Fractal Perspective on the Rapid Maxillary Expansion Treatment; Evaluation of the Relationship Between Midpalatal Suture Opening and Dental Effects

Abstract

Objective: This retrospective study investigates the relationship between the midpalatal suture opening and the dental effects of Rapid Maxillary Expansion (RME) treatment using fractal analysis. Methods: The participants of this study were selected from the patients who underwent Cone Beam Computed Tomography(CBCT) scans in 2019 and were treated with banded type Maxillary Expander. This study included 20 participants (with a mean age of 10.64§10.64, ranging from 8 to 13 years): 12 males and 8 females. Patients went through CBCT scan and images taken were analyzed using the ImageJ program. The following parameters were measured and analyzed before and after RME treatment: fractal dimensional value of Midpalatal suture(MPS), Distobuccal(DB), Mesiobuccal(MB), Palatal(P), Total distance, Cortical bone and linear values of External maxilla, Internal maxilla, Palatal roots, distance of Central fosses and angular values of Tipping value of 16 and 26. We used Spearman’s nonparametric test for non-normal variables to investigate the correlation between changes in MPS and other variables. Results: The results showed a strong positive correlation between the MPS and Right MB (0.34, p<0.05) and Left MB (0.59, p<0.05) variables and a strong negative correlation between the MPS and the External maxillary variables (-0.53, p<0.05). Conclusion: The results of the study have shown a strong correlation between right and left MB and External Maxilla. RME caused a reduction in buccal alveolar bone thickness and a slight reduction in MPS thickness in growing patients. Therefore, we suggest that fractal analysis can be used to evaluate the skeletal and dental effects of RME in patients.