Craniofacial sutures changes associated with maxillary expansion using C-expander in adults: a retrospective study.

BACKGROUD: Maxillary transverse deficiency in adults presents a therapeutic challenge due to fused craniofacial sutures. This study aimed to assess the changes in craniofacial sutures induced by C-expander treatment in adults.

METHODOLOGY: This retrospective study included 35 patients diagnosed with maxillary transverse deficiency following successful treatment with C-expander. Cone- beam computed tomography(CBCT)scans were performed and analyzed both before and after the intervention. Changes in the widths of nine craniofacial sutures were measured and compared, including the frontonasal, frontomaxillary, frontozygomatic, nasomaxillary, internasal, pterygomaxillary, zygomaticomaxillary, temporozygomatic, and midpalatal sutures. Additionally, five linear measurements in the coronal plane were quantified and analyzed.

RESULTS

C-expander induced significant increases in the widths of the midpalatal, frontomaxillary, nasomaxillary, internasal, frontozygomatic, superior zygomaticotemporal and pterygomaxillary sutures (P < 0.05), except the zygomaticomaxillary and inferior zygomaticotemporal sutures (P > 0.05). The most pronounced increase was observed in the midpalatal suture (3.76 ± 1.63 mm), followed by the frontomaxillary (1.25 ± 0.70 mm) and the inferior nasomaxillary sutures (0.64 ± 0.41 mm). All of the linear measurements have significant increases (P < 0.05). The largest change was at the maxillary base bone width (3.61 ± 1.34 mm), followed by the inter-zygomaticomaxillary suture width (3.16 ± 1.05 mm), the inter-zygomaticotemporal suture width (1.67 ± 0.49 mm), the inter-frontozygomatic suture width (0.43 ± 0.26 mm), and the inter-frontomaxillary suture width (0.30 ± 0.19 mm).

CONCLUSIONS

C-expander treatment achieves clinically significant midpalatal suture expansion in adults with maxillary transverse deficiency, and widens most craniofacial sutures. Suture displacement magnitude varies by suture site, the greater anterior suture expansion may drive a clinically clockwise rotation of the nasomaxillary complex.