Cephalometric Sagittal Changes Suggestive of Maxillary Anterior Displacement and Mandibular Immediate Shift Following 3D-Guided Midpalatal Piezocorticotomy-Assisted MARPE in Adults: A Retrospective Cohort Study

Objectives: In this study, we aimed to evaluate the changes suggestive of maxillary anterior displacement in adults undergoing 3D-guided midpalatal piezocorticotomy-assisted Miniscrew-Assisted Rapid Palatal Expansion (MARPE), in addition to the contributing factors for forward maxillary movement and the subsequent immediate shift in the mandible. Methods: In this retrospective quasi-experimental study, cephalometric records of 80 adult patients (mean age 35.23 ± 8.76 years; 52 females and 28 males) were analyzed. Maxillary anterior displacement was assessed via SNA and A-Nperp(FH), while intermaxillary changes were measured using the ANB angle. Vertical and rotational changes were tracked through SN-MP, FH-MP, and various occlusal plane angles (OcP-FH, OcP-SN, OcP-GoMe). Facial height dimensions (TAFH, UAFH, LAFH, PFH) and dento-alveolar positions (U1-MP, U1LENGTH) were also recorded. Results: Following intervention, significant increases were observed in SNA (0.96°; 95% CI [0.48, 1.43]), ANB (1.42°; 95% CI [1.04, 1.80]), and A-Nperp(FH) (0.81 mm; 95% CI [0.24, 1.39]). The SN-GoMe angle increased by 0.98°, and Posterior Facial Height (PFH) decreased by 1.57 mm, while the upper incisor length (U1LENGTH) significantly decreased by 0.71 mm. Conclusions: In adults, 3D-guided midpalatal piezocorticotomy-assisted MARPE is associated with an increase in SNA, ANB, SN-GoMe, and A-Nperp(FH), and decreases in Posterior Facial Height (PFH) and the maxillary incisor length. The amount of mean midpalatal separation is moderately associated with the increase in SNA, while the increase in SNA is not associated with age or gender. Further 3D cephalometric studies would be beneficial to confirm the current findings.