with a greater amount of displacement. In cases where anterior teeth were retracted from the buccal side with force applied to the mini implant placed between the maxillary second premolar and the first molar to the canine power arm, it showed that a smaller degree of tipping movement was generated than when force was applied to the second premolar reinforced with a mini implant from the canine bracket. In cases where anterior teeth were retracted from the palatal side with force applied to the mini implant on the midpalatal suture, it resulted in a greater degree of tipping movement than when force was applied to the mini implant between the maxillary first and second molars. Conclusion: The results of this study verifies the effects of corticotomies and the effects of controlling orthodontic force vectors during tooth movement.

• The korean journal of orthodontics
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• v.26 no.4
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• pp.455-467
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• 1996

This study was designed to evaluate the expression of type I collagen in periodontal tissue during the experimental movement of rat incisors. Twenty-one Sprague-Dawley rats were divided into a control group(3 rats), and experimental groups(18 rats) where a force(75g) from helical springs across the maxillary incisors was applied. Experimental groups were sacrificed at 12 hours, 1, 4, 7, 14 and 28 days after force application, respectively. And tissue slides of control and experimental groups were studied histologically and immunohistochemically by LSAB(Labelled streptavidine Biotin) immunohistochemical staining for type I collagen. The results were as follows: 1. Until 28-day after force application, periodontal fibers were strectched on the tension side, and compressed in pressure side, and the arrangement of periodontal fibers was not recovered by that time. 2. The degree of type I collagen expression in control group was rare in the oral epithelium, predentin, pulp and periodontal ligament, but was mildly positive in osteoblasts, acellular cementum, cementoblasts, intermaxillary suture. 3. At acellular cementum of experimental group, the expression of type I collagen was moderate in 1-day and severe in 7-day, which was maintained until 28-day. 4. Type I collagen was observed in the newly formed fibrous connective tissue and osteoblasts at intermaxillary suture, moderately in 1-day, and severely in 14-day. 5. The tension side of periodontal ligament showed a more positive expression of type I collagen than the pressure side in 4-day. The degree was highest in 7-day and was not differentiated between sides in 14-day. 6. In the side wall of bone matrix on which osteoblasts were attached, type I collagen was expressed severely, especially in 7-day. From the above findings, we could suggest that bone remodeling in tooth movement be intimately related to the cell differentiation and the resulting formation of type I collagen.