Rapid Maxillary Expansion Based on the Correlation of the Maturation Between the Midpalatal and Zygomaticomaxillary Sutures through CBCT

The aim of this study was to evaluate and correlate the degree of maturation of the midpalatal suture (MPS) and zygomaticomaxillary suture (ZMS).

The sample consisted of 160 orthodontic patients, aged between 11 and 20 years, 59 men and 101 women, from archives of private clinics. Patients who presented Cone Beam Computed Tomography (CBCT) images in their initial orthodontic file were selected. CBCT images were exported to the InvivoDental5 program (Anatomage, San Jose, California), where axial MPS sections were used to evaluate the maturation stage, and cross-sectional sections in the coronal plane were used to evaluate the maturation of the ZMS. Spearman's correlation coefficient, McNemar-Bowker symmetry test and kappa agreement test with quadratic weighting were used to assess the correlation between the maturation stages of MPS and ZMS. Ordinal logistic regression analysis was used to verify the effect of age and gender on the classification. In all statistical tests, a significance level of 5% was adopted.

The MPS and ZMS displayed a significant correlation between their maturation stages. ZMS tended to present earlier maturation. Taking into account only the individuals from MPS stage C, an earlier ZMS stage was observed in 4.4% while a more advanced ZMS stage was observed in 24.37%. Among older individuals, this prevalence was 36.36%, thus 69.69% had an unfavorable prognosis for RME, following the proposed method.

The correlation between the maturation stages of MPS and ZMS increases the reliability of the RME prognosis through individual morphological evaluation of sutures.