Maxillary Forward Translation and Mandibular Immediate Shift Following 3D-Guided Midpalatal Piezocorticotomy Assisted MARPE in Adults: Lateral Cephalometric Pre- and Post-Treatment Study

Objectives: This study aimed to evaluate the forward translation of the maxillary base in adults undergoing 3D-guided midpalatal piezocorticotomy-assisted Miniscrew-Assisted Rapid Palatal Expansion (MARPE). Furthermore, the research investigated the contributing factors for forward maxillary movement and the subsequent immediate shift of the mandible. Methods: In this retrospective quasi-experimental study, cephalometric records of 80 adult patients (mean age 35.23 ± 8.76 years; 52 females, 28 males) were analyzed. Maxillary translation was assessed via SNA and A-Nperp(FH), while intermaxillary changes were measured using the ANB angle. Vertical and rotational changes were tracked through SN-MP, FH-MP, and various occlusal plane angles (OcP-FH, OcP-SN, OcP-GoMe). Facial height dimensions (TAFH, UAFH, LAFH, PFH) and dento-alveolar positions (U1-MP, U1LENGTH) were also recorded. Results: Following intervention, significant increases were observed in SNA (0.96°; 95% CI [0.48, 1.43]), ANB (1.42°; 95% CI [1.04, 1.80]), and A-Nperp(FH) (0.81 mm; 95% CI [0.24, 1.39]). The SN-GoMe angle increased by 0.98° and Posterior Facial Height (PFH) increased by 1.57 mm, while upper incisor length (U1LENGTH) significantly decreased by 0.71 mm. Conclusions: 3D-Guided midpalatal Piezocoroticotomy Assisted MARPE in adults is associated with the increase in SNA, ANB, SN-GoMe, Posterior Facial Height, A-Nperp(FH), and decrease in the maxillary incisor length. The amount of anterior midpalatal separation is not associated with the SNA increase while the latter is associated with the inclination of the maxillary plane (SN-MP).