Effect of miniscrew-assisted maxillary protraction on width changes in the circummaxillary sutures

To evaluate changes in the width of five circummaxillary sutures after miniscrew-assisted maxillary protraction (MAMP) and to identify which of them are most significantly affected.

Cone-beam computed tomography (CBCT) performed before and after MAMP treatment was used to assess the sutural and cephalometric changes in growing patients with skeletal Class III malocclusion (n = 17). CBCT-generated lateral cephalograms were analyzed for skeletal and dental changes. Width changes in the five circummaxillary sutures (frontomaxillary, pterygomaxillary, zygomaticofrontal, zygomaticomaxillary, and zygomaticotemporal) were measured before and after MAMP. Suture widths were measured using ImageJ software on CBCT images. The pre- and post-MAMP mean values of the bilateral width changes were compared. The magnitude of the width changes of the five circummaxillary sutures were ranked to identify the most substantially altered sutures. Statistical significance was determined using the Friedman test.

In the CBCT-generated lateral cephalometric analysis, statistically significant increases were observed in SNA and ANB values, with the most pronounced results seen in overjet (P < 0.05). After MAMP, all five circummaxillary sutures demonstrated a statistically significant increase in width. The zygomaticofrontal, pterygomaxillary, and zygomaticotemporal sutures exhibited significant changes, with the zygomaticofrontal suture showing the greatest increase in width.

Among patients with Class III malocclusion treated with MAMP, the most pronounced width increase was observed in the zygomaticofrontal suture, whereas the frontomaxillary suture exhibited the least change.