Transverse development of the human jaws between the ages of 8.5 and 15.5 years, studied longitudinally with use of implants

We report longitudinal data on the transverse widening of the maxilla and mandible from a sample of normal subjects (11 males and 20 females) with metallic implants of the Bjork type. Data were from measurements on lateral and frontal (posterior-anterior) cephalograms generated at annual intervals between the ages of 8.5 and 15.5 years (although data were not available for all subjects at all time points). The maxillary data were, in general, similar to those reported by Bjork and Skieller (1974, 1977) for a smaller sample of slightly younger boys. During the age interval studied, transverse widening was greater in the more posterior part of the palate. [The mean annual rate of change in the posterior-most (zygomatic) region was 0.43 mm, sd = 0.18 mm; p less than 0.001.] Although the rate of palatal widening was not large in absolute terms, widening appeared to continue throughout the age interval under study, and there was no evidence to support the conventionally accepted idea that palatal growth in the transverse dimension tapers off substantially or even ceases during the age interval under observation. Evidence of statistically significant widening of the mandibular arch by means of transverse rotation of the osseous matrix was noted in nine of the 29 subjects for whom three-dimensional mandibular information was available. For these nine subjects, the estimated annual increase in mandibular arch angle ranged from 0.52 degrees to 1.40 degrees. As far as we are aware, this is the first report of mandibular matrix rotation in the transverse direction from a sample of subjects with metallic implants. The finding that spontaneous changes in this dimension are relatively common raises the possibility that classical attitudes concerning the immutability of osseous relationships in the symphyseal region during growth may be inappropriate.