Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation.

The present study evaluated the skeletal alterations induced by rapid maxillary expansion procedures in 30 patients in the primary and mixed dentitions. The results were obtained with the use of lateral cephalometrics before and immediately after the active phase of expansion. The time span between these two cephalometric films ranged from 14 to 21 days; therefore the "growth factor" was not considered. Based on the differences in the cephalometric measurements studied on the first and second tracings, it seems that anterior displacement of the maxilla with significant changes in the SNA angle should not be expected, although point B was repositioned more posteriorly (SNB) because of the mandibular downward and backward rotation, with subsequent increase of the inclination of the mandibular plane. The alterations in the A-P position of the mandible was reflected in the increase of ANB and NAP angles. The maxilla always dislocates downward, displaying a downward and backward rotation in the palatine plane, significantly altering the following measurements: N-ANS, PNS-PNS', A-A', SN.PP. The anchoring molars also follow the downward maxillary displacement (M-M') and, as a direct consequence of the vertical displacement of the maxilla and upper molars (N-ANS, A-A', ANS-Me, N-Me, PNS-PNS'), the facial heights increase.