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Evaluation of optical density of the midpalatal suture 3 months after surgically assisted rapid maxillary expansion

¹ Department of Oral and Maxillofacial Radiology, São Paulo Metodista Dental School, São Paulo, Brazil; ² Orthodontic Post Graduate Program, São Paulo Metodista Dental School, São Paulo, Brazil

^* Correspondence to: Eduardo Kazuo Sannomiya, Department of Oral and Maxillofacial Radiology, São Paolo Metodista Dental School, Av. Lacerda Franco 1180-Aclimação, Brazil, CEP 01536-000; Email: eduardosannomiya{at}ig.com.br

Received 27 November 2005; revised 6 February 2006; accepted 2 March 2006

Objectives: This study evaluated new bone formation at the midpalatal suture after surgically assisted rapid maxillary expansion (SARME) by optical density analysis.

Methods: The study population consisted of 18 patients, 10 males and 8 females. All patients presented maxillary atresia with posterior crossbite and were submitted to SARME. Maxillary occlusal radiographs were taken at three stages (before SARME, immediately after SARME and after 3 months). Three patients did not attend the session at the 3-month period for achievement of the occlusal radiography and thus were excluded, leading to a final sample of 15 patients. Two regions were selected and analysed at each stage. Region A measured 8x1 mm² and was located 1.2 cm from the tangent to the maxillary central incisors at the region of the midpalatal suture. Region B measured 5x9 mm² and was located 4.3 cm from the tangent to the maxillary central incisors at the region of the midpalatal suture. An aluminium scale (step wedge) with eight steps varying from 1 mm to 8 mm was adapted at the end of the films. Radiographs were taken on a Spectro 70X machine (Dabi Atlante, Ribeirão Preto, Brazil) set at 70 kVp and 10 mA with an exposure time of 1.0 s. Radiographs were scanned using a Power Look 1000 scanner (Umax, Taiwan, China) and a computer Dimension E510 (Dell Computer, Taiwan, China). Optical density analysis was performed after digitization of radiographs using the software Image Tool (UTHSCSA, San Antonio, TX).

Results: Statistical analysis of region A revealed statistically significant differences between Stages I and II (P=0.0001), Stages II and III (P=0.0001) and Stages I and III (P=0.0003). In region B, statistically significant differences were observed between Stages I and II, I and III and II and III (P=0.0018, P=0.0003 and P=0.0003, respectively).

Conclusions: Optical density analysis improves post-treatment control of SARME procedures by surgeons and orthodontists. After 3 months, new bone formation at the midpalatal suture is not complete.

Keywords: radiograph; optical density; new bone formation