Three-dimensional analysis of midpalatal suture maturation stages in patients with maxillary transverse deficiency

Objective To investigate the differences in three-dimensional maxillary and palatal parameters as well as midpalatal suture maturation stages between Skeletal Class I malocclusion patients with maxillary transverse deficiency (MTD) and normal maxillary transverse development, in order to provide clinical guidance for orthodontic diagnosis and treatment. Methods This study was approved by the institutional ethics committee and informed consent was obtained. Cone-bean CT data from 66 Skeletal Class I malocclusion patients [22 males, 44 females; age (14.39 &#x00B1; 1.68) years] were analyzed. Based on Yonsei University width analysis, participants were divided into two groups: the maxillary transverse deficiency group [<i>n</i> = 33, age (14.34 &#x00B1; 1.99) years] and the maxillary transverse normal group [<i>n</i> = 33, age (14.43 &#x00B1; 1.33) years]. Parameters compared included midpalatal suture maturation stages (A-E), maxillary skeletal width on nasal floor (NF) and maxillary skeletal width on hard palate (HP), maxillary arch width on buccal alveolar crest (BAC) and maxillary arch width on lingual alveolar crest (LAC), palatal vault height, palatal bone thickness, palatal length, surface area, and volume. Results The proportion of patients with palatal suture maturity at stages D+E in the maxillary transverse deficiency group (33%, 11/33) was lower than that in the normal maxillary transverse development group (45%, 15/33), showing no statistically significant difference between the two groups. Compared to the maxillary transverse normal group, significant reductions were observed in the maxillary transverse deficiency group for maxillary widths [NF: (67.63 &#x00B1; 3.74) mm <i>vs. </i>(71.49 &#x00B1; 5.11) mm; HP: (64.60 &#x00B1; 3.53) mm <i>vs.</i> (68.40 &#x00B1; 4.64) mm], dental arch widths [BAC: (56.88 &#x00B1; 2.25) mm <i>vs.</i> (59.81 &#x00B1; 2.71) mm; LAC: (33.90 &#x00B1; 1.89) mm <i>vs.</i> (36.91 &#x00B1; 2.20) mm], and palatal surface area [(1 170.80 &#x00B1; 126.48) mm² <i>vs.</i> (1 264.76 &#x00B1; 140.10) mm²]. No significant differences were noted in palatal height, bone thickness, length, or volume. Conclusion Skeletal Class I malocclusion patients with MTD have narrowed maxillary and dental arch widths, reduced palatal surface area, and delayed midpalatal suture maturation. Early maxillary expansion is recommended to harmonize jaw relationship.