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             The 'Maturational Patient Report' supplied by GrowthTek clearly
                assists and guides the clinician in formulating a well-timed treatment
                plan.  It is very important not to rely on chronologic age in
                determining whether maxillary expansion will benefit the patient.
                This is particularly true when both skeletal and dental expansion
                are the goals. 

                The mid-palatal suture is not completely fused until late adolescence.
                As a result, maturational age can be used as a means of judging the 
                effectiveness of the procedure on an individualized patient basis.

                The following charts illustrate the amount of mid-palatal suture
                ossification relative to the varying adolescent periods of development.
                When the mid-palatal suture is anatomically divided into anterior
                and posterior portions, the following is seen:
                    ~ the posterior portion of the suture fuses first
                    ~ the most ideal time for skeletal expansion of the palate is prior
                            to the maturational stage SMI 4 which is during a period
                            of very high growth velocity
                    ~ it is best to complete expansion prior to maturational stage 9
                            which is during a period of decelerating growth velocity
                    ~ when judged on a maturational age basis, no sex differences exist
                    ~ relative to maturational level, advanced, average and delayed
                            maturers do not demonstrate any differences in ossification








               How can orthodontic maxillary expansion be developmentally

        selected reference: Revelo B, Fishman LS  Maturational evaluation of ossification 
                                       of the midpalatal suture   AJODO, 1992

                Note: Please refer to the other questions in this 'Clinical Applications'
                              section of this web site for specific clinical information regarding
                              maturational timing of treatment.     Also refer to the 'Background
                              Information' section of this web site for additional information.

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