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ONLINE ONLY | VOLUME 134, ISSUE 1, P8-9, JULY 2008

Editor's Summary, Q & A, Reviewer's Critique

Skeletal effects to the maxilla after rapid maxillary expansion
assessed with cone-beam computed tomography
Brett J. Garrett • Joseph M. Caruso • Kitichai Rungcharassaeng • James R. Farrage •
Jay S. Kim • Guy D. Taylor DOI: https://doi.org/10.1016/j.ajodo.2008.06.004
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Introduction
The purpose of this study was to use cone-beam computed tomography to
quantitatively evaluate skeletal expansion and alveolar tipping of the maxilla at the
maxillary canine (C1), first premolar (P1), second premolar (P2), and first molar (M1)
after rapid maxillary expansion (RME). The transverse effects to the maxillary suture,
nasal width, and maxillary sinus were also assessed.

Methods
Thirty consecutive patients (17 boys, 13 girls; mean age, 13.8 ± 1.7 years) who required
RME with Hyrax appliances as part of their comprehensive orthodontic treatment were
studied. Measurements before and after RME of palatal and buccal maxillary widths,
palatal alveolar angle, nasal width, nasal floor width, and maxillary sinus width at C1,
P1, P2, and M1 were compared by using Wilcoxon signed rank, Kruskal-Wallis, and
Wilcoxon rank sum tests. Pearson correlation analyses were also performed (α = .05).

Results and Conclusions

Skeletal expansion of the maxilla had a triangular pattern with a wider base in the
anterior region, accounting for 55% of total expansion at P1, 45% at P2, and 38% at
M1. Alveolar bending or tipping accounted for 6% of total expansion at P1, 9% at P2,
and 13% at M1. The remaining orthodontic (dental tipping) portions of total expansion
were 39% at P1, 46% at P2, and 49% at M1. RME produces a statistically significant
increase in nasal width and a decrease in maxillary sinus width (P <0.0001). Retention
time showed a significant negative correlation to the change in palatal maxillary width at
# $ % &
C1, P2, and M1 (P <0.05), the rate of appliance expansion had a significant correlation
with palatal maxillary expansion at P1 and P2 (P <0.05), and age had no statistically
significant association with any parameter (P >0.05).

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Article info
Footnotes
The full text of this article can be found at: www.ajodo.org.

Identification
DOI: https://doi.org/10.1016/j.ajodo.2008.06.004

Copyright
© 2008 American Association of Orthodontists. Published by Elsevier Inc. All rights
reserved.

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