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Dentoskeletal changes and their correlations after micro-implant-assisted palatal expansion (MARPE) in adults with advanced midpalatal suture ossification

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Abstract

Objectives

To evaluate and correlate the dentoskeletal changes of adult patients after miniscrew-assisted rapid palatal expander (MARPE) in the two final stages of midpalatal suture ossification.

Materials and methods

This interventional pre-post clinical study consisted of 20 adults (24.9±1.8 years), with transverse maxillary atresia, divided into two subgroups (n=10) based on the ossification degree of the midpalatal suture: stage D, fusion completed in the palatine bone; and stage E, fusion anteriorly in the maxilla. Cone beam computed tomography (CBCT) in the pre- (T0) and post-treatment (T1) time intervals were used to evaluate the anterior and posterior sutural opening, activation of the expander screw, vestibular-lingual inclinations, and widths of first premolars and first molars. Maxillary interincisor diastema was measured on patients’ plaster models in the same timepoints. The Wilcoxon-Mann-Whitney test, generalized linear models (GLM), and chi-square (χ2) test were employed.

Results

All variables significantly increased after MARPE therapy regardless of the ossification degree (P<0.05). Patients with stage D suture presented wider interincisal diastema and maxillary suture opening (on both regions, anterior and posterior) when compared with patients with stage E (P<0.05). Maxillary interincisor diastema was positively associated with anterior and posterior suture opening for all subjects (P<0.05). MARPE therapy was unsuccessful in six patients, mostly presented by individuals with E maturation stage of the midpalatal suture.

Conclusions

After MARPE, a significant correction in the transverse defect of the maxillary basal bone was achieved for adults in the last two midpalatal suture maturation stages.

Clinical relevance

Adult patients in stage D of maxillary suture ossification are more susceptible to dentoskeletal changes following MARPE therapy as compared to patients with stage E.

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Authors and Affiliations

  1. Department of Orthodontics, University Center of the Hermínio Ometto Foundation-FHO, Avenida Dr Maximiliano Baruto, 500, Araras, SP, Zip Code 13607-339, Brazil

    Igor Salmoria, Evaldo Chaves de Souza, Cristina Maria Franzini & William Custodio

  2. Department of Orthodontics, Centro Universitário Unifacvest: Centro Universitario Unifacvest, Florianópolis, SC, Brazil

    Alvaro Furtado

Authors
  1. Igor Salmoria
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  2. Evaldo Chaves de Souza
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  3. Alvaro Furtado
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  4. Cristina Maria Franzini
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  5. William Custodio
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Contributions

IS: standardizing methodology, intervention, data collection, and interpretation, and writing the manuscript. ESC: blinding, randomization, and clinical follow-up after intervention. AF: formulating the methodology, and clinical intervention. CMF and WC: guidance throughout the study and manuscript editing. The authors read and approved the final version of the manuscript.

Corresponding author

Correspondence to William Custodio.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Supplementary Information

Online Resource 1.

Assessment of method error according to Bland-Altman analysis and Dahlberg’s formula. (DOCX 46 kb)

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Salmoria, I., de Souza, E.C., Furtado, A. et al. Dentoskeletal changes and their correlations after micro-implant-assisted palatal expansion (MARPE) in adults with advanced midpalatal suture ossification. Clin Oral Invest 26, 3021–3031 (2022). https://doi.org/10.1007/s00784-021-04284-x

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