Evaluation Of Alternate Rapid Maxillary Expansion And Construction Effects On Circummaxillary Sutures By 99mTc-MDP SPECT Bone Scintigraphy

Aim of this study is to analyse alternate rapid maxillary expansion and construction (Alt- RAMEC) on circummaxillary sutures by 99mTechnetium-Methylene Diphosphonate (99mTc-MDP) Single Photone Emission Computed Tomography (SPECT) Bone Scintigraphy. Material of the retrospective study consisted of SPECT bone scintigraphic records taken from 7 adolescent treated by Alt-RAMEC at the Department of Orthodontics, Ankara University. All patients had skeletal Class lll malocclusion associated with/without maxillary construction. Mean chronological age of those was 11,3±0,86 years. Growth period was defined from h andwristfilms. All patients had in pubertal growth period. McNamara type maxillary expansion appliance was used. Alt-RAMEC protocol was used for providing elevation in both midpalatal and circummaxillary sutures. Activations were 7 weeks of Alt-RAMEC, commencing with expansion in the first week, alternating to constriction in the second week, and ending with expansion in the seventh week. The daily expansion/ constriction of the Alt-RAMEC was 0,5 mm. Bone activity of maxilla and circummaxi llarysutures was evaluated by 99mTechnetium- Methylene Diphosphonate (99mTc-MDP) of skull. SPECT images were obtained in transaxialcoronal- sagittal planes. The SPECT bone scintigraphy records were obtained before Alt- RAMEC (T1), after edge to edge incisor relati ons (T2) and after six months later then T2 period (T3). Repeated measurements analysis of variance (ANOVA) was used assess the difference between the periods. While bone activity was significant in posterior part of midpalatal and zygomaticomaxillary sutures in right side, it was significant in zygomatico-maxillary and temporo- maxillary sutures in left side. In conclusion Alt-RAMEC is an effective maxillary expansion modality effecting on circummaxillary sutures in addition to midpalatal suture.