Age-dependent effects on palate volume and morphology during orthodontic RME treatment

Abstract

Objectives Rapid maxillary expansion (RME) shows diferent age-dependent efects. It has been shown that RME leads to a parallel expansion prior to the age of 10, while later and especially from the age of 12, a V-shaped expansion happens (transverse, anterior > posterior; horizontal, inferior > superior). However, it is not clear to what extent these efects infuence palatal volume and morphology and eventually maxillary functional space. The aim of the present study was to examine possible age-related efects of treatment with a dental anchored RME appliance upon volume and width/height ratio of the anterior and posterior palate. Materials and methods Sixty children and adolescents with documented treatment histories after RME were divided into three equal groups according to age at treatment begin (PG 1, < 10 years, n=20; PG 2, 10 ≤ 12 years, n=20; PG 3, > 12 years, n=20). Maxillary dental casts before and after therapy were digitised. Changes in palatal volume were determined using 3D analyses. Results In all patients, the palatal volume increases signifcantly after RME. Older patients experienced smaller increases in total and posterior volume in absolute and percentage terms. The anterior palate volume increases are almost equal in all patients. Since palatal width increases more markedly than palatal height, the width/height ratio always increases. Except for the posterior region in PG 3, its increase is signifcant in all groups, both anteriorly and posteriorly. After successful RME, the palatal morphology appears normal anteriorly in PG 1, PG 2 and PG 3 and rather steep posteriorly in PG 3. Conclusions RME treatment with identical force application causes diferent, age-dependent efects upon palate volume and morphology. Width changes have a greater infuence on palate volume than height changes. Clinical relevance It is preferable to use an RME prior to the age of 10 if homogeneous changes of the anterior and posterior palate regarding maxillary symmetry and functional space are desired.