Correlation of the Radiographic Midpalatal and Zygomatico-maxillary Suture Maturation Stage with the Outcome of Rapid Maxillary Expansion in Patients Over 15 Years of Age

Amin Golshah; Zahra Zeidi; Fatemeh Azizi; Nafiseh Nikkerdar

doi:10.3889/oamjms.2025.12029

Authors

Amin Golshah Department of Orthodontic, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran https://orcid.org/0000-0002-8167-7632
Zahra Zeidi Students Research Committee, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
Fatemeh Azizi Department of Orthodontic, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran
Nafiseh Nikkerdar Department of Oral and Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran

DOI:

https://doi.org/10.3889/oamjms.2025.12029

Keywords:

Cone-Beam Computed Tomography, Cranial Sutures, Palatal Expansion Technique

Abstract

BACKGROUND: The absence of a standardized radiographic protocol for skeletal expansion assessment necessitates further investigation.

AIM: This study evaluates the correlation between midpalatal suture (MPS) and zygomaticomaxillary suture (ZMS) maturation stages and rapid maxillary expansion (RME) outcomes in patients over 15 years.

METHODS: Revised to include justification for the sample size and limitations regarding generalizability. Expanded the explanation of the statistical methods used to reinforce the robustness of the study.

RESULTS: Significant inverse correlations were noted between the MPS maturation stage with nasal width (NW; P<0.001), distance between the two infraorbital foramina (IOF; P=0.030), and distance between the two greater palatine foramina (GPF; P<0.001), and also between the ZMS maturation stage with the distance between the two GPF (P=0.012), and MPSD ratio with NW (P<0.001) and distance between the two GPF (P<0.001). The MPSD ratio was greater in females than males (P=0.009); while the distance between the two GPF in males was greater than that in females (P=0.034).

CONCLUSIONS: The skeletal radiographic criteria of the MPS and ZMS maturation stage were found to be correlated with anatomical landmarks (i.e., NW, IOF, and GPF) and MPSD ratio; thus, they can serve as prognostic criteria for the success of post-pubertal RME. The study emphasizes the clinical relevance of CBCT-based assessments in treatment planning for older patients and calls for additional research with larger sample sizes and longer follow-ups.

REFINEMENTS: Restated key findings while reinforcing their significance for orthodontic treatment planning. Reiterated the study’s limitations and the need for further research.

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