Evaluating the impact of various predictors on rapid maxillary expansion (RME) success.

OBJECTIVES

To evaluate indicators that predict the success of rapid maxillary expansion (RME) in late adolescents using pretreatment cone-beam computed tomography (CBCT).

MATERIALS AND

METHODS

A prospective clinical trial was conducted to integrate radiological and clinical evaluations with blinded outcome assessment. A total of 46 patients (18 males and 28 females) with a mean age of 15.7 ± 1.4 years were enrolled. All patients were diagnosed with posterior skeletal crossbite and underwent CBCT scans prior to rapid maxillary expansion (RME) using a bonded hyrax expander. Patients were divided into Successful (S-RME) or Failed (F-RME) groups based on midpalatal suture response four days after expansion initiation. Expansion was performed twice daily and continued until molar overcorrection, followed by a four-month fixation. Four CBCT variables (midpalatal suture maturation [MSM], Cervical vertebral maturation [CVM], midpalatal suture density [MSD], and the length and thickness of the palate), age, and sex were analyzed using t-tests, Mann-Whitney U, and chi-square. ICC evaluated random errors.

RESULTS

Age, maturation stage (MSM), CVM stage, MSD, and the length of the palate were all variables with a statistically significant correlation (P <.05). Sex, as well as the thickness and area of the palate, did not show significant differences between the groups (P >. 05).

CONCLUSIONS

Patients with a higher stage of MSM and CVM had a greater risk of RME failure. Additionally, patients with a lower density ratio and shorter palate length had a better prognosis for conventional RME.

CLINICAL RELEVANCE: Choosing between traditional and surgically assisted rapid maxillary expansion (RME) is challenging, especially in late adolescents. Orthodontists should consider additional indicators to guide clinical decisions.

CLINICAL TRIAL REGISTRATION NUMBER: ISRCTN31077190.