High-resolution multislice computerized tomography with multiplanar and 3-dimensional reformation imaging in rapid palatal expansion

Introduction: The purpose of this study was to evaluate whether high-resolution multislice computerized tomography (CT) with multiplanar reformation and 3-dimensional (3D) imaging is helpful in demonstrating the effects on midfacial sutures induced by rapid palatal expansion (RPE), thereby appraising and corroborating the current state of the art or possibly adding new findings. Methods: Two patients in different stages of skeletal maturity (aged 10 and 16 years) underwent CT examinations immediately after active opening with the RPE appliance. Results: The 3D CT imaging method proved to be valuable in visualizing skeletal effects on not only the midpalatal suture, but also adjacent sutures. It allowed precise 3D location of tooth positions. In the 3D CT images of 1 patient, the complete opening of the midpalatal suture was visible. The median dissection of the incisal foramen at the point of unification of the 2 nasopalatine channels could be visualized. Additionally, the positions of severely displaced maxillary canines could be located precisely. In the other patient, apart from the completely open midpalatal suture, the opening or widening of the internasal suture, the nasomaxillary sutures, and the frontomaxillary sutures were visible. Conclusions: The 3D imaging of high-resolution multislice CT opens up a new dimension in orofacial diagnosis. Improvements of the quantity and the exactness of diagnostic parameters were attained. The imaging method is helpful and indicated in RPE patients with additional diagnostic objectives related to the development of occlusion. This imaging method is recommended in borderline cases (juvenile or adult patients with questionable sutural response) to determine whether the suture is completely open or whether surgical support is needed.