Maxillary and Mandibular Changes with 3D-Guided Midpalatal Piezocorticotomy - Assisted MARPE in Adults: A Retrospective Longitudinal Study

Maxillary and Mandibular Changes with 3D-Guided Midpalatal Piezocorticotomy - Assisted MARPE in Adults: A Retrospective Longitudinal Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Maxillary and Mandibular Changes with 3D-Guided Midpalatal Piezocorticotomy - Assisted MARPE in Adults: A Retrospective Longitudinal Study Svitlana Koval, Daria Chepanova, Nika Stepanoff, Andrii Babii This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-8824079/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction. Despite the increasing success rate of MARPE in different age groups, the concern still exists regarding potential downward rotation of the maxillary complex and increase in the middle and lower anterior facial heights due to midfacial expansion. 3D-guided midpalatal piezocorticotomy (3D-GMP) assisted MARPE is intended to increase the success rate of MARPE in adults and eliminate the age and sex parameters as limitations along with improving outcomes of MARPE alone. Methods. This retrospective longitudinal study evaluated pre- and post-expansion lateral cephalometric radiographs following midfacial expansion with 3D- GMP MARPE. Images were rendered from the CBCTs of 80 adult patients with mean age 35.23 ± 8.76 years (male n = 28, female n = 52). Fifteen lateral cephalometric measurements were compared. Measurements included maxillary forward displacement, mandibular rotation, inclination of the maxillary plane, occlusal plane rotation, and linear measurements of the facial heights. Maxillary incisor position was measured relative to the maxillary plane. Results. The angles SNA, ANB, and the linear measurement A-Nperp(FH) differed significantly between stages T0 and T1 indicating forward maxillary base movement following intervention. Multivariate linear regression analysis of the PPA value showed that the only predictor of the post-expansion PPA is the pre-expansion value of the same parameter, while sex, age, ANB, and the amount of midpalatal separation were not significantly associated with post-expansion inclination of the maxillary plane. Risk analysis demonstrated risk reduction of the downward maxillary rotation following the 3D- GMP MARPE. Conclusions. 3D- guided midpalatal piezocorticotomy assited MARPE may offer advantages in decreasing the risk of downward maxillary rotation along with maxillary protraction in adults. Forward maxillary movement was shown to be one of the consistent outcomes of 3D- GMP MARPE which is augmented with increased amount of midpalatal separation in adult patients. MARPE adults 3D- guided piezocorticotomy downward maxillary rotation mandibular rotation Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Introduction Various Mini screw Assisted Rapid Palatal Expansion (MARPE) designs have shown high success rates in both adolescents ( 1 ) and adult patients. ( 2 , 3 ). Both direct and indirect positioning of the tooth-bone-borne midpalatal expansion appliances showed predictable midpalatal suture separation. Classifications were suggested based on the expansion efficiency and separation patterns (parallel/V-shaped) with non-piezocorticotomy MARPE showing that age is a reliable predictor for both efficiency and pattern of expansion. ( 4 ) Historically, surgically assisted rapid palatal expansion (SARPE) has been considered a golden standard of skeletally achieved midpalatal separation in adults. Advanced expansion devices were described in conjunction with SARPE ( 5 ) showing higher levels of success and stability compared to conventional bonded hyrax expanders. Lately, several studies compared MARPE to SARPE in adult patients showing more parallel expansion patterns, higher levels of expansion in posterior palatal regions in MARPE patients ( 6 ). The superiority of combining hybrid hyrax with Herbst appliance over the use of combination of conventional hyrax with Herbst appliance was shown by Manni and coauthors ( 7 ) supported by Radescu ( 8 ) who showed that pharyngeal airway space was significantly increased with combination of maxillary expansion and mandibular advancement rather than mandibular advancement alone. These findings add evidence of the effects of maxillary expansion as an adjunct in comprehensive orthodontic treatment. Study by Ngan and Wilmes concluded less dento-alveolar effects of tooth-borne maxillary expander combined with the facemask over hybrid-hyrax combined with the facemask in growing subjects. ( 9 ) This study is supported by findings reported by Demirsoy and colleagues ( 10 ) who reported equally effective hybrid-MSE and bone-borne expanders in young adults for correcting skeletal crossbites. Sharma reported significantly greater increase in width measurements when comparing custom MARPE to conventional MARPE in young adult patients. ( 11 ) Several minimal surgically-assisted techniques were described over the past five years including midpalatal corticotomies ( 12 ) and the MISMARPE approach ( 13 ) as auxiliaries to conventional MARPE approach. The corticotomy has elevated the success rate of the assisted MARPE procedure in adults to 95%. The corticotomy-assisted MARPE expansion was shown to reduce intra-expansion pain levels compared to non-assisted MARPE. ( 12 ) 3D guided midpalatal piezocorticotomy (3D-GMP) assisted MARPE was introduced in 2025 after two years of clinical observations ( 14 ). The method is intended to increase the success rate of MARPE in adults and eliminate the age and sex parameters as limitations. Secondary outcomes of the 3D-GMP include achieving parallel and symmetrical separation of the midpalatal suture, preventing nasal septum from displacement in either direction while allowing for more predictable pterygomaxillary suture separation. Despite the increasing success rate of MARPE in different age groups, the concern still exists regarding potential downward rotation of the maxillary complex and increase in the middle and lower anterior facial heights due to midfacial expansion. While Rapid Palatal Expansion effects in growing individuals are well documented ( 15 , 16 ), there is still conflicting evidence regarding the effects of Midfacial expansion in non-growing patients. This study is aimed to evaluate the maxillary and mandibular positional changes following 3D-GMP assisted MARPE in adult patients on lateral cephalometric radiographs derived from the CBCT volumes collected before the intervention and immediately following the completion of midfacial expansion. The study is additionally intended to define if Skeletal Classification or pre-existing downward rotation are associated with maxillary downward rotation, increase in Total Anterior Facial Height (TAFH), Lower Anterior Facial Height (LAFH) and other vertical measurements. Materials and Methods Study design. Approval was obtained from the Solutions IRB, protocol 0846. This retrospective study included patients with nasal base and maxillary base transverse deficiency with or without the presence of crossbite who underwent 3D- guided midpalatal piezocorticotomy-assisted MARPE expansion using custom designed and printed 3D piezocorticotomy guide and custom MARPE appliance at the private practice in Boca Raton, Florida, USA. Inclusion and exclusion Criteria. Initially 89 patients were considered for the study, 9 patients were later excluded due to incomplete records. The inclusion criteria were adults 19 years old and older with no previous history of midpalatal expansion and orthognathic surgery, no systemic diseases, no craniofacial deformities, with high quality CBCT images taken in full intercuspation before treatment (T0) and immediately after completion of midfacial expansion stage (T1). The mean duration of T0-T1 period was 8 ± 1.4 weeks. All patients exhibited successful separation of the midpalatal suture, reaching the success rate of the expansion procedure of 100%. None of the patients was excluded due to unsuccessful separation. The final sample included 80 patients (mean age 35.23 ± 8.76 years; male n = 28, female n = 52). (Table 1 ). Intervention. The 3D midpalatal piezocorticotomy guide was designed using CBCT volumes obtained with Planmeca G7 Viso (FOV 16x16 cm, Planmeca, Helsinki, Finland) and intraoral scans (iTero, Align Technology, San Jose, California, USA) of the patients, superimposed, and digitally analyzed in NemoCast (Nemotec, Madrid, Spain). The 3D guides were digitally constructed of three parts: occlusal coverage of the maxillary digital model, palatal coverage of the maxillary digital casts, and connectors. (Fig. 1 ) The location of the notches used for further 3D- guided midplatal piezocorticitomy was determined by viewing the digital guided in axial plane. The landmarks for determining the location of the notches were the position of the maxillary crests, location of the nasal septum, position of the PNS point. The depth of the cuts was measured and marked on the surface of the guided at the level of each incision. The location of the incisive foramen was marked and bypassed. The position of the notches was always planned distal to the incisive foramen to avoid injury to the incisive nerve and concomitant blood vessels. (Fig. 2 ) The custom MARPE appliance contained 6 miniscrews (Biomaterials Korea, Seoul, South Korea) with the length ranging from 9 to 15 mm and diameter 1.8 mm (Fig. 3 ). The Powerscrew (TigerDental, Hörbranz, Austria.) was used for the expansion with the activation of 0.11 mm per turn. The activation protocol included a period of 7 days with 2 turns/day after the initial installation and piezocorticotomy to allow for sufficient soft tissue healing. Further activation were kept at 1 turn a day (0.11 mm) for both males and females after the midpalatal split was confirmed. Patients were seen every week for the duration of the expansion stage. The expansion was considered completed when the palatal cusps of the maxillary first molars contacted the buccal cusps of the mandibular first molars. The framework arms of the appliance were removed at the expansion completion appointment, the CBCT (FOV 16x16 cm, Planmeca, Helsinki, Finland) with Ultra Low Dose protocol (ULD), 100 kV, 6.3 msA, 30 mkmSv, 600 voxel size was taken to confirm the amount of expansion. Data analysis. The exported lateral cephalometric radiographs processed in Romexis (Planmeca, Helsinki, Finland) were further traced manually in WebCeph (Seongnam-si, South Korea) by the Principal Investigator (SK). The lateral cephalometric radiographs were retraced again in 2 weeks for the increase intra-examiner reliability. Fifteen measurements were identified for the purpose of this study. (Table 2 ). Primary outcomes. The primary outcomes included identification of the measurements that significantly changed following intervention. The main parameters of interest included maxillary forward position defined by SNA, A-Nperp(FH), and maxillary downward rotation (SN-MP, PPA). Secondary Outcomes. Secondary outcomes included identifying any changes to the mandibular rotation (SNGoMe), changes in facial height (TAFH, LAFH, UAFH, PFH), changes in occlusal plane rotation (OcPSN, OcPFH, OcPGoMe), and maxillary incisor length (U1LENGTH), and inclination (U1MP). Additionally, multivariate regression analysis was run to determine if any factors are associated with the downward rotation of the maxillary plane following intervention. n: The number of participants calculated for the study (sample size) C: Cohen` coefficient, ⍺: Level of significance β: Probability of a type II error. The optimal number of participants for the study was calculated as 80 subjects. Statistical Methods All statistical analyses were conducted in StataNow/SE 19.5 (Stata Corp, College Station, TX, USA). Descriptive statistics were used to summarize studied population. To test the data normality, Shapiro-Wilk test and Quantile-Quantile plots were used for every measured variable. Paired t-tests and two-sample t-test was used to identify differences between groups for all measured variables. To demonstrate statistical significance and P-value of < .05 was used. Table 1 Characteristics of the study participants. Gender Female Male Total N 52 (65.0%) 28 (35.0%) 80 (100.0%) Age 37.942 (7.714) 30.179 (8.446) 35.225 (8.757) ANTSEP 5.554 (1.338) 6.646 (1.953) 5.936 (1.654) MEDSEP 5.745 (1.377) 6.802 (1.825) 6.115 (1.619) POSTSEP 5.210 (1.338) 6.390 (1.857) 5.623 (1.629) MEANSEP 5.503 (1.276) 6.612 (1.833) 5.891 (1.575) ANB 4.071 (2.336) 3.121 (2.992) 3.739 (2.606) Table 2 Descriptions of the parameters measured in the study ANTERSEP Separation of the midpalatal suture at the level of ANS, mm MEDSEP Separation of the midpalatal suture at the middle third, mm POSTSEP Separation of the midpalatal suture at the level of PNS, mm FRNASSEP Fronto-nasal separation, mm SKCLASS Skeletal Class DOWNWROT Downward rotation of the maxillary plane before treatment, 0 = 11 degrees SNA SNA before treatment, degrees ANB ANB angle degrees A-Nperp(FH) Distance between point A to the perpendicular to FH constructed through point N, mm SN-MP SN-ANS-PNS angle before treatment, degrees FH- MP (PPA) Palatal Plane angle to FH, degrees SN-GoMe Angle between the SN and GoMe, degrees OcP-SN Angle between the SN plane and the Occlusal plane, degrees OcP-GoMe Angle between the GoMe plane and the Occlusal plane, degrees OcP-FH Angle between the FH plane and the Occlusal plane, degrees TAFH Total anterior facial height, mm PFH Posterior Facial Height mm LAFH Lower anterior facial height, mm UAFH Upper anterior facial height, mm U1MP Angle between the axis of the maxillary central incisor and ANS-PNS plane, degrees U1LENGTH Lenth of the maxillary central incisor to the ANS-PNS plane mm Results Participant characteristics. The total number of participants (80) comprised of 52 females (65%) and 28 males (35%) with the mean age of 37.94 ± 7.71 years and 30.18 ± 8.45 years, respectively. The average ANB angle before treatment in females was 4.07 ± 2.34 degrees in females and 3.12 ± 3.0 degrees in males. The average midpalatal separation measured as a mean of anterior, medial, and posterior separation, was 5.5 ± 1.28 mm in females and 6.61 ± 1.83 mm in males. (Fig. 4) Figure 4. Lateral cephalometric tracing and measurements used for pre- and posttreatment analysis 1- ANB, 2 -PPA, 3- PFH, 4- SNA, 5 – SNGoMe, 6- SN-ANSPNS, 7 -U1MP, 8 -OcPFH, 9 – OcPSN, 10 – OcPGoMe, 11 – A- Nperp(FH), 12- TAFH, 13- UAFH, 14- U1LENGTH, 15 – LAFH. Maxillary forward position and base rotation. The angles SNA, ANB, and the linear measurement A-Nperp(FH) differed significantly between stages T0 and T1 indicating forward maxillary base movement following intervention. Subgroup analysis in midpalatal separation (MEANSEP) percentile groups showed significant variation in A-Nperp(FH) parameter. Regression analysis for the A-Nperp(FH) demonstrated a progressive increase in forward movement corresponding to increased midpalatal separation. The coefficients were − 1.74 for the percentile group 1 (0–25%), + 1.46 (for group 2), + 0.22 (group 3), and + 1.97 (group 4). (Table 4 , 5 ). No statistically significant difference of the maxillary forward position measurements (SNA, ANB, A-Nperp(FH)) was found between Skeletal Class I and II subgroups. Additionally, maxillary downward rotation (SN-MP, PPA) showed no statistically significant difference at T0 and T1. There were also no significant differences between percentile groups (indicating no association with the amount of midpalatal separation (MEANSEP)), nor Skeletal Class I and II subgroups. Mandibular rotation. Mandibular rotation was measured with SNGoMe angle. It demonstrated significant increase between T0 and T1, but did not show any significance between percentile groups or between Skeletal Class I and II groups. Occlusal plane rotation. Occlusal plane rotation was measured with three angles (OcPSN, OcPFH, OcPGoMe). OcPFH showed significant increase between T0 and T1 in Skeletal Class II. No difference between percentile groups was found. Posterior Facial Height. Posterior Facial Height (PFH) showed significant reduction following intervention (T0-T1). No difference between percentile groups nor Skeletal Class subgroups was found. Total anterior facial height, upper and lower anterior facial height. All three anterior facial height measurements (TAFH, UAFH, LAFH) did not demonstrate significant difference with intervention (T0-T1). There was no significant difference found between percentile groups and Skeletal Class I and II subgroups. Maxillary incisor length and inclination. Maxillary incisor length (U1LENGTH) significantly decreased following procedure while inclination (U1MP) showed no significant difference between stages T0 and T1. Additionally, no difference was demonstrated between Skeletal Class I and II groups and percentile groups. Maxillary downward rotation risk assessment ( Table 8 ). Multivariate linear regression analysis of the PPA value showed that the only predictor of the post-expansion PPA is the pre-expansion value of the same parameter, while sex, age, ANB, and the amount of midpalatal separation were not significantly associated with post-expansion inclination of the maxillary plane. Risk analysis demonstrated risk reduction of the downward maxillary rotation following the 3D GMP MARPE. Pre- and post-expansion crude analysis is presented in Table 3 . Evaluation of the main parameters in subgroups based on the amount of midpalatal expansion is presented in Tables 4 , 5 . Table 3 Pre- and Post- expansion Comparison Measurements T0 T1 P-value Mean SD Min Max [95% conf.interv] Mean SD Min Max [95% conf.interv] SNA 80.82 3.94 69.9 88.7 79.94 81.70 81.66 4.08 72.7 90.1 80.75 82.56 0.003* ANB 3.74 2.60 -3.9 10 3.16 4.32 5.16 2.67 -1 11.7 4.56 4.56 < 0.000* A-N perp(FH) .03 3.97 − .85 .91 − .85 .91 .84 3.66 .03 1.66 .03 1.66 0.006* SN-MP 8.11 3.52 − .9 15.9 7.33 8.89 8.26 3.37 .6 15.3 7.51 9.01 0.64 FH-MP (PPA) -1.16 3.40 -9.4 9.2 -1.92 − .41 − .98 3.38 -8.5 6.9 -1.73 − .22 0.60 SNGoME 35.27 8.22 16.5 51.8 33.44 37.10 36.25 8.61 17.6 52.1 34.33 38.16 0.001* OcP-SN 17.89 6.13 .8 41.5 16.52 19.25 18.24 5.70 3.2 31.3 16.97 19.50 0.49 OcP -GoMe 17.38 6.57 -11.6 31.1 15.91 18.84 18.00 6.11 1.2 32.2 16.65 19.36 0.21 OcP-FH 8.63 5.38 -3.8 31.6 7.43 9.82 9.0 5.05 -1.5 22.8 7.87 10.12 .46 TAFH 117.47 9.09 77.5 140.3 115.45 119.49 116.08 11.70 79.8 135.2 113.47 118.68 .13 PFH 76.65 8.03 52.4 99 74.86 78.44 75.08 9.78 50.7 99.1 72.90 77.26 .014* LAFH 68.38 6.29 41.9 83.1 66.98 69.78 67.62 7.73 43.2 81.9 65.90 69.34 .23 UAFH 50.90 4.17 35.9 63.9 49.97 51.83 50.63 5.09 37.1 58.9 49.49 51.76 .51 U1MP 108.76 7.71 91.6 124.8 107.04 110.48 107.76 8.40 82.4 127.3 105.89 109.63 0.07 U1LENGTH 29.70 2.94 20.2 35.3 29.04 30.35 28.99 3.51 17.8 35.1 28.21 29.77 .03* * Statistically significant difference Table 4 Amount of Midpalatal Separation in Percentile Groups Percentile Groups Min Max Mean SD Count 1 3.3 4.8 4.10 .55 20 2 4.81 5.7 5.22 .27 21 3 5.71 6.81 6.26 .32 19 4 6.81 10.17 5.89 1.58 20 Total 80 Table 5 Inter percentile group analysis for different variables Variable Group 1 Group 2 Group 3 Group 4 ANOVA Bartlett`s Test Kruskal-Wallis test Mean SD Mean SD Mean SD Mean SD SNA -1.33 2.05 -1.06 2.17 − .99 1.80 .04 3.48 n/a .02 .66 ANB -1.63 1.84 -1.29 1.84 -1.54 1.68 -1.24 1.49 .86 .78 n/a A-N perp(FH) -1.74 2.53 − .28 1.83 -1.52 2.97 .23 2.54 n/a .02 .04* SN-MP -1.07 2.17 .32 2.11 .88 2.69 − .72 4.11 n/a .01 .22 FH-MP (PPA) − .71 3.53 − .43 2.75 1.35 2.86 − .86 3.12 .10 .70 n/a SNGoME -1.21 1.54 − .80 2.10 − .93 1.83 − .98 4.01 n/a < .000 .73 OcP-SN .11 4.15 − .38 2.16 − .18 7.28 − .93 3.84 n/a < .000 .52 OcP -GoMe -1.32 4.41 − .45 2.68 − .75 6.54 − .02 3.99 n/a < .002 .69 OcP-FH .48 4.25 -1.11 2.78 .3 6.85 -1.08 3.36 n/a < .000 .63 TAFH .25 3.76 − .82 3.85 1.87 8.92 4.41 12.54 n/a < .000 .87 PFH 1.21 2.37 .22 3.31 1.76 6.11 3.16 8.55 n/a < .000 .68 LAFH .50 3.34 − .71 2.60 .27 6.51 3.04 8.39 n/a < .000 .41 UAFH − .48 2.53 − .67 2.68 1.32 3.88 1.03 5.08 n/a < .006 .43 U1MP − .35 4.42 2.04 4.66 2.89 3.81 − .54 5.92 .06 .29 n/a U1LENGTH .89 1.71 .06 1.67 − .20 3.40 2.05 3.98 n/a < .000 .09 *Statistically significant difference. The Regression analysis for four percentile groups for the Difference in A-N distance measured along FH (Fig. 5 ): DIFFANFH= -1.74 + 1.46 (Group2) + 0.22 (Group3) + 1.97 (Group4) DIFFANFH – change in score (predicted outcome) -1.74 – the constant defined by the baseline change in Group 1 + 1.46, + 0.22, + 1.97 – coefficients showing how much higher Groups 2,3, and 4 are compared to Group 1 Subgroup analysis based on skeletal classification is presented in Tables 6 and 7 . Table 6 Skeletal Class I and Class II Subgroups Characteristics before Treatment Skeletal Class I II Total N 38 (50.7%) 37 (49.3%) 75 (100.0%) MEANSEP 5.844 (1.682) 5.875 (1.462) 5.859 (1.567) ANB 2.284 (1.081) 5.965 (1.428) 4.100 (2.238) TAFH 118.400 (10.975) 116.892 (6.788) 117.656 (9.122) PPA -1.153 (3.655) -0.997 (3.150) -1.076 (3.393) PFH 76.992 (8.728) 75.727 (7.451) 76.368 (8.093) SNA 79.876 (3.911) 81.722 (3.842) 80.787 (3.961) SNGoMe 35.253 (8.179) 36.389 (7.848) 35.813 (7.984) SN-MP 8.366 (3.439) 8.014 (3.735) 8.192 (3.568) U1-MP 110.011 (6.069) 106.273 (8.397) 108.167 (7.501) OcP-SN 17.668 (4.638) 19.051 (6.951) 18.351 (5.895) OcP-GoMe 17.576 (5.889) 17.332 (7.509) 17.456 (6.692) OcP_FH 8.161 (4.261) 10.043 (5.783) 9.089 (5.123) ANperpFH -0.726 (3.652) 0.749 (3.908) 0.001 (3.827) LAFH 68.424 (7.594) 68.630 (4.652) 68.525 (6.275) UAFH 51.318 (4.545) 50.722 (3.957) 51.024 (4.247) U1-length 29.521 (3.128) 30.127 (2.638) 29.820 (2.893) Table 7 Skeletal Class I and II Subgroup Comparative Analysis Variable I II Intergroup P value T0 T1 P value T0 T1 P value Mean SD Mean SD Mean SD Mean SD SNA 79.88 3.91 81.00 4.03 .004 81.72 3.84 81.98 4.00 .16 .13 ANB 2.28 1.08 3.93 2.01 .0052* 5.96 1.43 6.95 1.99 .16 .08 A-N perp(FH) − .73 3.65 − .084 3.39 .15 .75 3.91 1.62 3.21 .027* .07 SN-MP 8.37 3.44 8.33 2.87 .92 8.01 3.73 8.77 3.59 .12 .22 FH-MP (PPA) -1.15 3.66 − .70 3.48 .36 − .10 3.15 − .83 3.20 .74 .687 SNGoME 35.25 8.18 36.03 8.28 .01* 36.39 7.85 37.68 8.49 .004* .69 OcP-SN 17.67 4.64 18.53 4.98 .025* 19.05 6.95 18.78 6.00 .45 .29 OcP -GoMe 17.58 5.89 17.49 5.62 .50 17.33 7.51 18.89 6.55 .19 .12 OcP-FH 8.16 4.26 9.49 4.96 .016* 10.04 5.78 9.19 4.95 .98 .04* TAFH 118.4 10.97 118.23 11.44 .096 116.89 6.79 114.53 10.91 .35 .23 PFH 76.99 8.73 76.64 9.29 .36 75.73 7.45 72.98 9.77 .001* .052 LAFH 68.42 7.59 68.67 7.94 .10 68.63 4.65 66.97 6.65 .32 .13 UAFH 51.32 4.54 51.37 4.56 .319 50.72 3.96 50.25 5.48 .86 .53 U1MP 110.01 6.07 109.62 7.79 .616 106.27 8.40 105.19 8.55 .17 .53 U1LENGTH 29.52 3.13 29.04 3.36 .50 30.13 2.64 29.16 3.22 .18 .47 *Statistically significant difference Table 8 Risk Assessment for the Downward Maxillary Plane Rotation in Subjects with and without downward rotation before treatment Risk in Group with Initial Rotation Risk in Group without Initial Rotation Total 0.53 0.11 0.19 95% CI Risk Difference .43 .16 .69 Risk Ratio 5.0 2.18 11.53 P<.001 Multivariable linear regression analysis for the downward maxillary plane analysis: PPAA= -1.91 + 0.576(PPAB) − 1.64(SEX) − 0.05(AGE) − 0.08(MEANSEP) + 0.05(SNAB) − 0.004(ANBB ), where SEX, AGE, MEANSEP, SNA, ANB were not statistically significant, PPAA – is PPA after intervention, PPAB – is PPA before intervention, -1.91 =ß 0, -1.64 = ß 1, -0.05 = ß 2 , -0.08 = ß 3 , + 0.05 = ß 4, -0.004= ß 5 . Thus, simplified, the regression analysis of the predicted PPA after intervention is dependent on the value of PPA before the intervention and not significantly associated with sex, age, amount of midpalatal septation, amount of posterior midpalatal separation, pre-treatment SNA and ANB: PPAA= -1.91 + 0.576(PPAB)- 1.64 (SEX) If SEX equals 1 (male), the outcome is decreased by the ß of SEX. For example: PPAA= -1.91 + 0.576 (0.6) – 1.64 (0) = -1.91 + 0.346–0 = -1.56 : In a female with the pre-treatment PPA = 0.6 degrees the post-treatment PPA is predicted to be -1.56 which indicated counter-clockwise rotation. This model describes 37.7% variation in PPA after the procedure. Discussion The objective of this study was to evaluate the effects of 3D guided midpalatal piezocorticotomy-assisted MARPE in adults. The mechanisms of maxillary, mandibular base, and occlusal plane responses differ between various maxillary expansion techniques. The latter are widely described in the literature and include Rapid Palatal Expansion (RPE), Surgically-Assisted Rapid Palatal Expansion (SARPE), and Miniscrew-Assisted Rapid Palatal Expansion (MARPE). Some studies involving RPE in mixed dentition reported both forward maxillary displacement and downward maxillary base rotation ( 17 , 18 ), others report significant anterior facial height increase along with maxillary downward rotation ( 19 , 20 ). Similarly, Chung ( 16 ) described significant downward maxillary rotation with the increase in the anterior face height following RPE is adolescents. Mandibular backward rotation along with occlusal plane rotation was described by Da Costa Silva in mixed dentition patients treated with RPE. ( 21 ) SARPE treatment routinely involved the use of fixed hyrax-type expanders. Studies analyzed in a systematic review and meta-analysis published by Lin and coauthors ( 22 ) demonstrated similar forward maxillary translation and downward maxillary plane rotation when measured with SN-MP angle. Study by Oliveira ( 23 ) supported backward mandibular rotation and transient lateral mandibular displacement following maxillary expansion with SARPE. On the opposite side, maxillary rotation following SARPE was described by Farfel ( 24 ) who did not report any rotation of the ANS-PNS plane. Parhiz ( 5 ) suggested predictive parameters that were associated with the downward rotation of the maxillary plane following SARPE. Those parameters included pre-existing downward rotation of the maxillary plane (measured as SN-ANS-PNS angle), gender, and age. These were shown to define 75% of the post-treatment downward rotation of the maxillary plane. Most studies on SARPE report downward rotation of the maxillary plane similar to studies on RPE. RPE was also reported to produce more dento-alveolar effects associated with molar mesial movement, molar extrusion, maxillary incisor proclination and others ( 9 ). These effects could be contributing to the maxillary downward rotation with both treatment modalities. Our study of 3D- GMP MARPE supports earlier studies on MARPE in adolescents and young adults which showed no downward rotation of the maxillary plane ( 25 , 26 ). In the current study, when measured with SN-MP and PPA angles, no statistically significant difference was found between pre- and post-treatment measurements. Moreover, no difference was found between Skeletal Classes I and II, which was not evaluated earlier. In our study, patients with downward rotation before treatment were evaluated to determine the risk of development downward rotation following intervention. Our results indicate that even though there is a low risk to develop downward rotation in subjects who did not exhibit this characteristic before treatment, there is only 53% risk of maintaining downward rotation after intervention in those who entered the treatment with pre-existing downward rotation. This data indicates a possibility of counterclockwise rotation of the maxillary plane. This tendency was described using 3D cephalometric evaluation by Koval and co-authors ( 27 ) in a case report showing uneven rotation of the maxillary plane around the center of resistance with relatively equal upward displacement of ANS and downward displacement of PNS. Empson and colleagues ( 28 ) compared MARPE and RPE treatment. MARPE intervention led to backward mandibular rotation, while RPE intervention was associated with the significant downward displacement of point A, which was not observed with MARPE. Our data supports backward mandibular rotation measured with SNGoMe angle. Mandibular backward rotation following intervention was supported by the significant increase in occlusal plane rotation measured with OcPGoMe angle but not with OcPFH nor OcPSN angles. Occlusal plane inclination shows similar pattern with all expansion techniques (RPE, SARPE, MARPE) and are possibly linked to maxillary molar tipping and cusp inclination. When MARPE was combined with the facemask or similar protraction device and compared with combination of RPE and facemask (FM) ( 29 ), significant maxillary incisor inclination with mandibular plane rotation was demonstrated in RPE + FM group. Both groups equally significantly showed forward maxillary displacement with increase in SNA. Skeletal Class III patients treatment with combination of MARPE and FM was reported by Cho and coauthors ( 30 ) who concluded significant increase in SNA and ANB, no changes in mandibular plane angle, no changes in SNB. Authors did not evaluate the maxillary plane and occlusal plane inclinations. Qi and colleagues ( 31 ) evaluated the internal Temporo-mandibular Joint (TMJ) spaces in comparison with the maxillary base and upper molar height changes. Their results indicated that immediately after MARPE-induced expansion, superior and posterior condylar spaces increased. Both changes weakly correlated with the increase in the maxillary molar palatal cusp height and maxillary base increase. Our data of 80 patients treated with 3D-GMP MARPE provides evidence of significant forward movement of maxillary base when measured with SNA, ANB, and A-Nperp(FH). The latter was shown to progress with the increase in the amount of midpalatal separation. Possible explanation of these findings is that the amount of midfacial expansion with 3D- GMP MARPE releases pterygomaxillary sutures allowing for the forward maxillary movement. Pterygomaxillary suture separation with MARPE expansion was earlier reported by Colak and Cantarella ( 32 , 33 ). 3D-GMP as an auxiliary procedure combined with MARPE increased success rate of MARPE expansion to 100% compared to 84% reported by Shin and colleagues ( 34 ) who studied the predictability of midpalatal suture separation was evaluated with regression analysis. Authors showed that age, palate length, and midpalatal suture maturation stage were predictors for successful midpalatal separation in young adult patients. The 3D-GMP -Assisted MARPE is reported to eliminate remaining limitations to predictable midfacial separation in adult patients. Our data did not report any significant maxillary plane changes. This can be explained in several ways. First of all, all studies involving custom MARPE appliances featured hybrid design with different framework design but mutual feature of bone-borne middle part. The existing framework design attached to the rigidly anchored middle part resulted in no-to-minimal mesial dental migration while allowing for some lateral tipping. SARPE involves some variation of hyrax-type fixed expander with or without pre-surgical activation, which guides further maxillary plane to follow dento-alveolar relationship while in active expansion process. All three treatment modalities involve significant backward mandibular rotation that was shown to be transient when compared to post-expansion orthodontic finishing. This is possibly explained by dento-alveolar and dental movements that guide forward mandibular displacement after expansion. The limitations of the current study include lack of the comparison group with no auxiliary procedure when combined with MARPE and the lack of long-term data reported. Further studies are needed to compare long-term stability of the 3D- GMP MARPE. Conclusions 3D- guided midpalatal piezocorticotomy assisted MARPE may offer advantages in decreasing the risk of downward maxillary rotation along with maxillary protraction in adults. Forward maxillary movement was shown to be one of the consistent outcomes of 3D- GMP MARPE which is augmented with increased amount of midpalatal separation in adult patients. Long-term research is needed to evaluate the effects of different designs of MARPE appliances in conjunction with 3D GMP MARPE along with the stability of the outcomes. Abbreviations MARPE Miniscrew-Assisted Rapid Palatal Expansion SARPE Surgically Assisted Rapid Palatal Expansion RPE Rapid Palatal Expander 3D-GMP 3-Dimensional Guided Midpalatal Piezocorticotomy Declarations Author contributions SK contributed to conceptualization, manuscript text, editing, supervision of the project; DC contributed to preparing Fig.1-4, Tables 1-8, editing and reviewing; NS contributed to manuscript writing and editing; AB contributed to data analysis, editing, and writing. Funding Not applicable. Data availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. Ethics approval and consent to participate The study protocol was reviewed and approved by Solutions Institutional Review Board (Solutions IRB) (Approval No. 0846). Written informed consent was obtained from all participants. Consent for publication Written informed consent for publication of anonymized data was obtained from all participants prior to enrollment. Declaration of competing interest One author (SK) declares a pending patent: US and Canada Patent Pending: Piezocorticotomy guide for midpalatal skeletal expansion (Application # 18/919,416). References Chun JH, de Castro ACR, Oh S, Kim KH, Choi SH, Nojima LI, et al. Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT. BMC Oral Health. 2022;22(1):114. Thi Hong Thuy P, Viet H, Thu Trang P, Phuong Linh D, Viet Anh N. Midpalatal suture bone regeneration following customized miniscrew-assisted rapid palatal expansion in nongrowing patients: A retrospective observational study. Med (Baltim). 2025;104(41):e44624. Akyalcin S, Alev Y. Clinical advances in maxillary skeletal expansion and introduction of a new MARPE concept. J Esthet Restor Dent Off Publ Am Acad Esthet Dent Al. 2023;35(1):291–8. Song GH, Lee SM, Chung DH, Lee JW, Park JH. Expansion Pattern of Miniscrew Assisted Rapid Maxillary Expansion (MARPE) After Midpalatal Suture Separation: Clustering-Based Classification. Orthod Craniofac Res. 2025;28(6):1070–81. Parhiz A, Schepers S, Lambrichts I, Vrielinck L, Sun Y, Politis C. Lateral cephalometry changes after SARPE. Int J Oral Maxillofac Surg. 2011;40(7):662–71. de Oliveira CB, Ayub P, Ledra IM, Murata WH, Suzuki SS, Ravelli DB, et al. Microimplant assisted rapid palatal expansion vs surgically assisted rapid palatal expansion for maxillary transverse discrepancy treatment. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 2021;159(6):733–42. Manni A, Pasini M, Giuca MR, Morganti R, Cozzani M. A retrospective cephalometric study on pharyngeal airway space changes after rapid palatal expansion and Herbst appliance with or without skeletal anchorage. Prog Orthod. 2016;17(1):29. Rădescu OD, Colosi HA, Albu S. Effects of rapid palatal expansion (RPE) and twin block mandibular advancement device (MAD) on pharyngeal structures in Class II pediatric patients from Cluj-Napoca, Romania. Cranio J Craniomandib Pract. 2020;38(1):22–9. Ngan P, Wilmes B, Drescher D, Martin C, Weaver B, Gunel E. Comparison of two maxillary protraction protocols: tooth-borne versus bone-anchored protraction facemask treatment. Prog Orthod. 2015;16:26. Demirsoy KK, Buyuk SK, Alev Y, Bicer T, Abay F. Comparative Evaluation of Skeletal, Dentoalveolar, and Airway Effects of Bone-Borne and Hybrid Expanders in Young Adults. Orthod Craniofac Res. 2025. Sharma Y, Suh H, Bianchi J, Yoon A, Oh H. Treatment outcomes of 3D-printed custom and conventional mini-implant assisted rapid palatal expanders (MARPE). Prog Orthod. 2025;26(1):30. Elshehaby M, Albelasy NF, Elbialy MA, Hafez AM, Abdelnaby YL. Evaluation of pain intensity and airway changes in non-growing patients treated by MARPE with and without micro-osteoperforation: a randomized clinical trial. BMC Oral Health. 2024;24(1):1411. Haas Júnior OL, Matje PRB, da Rosa BM, Piccoli VD, Rizzatto SMD, de Oliveira RB et al. MISMARPE protocol: minimally invasive surgical and miniscrew-assisted rapid palatal expansion. Dent Press J Orthod. 2024;29(3): e24spe3 Koval S, Kolesnyk V, Chepanova D. Applications of the Novel Midpalatal Piezocorticotomy Guide for MARPE Midfacial Skeletal Expansion. J Clin Med. 2025;14(13):4728. Cerruto C, Ugolini A, Di Vece L, Doldo T, Caprioglio A, Silvestrini-Biavati A. Cephalometric and dental arch changes to Haas-type rapid maxillary expander anchored to deciduous vs permanent molars: a multicenter, randomized controlled trial. J Orofac Orthop Fortschr Kieferorthop OrganOfficial J Dtsch Ges Kieferorthop. 2017;78(5):385–93. Chung CH, Font B. Skeletal and dental changes in the sagittal, vertical, and transverse dimensions after rapid palatal expansion. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 2004;126(5):569–75. Habeeb M, Boucher N, Chung CH. Effects of rapid palatal expansion on the sagittal and vertical dimensions of the maxilla: a study on cephalograms derived from cone-beam computed tomography. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 2013;144(3):398–403. Cozza P, Giancotti A, Petrosino A. Rapid palatal expansion in mixed dentition using a modified expander: a cephalometric investigation. J Orthod. 2001;28(2):129–34. da Silva Filho OG, Montes LA, Torelly LF. Rapid maxillary expansion in the deciduous and mixed dentition evaluated through posteroanterior cephalometric analysis. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 1995;107(3):268–75. Du H, Zeng X. long. [Three-dimensional changes of maxilla after rapid maxillary expansion]. Zhonghua Kou Qiang Yi Xue Za Zhi Zhonghua Kouqiang Yixue Zazhi Chin J Stomatol. 2006;41(3):168–71. da Silva Filho OG, Boas MC, Capelozza Filho L. Rapid maxillary expansion in the primary and mixed dentitions: a cephalometric evaluation. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 1991;100(2):171–9. Lin JH, Wang S, Abdullah UA, Le AD, Chung CH, Li C. Sagittal and Vertical Changes of the Maxilla after Surgically Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(10):3488. Oliveira TFM, Pereira-Filho VA, Gabrielli MFR, Gonçales ES, Santos-Pinto A. Effects of surgically assisted rapid maxillary expansion on mandibular position: a three-dimensional study. Prog Orthod. 2017;18(1):22. Farfel V, Morea GC, Ferreira LM, Pereira MD. Evaluation of Sagittal and Vertical Changes in Maxillary Dental, Skeletal, and Soft Tissue Following Surgically Assisted Rapid Maxillary Expansion: A Retrospective Longitudinal Study. J Craniofac Surg. 2022;33(4):e398–401. Thi Hong Thuy P, Thu Trang P, Thi Thu Hang P, Viet H. Clinical and cone-beam computed tomography outcomes of miniscrew-assisted rapid palatal expansion in the treatment of maxillary transverse deficiency: A prospective study. Med (Baltim). 2025;104(38):e44684. Xue H, Qi Y, Ni X, Feng Y, Lin J. Efficiency of Cone-Beam Computed Tomography-Based Personalized Microimplant-Assisted Rapid Palatal Expansion in Patients With Maxillary Transverse Deficiency and Thin Palatal Bone. Int Dent J. 2026;76(1):109307. Koval S, Kolesnyk V, Chepanova D. Immediate 3D Skull Changes Following 3D-Guided Midpalatal Piezocorticotomy-Assisted MARPE: Case Report. Dent J. 2026;14(1):24. Empson I, Del Santo M, Kuo CL, Vich ML, Liu D, Yadav S, et al. Short- and long-term effects of conventional and miniscrew-assisted rapid palatal expansion on hard tissues using voxel-based superimposition of serial cone-beam computed tomography scans. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 2024;166(5):445–e4572. Park HJ, Yu HS, Kim SH, Ahn HW, Kang YG, Park JJ. Comparison of treatment effects with or without miniscrews for maxillary protraction in growing patients with Class III malocclusion. Am J Orthod Dentofac Orthop Off Publ Am Assoc Orthod Its Const Soc Am Board Orthod. 2025;168(3):327–38. Cho MH, Choi YK, Kim SH, Kim SS, Park HR, Kim YI. Effect of miniscrew-assisted maxillary protraction on width changes in the circummaxillary sutures. Angle Orthod. 2025;95(3):283–9. Qi Y, Ding L, Xue L, Xu S, Lin J. Analysis of changes and correlation in condyle-fossa relationship after maxillary skeletal expansion. Orthod Craniofac Res. 2024;27(5):681–9. Cantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod. 2017;18(1):34. Colak O, Paredes NA, Elkenawy I, Torres M, Bui J, Jahangiri S, et al. Tomographic assessment of palatal suture opening pattern and pterygopalatine suture disarticulation in the axial plane after midfacial skeletal expansion. Prog Orthod. 2020;21(1):21. Shin H, Hwang CJ, Lee KJ, Choi YJ, Han SS, Yu HS. Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: A preliminary study. Korean J Orthod. 2019;49(6):360–71. Additional Declarations Competing interest reported. One author (SK) declares a pending patent: US and Canada Patent Pending: Piezocorticotomy guide for midpalatal skeletal expansion (Application # 18/919,416). 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8824079","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":588070246,"identity":"3a421e9a-d5a2-42a2-9174-c7f9fce66bcd","order_by":0,"name":"Svitlana Koval","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAzklEQVRIie3PMQqDMBSA4YSCLqFzpEiuYBG61NKrRAR7hYwR4U2Cq8ewN1BC6yJ0dWzoBTxC09Kli9qtQ74h8OD9kIeQZf0pLM2zdjOJ7p9hWeKQViL+W0LN/qKEVUmDK6GY4z2ykQvlS1dd6qkkGFKO615tYRPnlPcqlCRNh8mE9AHWkGKTAIpBxZKS3WTCitv4So7gtQsT1BUInyGKgeKFSdBB0FZ9lAB533IKYe4Wlq+0LgQ9lG6nx1Hs/dJV1+mPGc3X5MytW5ZlWfOeHslNSST7aOMAAAAASUVORK5CYII=","orcid":"","institution":"DrKoval Orthodontics","correspondingAuthor":true,"prefix":"","firstName":"Svitlana","middleName":"","lastName":"Koval","suffix":""},{"id":588070247,"identity":"2f64ea54-e60d-4f11-b13d-4198785abace","order_by":1,"name":"Daria Chepanova","email":"","orcid":"","institution":"DrKoval Orthodontics","correspondingAuthor":false,"prefix":"","firstName":"Daria","middleName":"","lastName":"Chepanova","suffix":""},{"id":588070248,"identity":"6cebb1d9-4203-476c-bcc7-60c12da468f7","order_by":2,"name":"Nika Stepanoff","email":"","orcid":"","institution":"DrKoval Orthodontics","correspondingAuthor":false,"prefix":"","firstName":"Nika","middleName":"","lastName":"Stepanoff","suffix":""},{"id":588070249,"identity":"88b6670d-420a-4292-8e1c-0655b74bc3f5","order_by":3,"name":"Andrii Babii","email":"","orcid":"","institution":"Nova Southeastern University","correspondingAuthor":false,"prefix":"","firstName":"Andrii","middleName":"","lastName":"Babii","suffix":""}],"badges":[],"createdAt":"2026-02-08 20:38:20","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8824079/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8824079/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":102311205,"identity":"62c739da-63cd-4722-90ef-34536e8b8022","added_by":"auto","created_at":"2026-02-10 11:57:13","extension":"jpeg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":110145,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eSchematic image of the 3D- printed midpalatal piezocorticotomy guide\u003c/strong\u003e: 1- incisive foramen, 2 – incision notch for the midpalatal piezocorticotomy, 3 – guide base covering the hard palate, 4 – location of the transverse palatal suture, 5 – 3D printed guide connector, 6 – 3D printed guide occlusal splint covering occlusal surfaces of the maxillary teeth.\u003c/p\u003e","description":"","filename":"floatimage1.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/0e32506c89b36f126f8bf23c.jpeg"},{"id":102311291,"identity":"501380c3-4ab3-4e21-a7b5-0e38ad982b62","added_by":"auto","created_at":"2026-02-10 11:57:40","extension":"jpeg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":152696,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCBCT slices (A- sagittal, B- coronal) with the 3D designed midpalatal piezocorticotomy guide: \u003c/strong\u003e1 – location of the hard palate, 2 – cross-sectional view of the guide base covering the hard palate, 3 – location of the incision notches within the base of the 3D designed guide, 4 – designed occlusal coverage of the guide, 5 – coronal view of the guide base, 6 – nasal septum.\u003c/p\u003e","description":"","filename":"floatimage2.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/9366d2c752aedc39c20b25ef.jpeg"},{"id":102311721,"identity":"cfd0dae5-a7c0-48c2-ac09-daebeb221863","added_by":"auto","created_at":"2026-02-10 11:58:44","extension":"jpeg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":226327,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eOcclusal view of the custom designed MARPE following 3D guided midpalatal piezocorticotomy: \u003c/strong\u003e1 – diastema following expansion, 2 – flowable composite covered miniscrew heads, 3 – expansion screw, 4 – healing piezocrticotomy incision, 5 – custom designed and milled MARPE framework.\u003c/p\u003e","description":"","filename":"floatimage3.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/217aa6aa093f443738940ba5.jpeg"},{"id":102311962,"identity":"80f8ae4a-824d-42b9-93a4-cccd9f64bf88","added_by":"auto","created_at":"2026-02-10 11:59:31","extension":"jpeg","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":103630,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eLateral cephalometric tracing and measurements used for pre- and posttreatment analysis: \u003c/strong\u003e1- ANB, 2 -PPA, 3- PFH, 4- SNA, 5 – SNGoMe, 6- SN-ANSPNS, 7 -U1MP, 8 -OcPFH, 9 – OcPSN, 10 – OcPGoMe, 11 – A- Nperp(FH), 12- TAFH, 13- UAFH, 14- U1LENGTH, 15 – LAFH.\u003c/p\u003e","description":"","filename":"floatimage5.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/65215f2742816295ab3cddc4.jpeg"},{"id":102311717,"identity":"932ee8b6-58ac-42d8-bf5b-67e0f6746e63","added_by":"auto","created_at":"2026-02-10 11:58:42","extension":"jpeg","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":59962,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eAdjusted predictions of A-Nperp(FH) change in Percentile Groups.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"floatimage6.jpeg","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/ba3d01d38c3747fc1ea9dbf8.jpeg"},{"id":105103182,"identity":"e3537bd6-5f54-4fbc-995d-88a0beb879fc","added_by":"auto","created_at":"2026-03-21 07:55:50","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":2250840,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8824079/v1/dbf1d370-6bc9-49bd-bdcb-a5664c40acbb.pdf"}],"financialInterests":"Competing interest reported. One author (SK) declares a pending patent: US and Canada Patent Pending: Piezocorticotomy guide for midpalatal skeletal expansion (Application # 18/919,416).","formattedTitle":"Maxillary and Mandibular Changes with 3D-Guided Midpalatal Piezocorticotomy - Assisted MARPE in Adults: A Retrospective Longitudinal Study","fulltext":[{"header":"Introduction","content":"\u003cp\u003eVarious Mini screw Assisted Rapid Palatal Expansion (MARPE) designs have shown high success rates in both adolescents (\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e) and adult patients. (\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e). Both direct and indirect positioning of the tooth-bone-borne midpalatal expansion appliances showed predictable midpalatal suture separation. Classifications were suggested based on the expansion efficiency and separation patterns (parallel/V-shaped) with non-piezocorticotomy MARPE showing that age is a reliable predictor for both efficiency and pattern of expansion. (\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e) Historically, surgically assisted rapid palatal expansion (SARPE) has been considered a golden standard of skeletally achieved midpalatal separation in adults. Advanced expansion devices were described in conjunction with SARPE (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) showing higher levels of success and stability compared to conventional bonded hyrax expanders. Lately, several studies compared MARPE to SARPE in adult patients showing more parallel expansion patterns, higher levels of expansion in posterior palatal regions in MARPE patients (\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe superiority of combining hybrid hyrax with Herbst appliance over the use of combination of conventional hyrax with Herbst appliance was shown by Manni and coauthors (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e) supported by Radescu (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e) who showed that pharyngeal airway space was significantly increased with combination of maxillary expansion and mandibular advancement rather than mandibular advancement alone. These findings add evidence of the effects of maxillary expansion as an adjunct in comprehensive orthodontic treatment.\u003c/p\u003e \u003cp\u003eStudy by Ngan and Wilmes concluded less dento-alveolar effects of tooth-borne maxillary expander combined with the facemask over hybrid-hyrax combined with the facemask in growing subjects. (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e) This study is supported by findings reported by Demirsoy and colleagues (\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e) who reported equally effective hybrid-MSE and bone-borne expanders in young adults for correcting skeletal crossbites.\u003c/p\u003e \u003cp\u003eSharma reported significantly greater increase in width measurements when comparing custom MARPE to conventional MARPE in young adult patients. (\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e) Several minimal surgically-assisted techniques were described over the past five years including midpalatal corticotomies (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e) and the MISMARPE approach (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e) as auxiliaries to conventional MARPE approach. The corticotomy has elevated the success rate of the assisted MARPE procedure in adults to 95%. The corticotomy-assisted MARPE expansion was shown to reduce intra-expansion pain levels compared to non-assisted MARPE. (\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e3D guided midpalatal piezocorticotomy (3D-GMP) assisted MARPE was introduced in 2025 after two years of clinical observations (\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e). The method is intended to increase the success rate of MARPE in adults and eliminate the age and sex parameters as limitations. Secondary outcomes of the 3D-GMP include achieving parallel and symmetrical separation of the midpalatal suture, preventing nasal septum from displacement in either direction while allowing for more predictable pterygomaxillary suture separation.\u003c/p\u003e \u003cp\u003eDespite the increasing success rate of MARPE in different age groups, the concern still exists regarding potential downward rotation of the maxillary complex and increase in the middle and lower anterior facial heights due to midfacial expansion. While Rapid Palatal Expansion effects in growing individuals are well documented (\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e, \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e), there is still conflicting evidence regarding the effects of Midfacial expansion in non-growing patients. This study is aimed to evaluate the maxillary and mandibular positional changes following 3D-GMP assisted MARPE in adult patients on lateral cephalometric radiographs derived from the CBCT volumes collected before the intervention and immediately following the completion of midfacial expansion. The study is additionally intended to define if Skeletal Classification or pre-existing downward rotation are associated with maxillary downward rotation, increase in Total Anterior Facial Height (TAFH), Lower Anterior Facial Height (LAFH) and other vertical measurements.\u003c/p\u003e"},{"header":"Materials and Methods","content":"\u003cp\u003e \u003cb\u003eStudy design.\u003c/b\u003e Approval was obtained from the Solutions IRB, protocol 0846. This retrospective study included patients with nasal base and maxillary base transverse deficiency with or without the presence of crossbite who underwent 3D- guided midpalatal piezocorticotomy-assisted MARPE expansion using custom designed and printed 3D piezocorticotomy guide and custom MARPE appliance at the private practice in Boca Raton, Florida, USA.\u003c/p\u003e \u003cp\u003e \u003cb\u003eInclusion and exclusion Criteria.\u003c/b\u003e Initially 89 patients were considered for the study, 9 patients were later excluded due to incomplete records. The inclusion criteria were adults 19 years old and older with no previous history of midpalatal expansion and orthognathic surgery, no systemic diseases, no craniofacial deformities, with high quality CBCT images taken in full intercuspation before treatment (T0) and immediately after completion of midfacial expansion stage (T1). The mean duration of T0-T1 period was 8\u0026thinsp;\u0026plusmn;\u0026thinsp;1.4 weeks.\u003c/p\u003e \u003cp\u003eAll patients exhibited successful separation of the midpalatal suture, reaching the success rate of the expansion procedure of 100%. None of the patients was excluded due to unsuccessful separation. The final sample included 80 patients (mean age 35.23\u0026thinsp;\u0026plusmn;\u0026thinsp;8.76 years; male n\u0026thinsp;=\u0026thinsp;28, female n\u0026thinsp;=\u0026thinsp;52). (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003eIntervention.\u003c/b\u003e The 3D midpalatal piezocorticotomy guide was designed using CBCT volumes obtained with Planmeca G7 Viso (FOV 16x16 cm, Planmeca, Helsinki, Finland) and intraoral scans (iTero, Align Technology, San Jose, California, USA) of the patients, superimposed, and digitally analyzed in NemoCast (Nemotec, Madrid, Spain). The 3D guides were digitally constructed of three parts: occlusal coverage of the maxillary digital model, palatal coverage of the maxillary digital casts, and connectors. (Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e) The location of the notches used for further 3D- guided midplatal piezocorticitomy was determined by viewing the digital guided in axial plane. The landmarks for determining the location of the notches were the position of the maxillary crests, location of the nasal septum, position of the PNS point. The depth of the cuts was measured and marked on the surface of the guided at the level of each incision. The location of the incisive foramen was marked and bypassed. The position of the notches was always planned distal to the incisive foramen to avoid injury to the incisive nerve and concomitant blood vessels. (Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e)\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eThe custom MARPE appliance contained 6 miniscrews (Biomaterials Korea, Seoul, South Korea) with the length ranging from 9 to 15 mm and diameter 1.8 mm (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). The Powerscrew (TigerDental, H\u0026ouml;rbranz, Austria.) was used for the expansion with the activation of 0.11 mm per turn. The activation protocol included a period of 7 days with 2 turns/day after the initial installation and piezocorticotomy to allow for sufficient soft tissue healing. Further activation were kept at 1 turn a day (0.11 mm) for both males and females after the midpalatal split was confirmed. Patients were seen every week for the duration of the expansion stage. The expansion was considered completed when the palatal cusps of the maxillary first molars contacted the buccal cusps of the mandibular first molars. The framework arms of the appliance were removed at the expansion completion appointment, the CBCT (FOV 16x16 cm, Planmeca, Helsinki, Finland) with Ultra Low Dose protocol (ULD), 100 kV, 6.3 msA, 30 mkmSv, 600 voxel size was taken to confirm the amount of expansion.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eData analysis.\u003c/b\u003e The exported lateral cephalometric radiographs processed in Romexis (Planmeca, Helsinki, Finland) were further traced manually in WebCeph (Seongnam-si, South Korea) by the Principal Investigator (SK). The lateral cephalometric radiographs were retraced again in 2 weeks for the increase intra-examiner reliability. Fifteen measurements were identified for the purpose of this study. (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e \u003cb\u003ePrimary outcomes.\u003c/b\u003e The primary outcomes included identification of the measurements that significantly changed following intervention. The main parameters of interest included maxillary forward position defined by SNA, A-Nperp(FH), and maxillary downward rotation (SN-MP, PPA).\u003c/p\u003e \u003cp\u003e \u003cb\u003eSecondary Outcomes.\u003c/b\u003e Secondary outcomes included identifying any changes to the mandibular rotation (SNGoMe), changes in facial height (TAFH, LAFH, UAFH, PFH), changes in occlusal plane rotation (OcPSN, OcPFH, OcPGoMe), and maxillary incisor length (U1LENGTH), and inclination (U1MP). Additionally, multivariate regression analysis was run to determine if any factors are associated with the downward rotation of the maxillary plane following intervention.\u003c/p\u003e\u003cp\u003e\u003cimg 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\" width=\"442\" height=\"265\"\u003e\u003c/p\u003e\u003cp\u003en: The number of participants calculated for the study (sample size)\u003c/p\u003e \u003cp\u003eC: Cohen` coefficient,\u003c/p\u003e \u003cp\u003e⍺: Level of significance\u003c/p\u003e \u003cp\u003eβ: Probability of a type II error.\u003c/p\u003e \u003cp\u003eThe optimal number of participants for the study was calculated as 80 subjects.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eStatistical Methods\u003c/h3\u003e\n\u003cp\u003eAll statistical analyses were conducted in StataNow/SE 19.5 (Stata Corp, College Station, TX, USA). Descriptive statistics were used to summarize studied population. To test the data normality, Shapiro-Wilk test and Quantile-Quantile plots were used for every measured variable. Paired t-tests and two-sample t-test was used to identify differences between groups for all measured variables. To demonstrate statistical significance and P-value of \u0026lt;\u0026thinsp;.05 was used.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of the study participants.\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e52 (65.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e28 (35.0%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e37.942 (7.714)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.179 (8.446)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.225 (8.757)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANTSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.554 (1.338)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.646 (1.953)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.936 (1.654)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMEDSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.745 (1.377)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.802 (1.825)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.115 (1.619)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSTSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.210 (1.338)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.390 (1.857)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.623 (1.629)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMEANSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.503 (1.276)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.612 (1.833)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.891 (1.575)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.071 (2.336)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.121 (2.992)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.739 (2.606)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eDescriptions of the parameters measured in the study\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"2\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANTERSEP\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparation of the midpalatal suture at the level of ANS, mm\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMEDSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparation of the midpalatal suture at the middle third, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePOSTSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparation of the midpalatal suture at the level of PNS, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFRNASSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFronto-nasal separation, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSKCLASS\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSkeletal Class\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDOWNWROT\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDownward rotation of the maxillary plane before treatment, 0\u0026thinsp;=\u0026thinsp;\u0026lt;\u0026thinsp;11 degrees, 1\u0026thinsp;=\u0026thinsp;\u0026gt;\u0026thinsp;11 degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSNA before treatment, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eANB angle degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-Nperp(FH)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDistance between point A to the perpendicular to FH constructed through point N, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSN-ANS-PNS angle before treatment, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFH- MP (PPA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePalatal Plane angle to FH, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngle between the SN and GoMe, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngle between the SN plane and the Occlusal plane, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngle between the GoMe plane and the Occlusal plane, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-FH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngle between the FH plane and the Occlusal plane, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal anterior facial height, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003ePosterior Facial Height mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLower anterior facial height, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUpper anterior facial height, mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAngle between the axis of the maxillary central incisor and ANS-PNS plane, degrees\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1LENGTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLenth of the maxillary central incisor to the ANS-PNS plane mm\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eParticipant characteristics.\u003c/b\u003e The total number of participants (80) comprised of 52 females (65%) and 28 males (35%) with the mean age of 37.94\u0026thinsp;\u0026plusmn;\u0026thinsp;7.71 years and 30.18\u0026thinsp;\u0026plusmn;\u0026thinsp;8.45 years, respectively. The average ANB angle before treatment in females was 4.07\u0026thinsp;\u0026plusmn;\u0026thinsp;2.34 degrees in females and 3.12\u0026thinsp;\u0026plusmn;\u0026thinsp;3.0 degrees in males. The average midpalatal separation measured as a mean of anterior, medial, and posterior separation, was 5.5\u0026thinsp;\u0026plusmn;\u0026thinsp;1.28 mm in females and 6.61\u0026thinsp;\u0026plusmn;\u0026thinsp;1.83 mm in males. (Fig.\u0026nbsp;4)\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eFigure\u0026nbsp;4. Lateral cephalometric tracing and measurements used for pre- and posttreatment analysis\u003c/strong\u003e \u003cp\u003e1- ANB, 2 -PPA, 3- PFH, 4- SNA, 5 \u0026ndash; SNGoMe, 6- SN-ANSPNS, 7 -U1MP, 8 -OcPFH, 9 \u0026ndash; OcPSN, 10 \u0026ndash; OcPGoMe, 11 \u0026ndash; A- Nperp(FH), 12- TAFH, 13- UAFH, 14- U1LENGTH, 15 \u0026ndash; LAFH.\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cb\u003eMaxillary forward position and base rotation.\u003c/b\u003e The angles SNA, ANB, and the linear measurement A-Nperp(FH) differed significantly between stages T0 and T1 indicating forward maxillary base movement following intervention. Subgroup analysis in midpalatal separation (MEANSEP) percentile groups showed significant variation in A-Nperp(FH) parameter. Regression analysis for the A-Nperp(FH) demonstrated a progressive increase in forward movement corresponding to increased midpalatal separation. The coefficients were \u0026minus;\u0026thinsp;1.74 for the percentile group 1 (0\u0026ndash;25%), +\u0026thinsp;1.46 (for group 2), +\u0026thinsp;0.22 (group 3), and +\u0026thinsp;1.97 (group 4). (Table\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e,\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). No statistically significant difference of the maxillary forward position measurements (SNA, ANB, A-Nperp(FH)) was found between Skeletal Class I and II subgroups. Additionally, maxillary downward rotation (SN-MP, PPA) showed no statistically significant difference at T0 and T1. There were also no significant differences between percentile groups (indicating no association with the amount of midpalatal separation (MEANSEP)), nor Skeletal Class I and II subgroups.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMandibular rotation.\u003c/b\u003e Mandibular rotation was measured with SNGoMe angle. It demonstrated significant increase between T0 and T1, but did not show any significance between percentile groups or between Skeletal Class I and II groups.\u003c/p\u003e \u003cp\u003e \u003cb\u003eOcclusal plane rotation.\u003c/b\u003e Occlusal plane rotation was measured with three angles (OcPSN, OcPFH, OcPGoMe). OcPFH showed significant increase between T0 and T1 in Skeletal Class II. No difference between percentile groups was found.\u003c/p\u003e \u003cp\u003e \u003cb\u003ePosterior Facial Height.\u003c/b\u003e Posterior Facial Height (PFH) showed significant reduction following intervention (T0-T1). No difference between percentile groups nor Skeletal Class subgroups was found.\u003c/p\u003e \u003cp\u003e \u003cb\u003eTotal anterior facial height, upper and lower anterior facial height.\u003c/b\u003e All three anterior facial height measurements (TAFH, UAFH, LAFH) did not demonstrate significant difference with intervention (T0-T1). There was no significant difference found between percentile groups and Skeletal Class I and II subgroups.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMaxillary incisor length and inclination.\u003c/b\u003e Maxillary incisor length (U1LENGTH) significantly decreased following procedure while inclination (U1MP) showed no significant difference between stages T0 and T1. Additionally, no difference was demonstrated between Skeletal Class I and II groups and percentile groups.\u003c/p\u003e \u003cp\u003e \u003cb\u003eMaxillary downward rotation risk assessment (\u003c/b\u003eTable\u0026nbsp;\u003cspan refid=\"Tab8\" class=\"InternalRef\"\u003e8\u003c/span\u003e\u003cb\u003e).\u003c/b\u003e Multivariate linear regression analysis of the PPA value showed that the only predictor of the post-expansion PPA is the pre-expansion value of the same parameter, while sex, age, ANB, and the amount of midpalatal separation were not significantly associated with post-expansion inclination of the maxillary plane. Risk analysis demonstrated risk reduction of the downward maxillary rotation following the 3D GMP MARPE.\u003c/p\u003e \u003cp\u003ePre- and post-expansion crude analysis is presented in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e. Evaluation of the main parameters in subgroups based on the amount of midpalatal expansion is presented in Tables\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e,\u003cspan refid=\"Tab5\" class=\"InternalRef\"\u003e5\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003ePre- and Post- expansion Comparison\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"14\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eMeasurements\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c7\" namest=\"c2\"\u003e \u003cp\u003eT0\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"6\" nameend=\"c13\" namest=\"c8\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c14\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP-value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003e[95% conf.interv]\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c13\" namest=\"c12\"\u003e \u003cp\u003e[95% conf.interv]\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e80.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e69.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e88.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e79.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e81.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e81.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e72.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e90.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e80.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e82.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.003*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-3.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e4.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e11.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;0.000*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-N perp(FH)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e1.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.006*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e15.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e15.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e7.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e9.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.64\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFH-MP (PPA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-9.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e9.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e-1.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-8.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e6.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e-1.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.60\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNGoME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e16.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e33.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e37.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e36.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.61\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e17.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e34.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e38.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.001*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e16.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e18.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e31.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e16.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e19.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP -GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-11.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e15.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e18.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e18.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e1.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e32.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e16.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e19.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-FH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-3.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e7.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e9.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e9.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e-1.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e22.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e7.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e10.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.46\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e117.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e9.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e77.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e140.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e115.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e119.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e116.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e11.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e79.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e135.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e113.47\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e118.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e52.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e74.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e78.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e75.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e50.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e99.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e72.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e77.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.014*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e41.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e83.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e66.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e69.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e67.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e7.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e43.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e81.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e65.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e69.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e50.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e63.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e49.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e51.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e50.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.09\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e37.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e58.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e49.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e51.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e108.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e91.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e124.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e107.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e110.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e107.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e82.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e127.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e105.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e109.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c14\"\u003e \u003cp\u003e0.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1LENGTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e20.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e35.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e29.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e28.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e17.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c11\"\u003e \u003cp\u003e35.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c12\"\u003e \u003cp\u003e28.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c13\"\u003e \u003cp\u003e29.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c14\"\u003e \u003cp\u003e.03*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e* Statistically significant difference\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAmount of Midpalatal Separation in Percentile Groups\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"6\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePercentile Groups\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMin\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMax\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eCount\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e3.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e4.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e21\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e6.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c6\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab5\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 5\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eInter percentile group analysis for different variables\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eGroup 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eGroup 2\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c7\" namest=\"c6\"\u003e \u003cp\u003eGroup 3\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c9\" namest=\"c8\"\u003e \u003cp\u003eGroup 4\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eANOVA\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eBartlett`s Test\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eKruskal-Wallis test\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.66\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-1.24\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-N perp(FH)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-1.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e2.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.04*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFH-MP (PPA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e2.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNGoME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e1.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e4.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.38\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e7.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.52\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP -GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.02\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.002\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-FH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e-1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.63\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.82\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e4.41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e12.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.87\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.76\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.68\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.34\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e6.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e3.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.41\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e2.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.006\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.43\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e2.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e2.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.81\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e5.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1LENGTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e.06\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e1.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e3.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e2.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e3.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c10\"\u003e \u003cp\u003en/a\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;.000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.09\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e*Statistically significant difference.\u003c/p\u003e \u003cp\u003eThe Regression analysis for four percentile groups for the Difference in A-N distance measured along FH (Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e5\u003c/span\u003e):\u003c/p\u003e\n\u003ch3\u003eDIFFANFH= -1.74 + 1.46 (Group2) + 0.22 (Group3) + 1.97 (Group4)\u003c/h3\u003e\n\u003cp\u003e \u003cb\u003eDIFFANFH \u0026ndash; change in score (predicted outcome)\u003c/b\u003e \u003c/p\u003e \u003cp\u003e-1.74 \u0026ndash; the constant defined by the baseline change in Group 1\u003c/p\u003e \u003cp\u003e+\u0026thinsp;1.46, +\u0026thinsp;0.22, +\u0026thinsp;1.97 \u0026ndash; coefficients showing how much higher Groups 2,3, and 4 are compared to Group 1\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eSubgroup analysis based on skeletal classification is presented in Tables\u0026nbsp;\u003cspan refid=\"Tab6\" class=\"InternalRef\"\u003e6\u003c/span\u003e and \u003cspan refid=\"Tab7\" class=\"InternalRef\"\u003e7\u003c/span\u003e.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab6\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 6\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSkeletal Class I and Class II Subgroups Characteristics before Treatment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eSkeletal Class\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eII\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e38 (50.7%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e37 (49.3%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e75 (100.0%)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMEANSEP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5.844 (1.682)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.875 (1.462)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5.859 (1.567)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.284 (1.081)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.965 (1.428)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e4.100 (2.238)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118.400 (10.975)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e116.892 (6.788)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e117.656 (9.122)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePPA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.153 (3.655)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e-0.997 (3.150)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e-1.076 (3.393)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76.992 (8.728)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e75.727 (7.451)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.368 (8.093)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.876 (3.911)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e81.722 (3.842)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e80.787 (3.961)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNGoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.253 (8.179)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e36.389 (7.848)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e35.813 (7.984)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.366 (3.439)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.014 (3.735)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.192 (3.568)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110.011 (6.069)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e106.273 (8.397)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e108.167 (7.501)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.668 (4.638)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e19.051 (6.951)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.351 (5.895)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.576 (5.889)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e17.332 (7.509)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.456 (6.692)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP_FH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.161 (4.261)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.043 (5.783)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.089 (5.123)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANperpFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-0.726 (3.652)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e0.749 (3.908)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e0.001 (3.827)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.424 (7.594)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e68.630 (4.652)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.525 (6.275)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51.318 (4.545)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e50.722 (3.957)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.024 (4.247)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1-length\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.521 (3.128)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e30.127 (2.638)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.820 (2.893)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab7\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 7\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSkeletal Class I and II Subgroup Comparative Analysis\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"12\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c6\" namest=\"c2\"\u003e \u003cp\u003eI\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"5\" nameend=\"c11\" namest=\"c7\"\u003e \u003cp\u003eII\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c12\" morerows=\"2\" rowspan=\"3\"\u003e \u003cp\u003eIntergroup\u003c/p\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eT0\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e \u003cp\u003eT0\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e \u003cp\u003eT1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c11\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eP value\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c9\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c10\"\u003e \u003cp\u003eSD\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNA\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e79.88\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e81.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.004\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e81.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e81.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e4.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eANB\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e2.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e1.08\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e3.93\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.0052*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e5.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e1.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e6.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e1.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.08\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eA-N perp(FH)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.084\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e1.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.027*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.07\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSN-MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e8.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e2.87\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e8.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e8.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.22\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFH-MP (PPA)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e-1.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.66\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.83\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.74\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.687\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSNGoME\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e35.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e36.03\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e8.28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.01*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e36.39\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e37.68\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e8.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.004*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-SN\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e18.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.025*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e19.05\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e18.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.00\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.29\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP -GoMe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e17.58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e5.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e17.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e5.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e17.33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.51\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e18.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.12\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eOcP-FH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e8.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.26\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e9.49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.016*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e10.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e5.78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e9.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e4.95\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.04*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e118.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e10.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e118.23\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e11.44\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.096\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e116.89\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e6.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e114.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e10.91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.35\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.23\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e76.99\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e8.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e76.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e9.29\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e75.73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e7.45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e72.98\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e9.77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.001*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.052\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e68.42\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e7.59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e68.67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.94\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e68.63\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e4.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e66.97\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e6.65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.13\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUAFH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e51.32\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e4.54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e51.37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e4.56\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.319\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e50.72\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e3.96\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e50.25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e5.48\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.86\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1MP\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e110.01\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e6.07\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e109.62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e7.79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.616\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e106.27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e8.40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e105.19\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e8.55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eU1LENGTH\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e29.52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e3.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e29.04\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c5\"\u003e \u003cp\u003e3.36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c7\"\u003e \u003cp\u003e30.13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c8\"\u003e \u003cp\u003e2.64\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c9\"\u003e \u003cp\u003e29.16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c10\"\u003e \u003cp\u003e3.22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c11\"\u003e \u003cp\u003e.18\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c12\"\u003e \u003cp\u003e.47\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"12\"\u003e*Statistically significant difference\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab8\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 8\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eRisk Assessment for the Downward Maxillary Plane Rotation in Subjects with and without downward rotation before treatment\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk in Group with Initial Rotation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRisk in Group without Initial Rotation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e0.53\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0.11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.19\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e95% CI\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk Difference\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e.43\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.16 .69\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk Ratio\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e5.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.18 11.53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"2\" nameend=\"c2\" namest=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eP\u0026lt;.001\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003eMultivariable linear regression analysis for the downward maxillary plane analysis:\u003c/p\u003e \u003cp\u003e \u003cb\u003ePPAA= -1.91\u0026thinsp;+\u0026thinsp;0.576(PPAB)\u0026thinsp;\u0026minus;\u0026thinsp;1.64(SEX)\u0026thinsp;\u0026minus;\u0026thinsp;0.05(AGE)\u0026thinsp;\u0026minus;\u0026thinsp;0.08(MEANSEP)\u0026thinsp;+\u0026thinsp;0.05(SNAB)\u0026thinsp;\u0026minus;\u0026thinsp;0.004(ANBB\u003c/b\u003e), where\u003c/p\u003e \u003cp\u003eSEX, AGE, MEANSEP, SNA, ANB were not statistically significant, PPAA \u0026ndash; is PPA after intervention, PPAB \u0026ndash; is PPA before intervention, -1.91 =\u0026szlig;\u003csub\u003e0,\u003c/sub\u003e -1.64 = \u0026szlig;\u003csub\u003e1,\u003c/sub\u003e -0.05 = \u0026szlig;\u003csub\u003e2\u003c/sub\u003e, -0.08 = \u0026szlig;\u003csub\u003e3\u003c/sub\u003e, +\u0026thinsp;0.05 = \u0026szlig;\u003csub\u003e4,\u003c/sub\u003e -0.004= \u0026szlig;\u003csub\u003e5\u003c/sub\u003e.\u003c/p\u003e \u003cp\u003eThus, simplified, the regression analysis of the predicted PPA after intervention is dependent on the value of PPA before the intervention and not significantly associated with sex, age, amount of midpalatal septation, amount of posterior midpalatal separation, pre-treatment SNA and ANB:\u003c/p\u003e\n\u003ch3\u003ePPAA= -1.91 + 0.576(PPAB)- 1.64 (SEX)\u003c/h3\u003e\n\u003cp\u003eIf SEX equals 1 (male), the outcome is decreased by the \u0026szlig; of SEX.\u003c/p\u003e \u003cp\u003eFor example: PPAA= -1.91\u0026thinsp;+\u0026thinsp;0.576 (0.6) \u0026ndash; 1.64 (0) = -1.91\u0026thinsp;+\u0026thinsp;0.346\u0026ndash;0 = -1.56 : In a female with the pre-treatment PPA\u0026thinsp;=\u0026thinsp;0.6 degrees the post-treatment PPA is predicted to be -1.56 which indicated counter-clockwise rotation.\u003c/p\u003e \u003cp\u003eThis model describes 37.7% variation in PPA after the procedure.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe objective of this study was to evaluate the effects of 3D guided midpalatal piezocorticotomy-assisted MARPE in adults. The mechanisms of maxillary, mandibular base, and occlusal plane responses differ between various maxillary expansion techniques. The latter are widely described in the literature and include Rapid Palatal Expansion (RPE), Surgically-Assisted Rapid Palatal Expansion (SARPE), and Miniscrew-Assisted Rapid Palatal Expansion (MARPE).\u003c/p\u003e \u003cp\u003eSome studies involving RPE in mixed dentition reported both forward maxillary displacement and downward maxillary base rotation (\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e), others report significant anterior facial height increase along with maxillary downward rotation (\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e, \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e). Similarly, Chung (\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e) described significant downward maxillary rotation with the increase in the anterior face height following RPE is adolescents.\u003c/p\u003e \u003cp\u003eMandibular backward rotation along with occlusal plane rotation was described by Da Costa Silva in mixed dentition patients treated with RPE. (\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e)\u003c/p\u003e \u003cp\u003eSARPE treatment routinely involved the use of fixed hyrax-type expanders. Studies analyzed in a systematic review and meta-analysis published by Lin and coauthors (\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e) demonstrated similar forward maxillary translation and downward maxillary plane rotation when measured with SN-MP angle. Study by Oliveira (\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e) supported backward mandibular rotation and transient lateral mandibular displacement following maxillary expansion with SARPE. On the opposite side, maxillary rotation following SARPE was described by Farfel (\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e) who did not report any rotation of the ANS-PNS plane.\u003c/p\u003e \u003cp\u003eParhiz (\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e) suggested predictive parameters that were associated with the downward rotation of the maxillary plane following SARPE. Those parameters included pre-existing downward rotation of the maxillary plane (measured as SN-ANS-PNS angle), gender, and age. These were shown to define 75% of the post-treatment downward rotation of the maxillary plane.\u003c/p\u003e \u003cp\u003eMost studies on SARPE report downward rotation of the maxillary plane similar to studies on RPE. RPE was also reported to produce more dento-alveolar effects associated with molar mesial movement, molar extrusion, maxillary incisor proclination and others (\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e). These effects could be contributing to the maxillary downward rotation with both treatment modalities.\u003c/p\u003e \u003cp\u003eOur study of 3D- GMP MARPE supports earlier studies on MARPE in adolescents and young adults which showed no downward rotation of the maxillary plane (\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e, \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e). In the current study, when measured with SN-MP and PPA angles, no statistically significant difference was found between pre- and post-treatment measurements. Moreover, no difference was found between Skeletal Classes I and II, which was not evaluated earlier. In our study, patients with downward rotation before treatment were evaluated to determine the risk of development downward rotation following intervention. Our results indicate that even though there is a low risk to develop downward rotation in subjects who did not exhibit this characteristic before treatment, there is only 53% risk of maintaining downward rotation after intervention in those who entered the treatment with pre-existing downward rotation. This data indicates a possibility of counterclockwise rotation of the maxillary plane. This tendency was described using 3D cephalometric evaluation by Koval and co-authors (\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e) in a case report showing uneven rotation of the maxillary plane around the center of resistance with relatively equal upward displacement of ANS and downward displacement of PNS.\u003c/p\u003e \u003cp\u003eEmpson and colleagues (\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e) compared MARPE and RPE treatment. MARPE intervention led to backward mandibular rotation, while RPE intervention was associated with the significant downward displacement of point A, which was not observed with MARPE. Our data supports backward mandibular rotation measured with SNGoMe angle. Mandibular backward rotation following intervention was supported by the significant increase in occlusal plane rotation measured with OcPGoMe angle but not with OcPFH nor OcPSN angles. Occlusal plane inclination shows similar pattern with all expansion techniques (RPE, SARPE, MARPE) and are possibly linked to maxillary molar tipping and cusp inclination.\u003c/p\u003e \u003cp\u003eWhen MARPE was combined with the facemask or similar protraction device and compared with combination of RPE and facemask (FM) (\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e), significant maxillary incisor inclination with mandibular plane rotation was demonstrated in RPE\u0026thinsp;+\u0026thinsp;FM group. Both groups equally significantly showed forward maxillary displacement with increase in SNA. Skeletal Class III patients treatment with combination of MARPE and FM was reported by Cho and coauthors (\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e) who concluded significant increase in SNA and ANB, no changes in mandibular plane angle, no changes in SNB. Authors did not evaluate the maxillary plane and occlusal plane inclinations. Qi and colleagues (\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e) evaluated the internal Temporo-mandibular Joint (TMJ) spaces in comparison with the maxillary base and upper molar height changes. Their results indicated that immediately after MARPE-induced expansion, superior and posterior condylar spaces increased. Both changes weakly correlated with the increase in the maxillary molar palatal cusp height and maxillary base increase. Our data of 80 patients treated with 3D-GMP MARPE provides evidence of significant forward movement of maxillary base when measured with SNA, ANB, and A-Nperp(FH). The latter was shown to progress with the increase in the amount of midpalatal separation. Possible explanation of these findings is that the amount of midfacial expansion with 3D- GMP MARPE releases pterygomaxillary sutures allowing for the forward maxillary movement. Pterygomaxillary suture separation with MARPE expansion was earlier reported by Colak and Cantarella (\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e).\u003c/p\u003e \u003cp\u003e3D-GMP as an auxiliary procedure combined with MARPE increased success rate of MARPE expansion to 100% compared to 84% reported by Shin and colleagues (\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e) who studied the predictability of midpalatal suture separation was evaluated with regression analysis. Authors showed that age, palate length, and midpalatal suture maturation stage were predictors for successful midpalatal separation in young adult patients. The 3D-GMP -Assisted MARPE is reported to eliminate remaining limitations to predictable midfacial separation in adult patients.\u003c/p\u003e \u003cp\u003eOur data did not report any significant maxillary plane changes. This can be explained in several ways. First of all, all studies involving custom MARPE appliances featured hybrid design with different framework design but mutual feature of bone-borne middle part. The existing framework design attached to the rigidly anchored middle part resulted in no-to-minimal mesial dental migration while allowing for some lateral tipping. SARPE involves some variation of hyrax-type fixed expander with or without pre-surgical activation, which guides further maxillary plane to follow dento-alveolar relationship while in active expansion process. All three treatment modalities involve significant backward mandibular rotation that was shown to be transient when compared to post-expansion orthodontic finishing. This is possibly explained by dento-alveolar and dental movements that guide forward mandibular displacement after expansion.\u003c/p\u003e \u003cp\u003eThe limitations of the current study include lack of the comparison group with no auxiliary procedure when combined with MARPE and the lack of long-term data reported. Further studies are needed to compare long-term stability of the 3D- GMP MARPE.\u003c/p\u003e"},{"header":"Conclusions","content":"\u003cp\u003e3D- guided midpalatal piezocorticotomy assisted MARPE may offer advantages in decreasing the risk of downward maxillary rotation along with maxillary protraction in adults. Forward maxillary movement was shown to be one of the consistent outcomes of 3D- GMP MARPE which is augmented with increased amount of midpalatal separation in adult patients. Long-term research is needed to evaluate the effects of different designs of MARPE appliances in conjunction with 3D GMP MARPE along with the stability of the outcomes.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eMARPE \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Miniscrew-Assisted Rapid Palatal Expansion\u003c/p\u003e\n\u003cp\u003eSARPE \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;Surgically Assisted Rapid Palatal Expansion\u003c/p\u003e\n\u003cp\u003eRPE \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Rapid Palatal Expander\u003c/p\u003e\n\u003cp\u003e3D-GMP \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; 3-Dimensional Guided Midpalatal Piezocorticotomy\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eAuthor contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSK contributed to conceptualization, manuscript text, editing, supervision of the project; DC contributed to preparing Fig.1-4, Tables 1-8, editing and reviewing; NS contributed to manuscript writing and editing; AB contributed to data analysis, editing, and writing.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData availability\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study protocol was reviewed and approved by Solutions Institutional Review Board (Solutions IRB) (Approval No. 0846). Written informed consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWritten informed consent for publication of anonymized data was obtained from all participants prior to enrollment.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDeclaration of competing interest\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOne author (SK) declares a pending patent: US and Canada Patent Pending: Piezocorticotomy guide for midpalatal skeletal expansion (Application # 18/919,416).\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eChun JH, de Castro ACR, Oh S, Kim KH, Choi SH, Nojima LI, et al. Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT. BMC Oral Health. 2022;22(1):114.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThi Hong Thuy P, Viet H, Thu Trang P, Phuong Linh D, Viet Anh N. Midpalatal suture bone regeneration following customized miniscrew-assisted rapid palatal expansion in nongrowing patients: A retrospective observational study. Med (Baltim). 2025;104(41):e44624.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAkyalcin S, Alev Y. Clinical advances in maxillary skeletal expansion and introduction of a new MARPE concept. J Esthet Restor Dent Off Publ Am Acad Esthet Dent Al. 2023;35(1):291\u0026ndash;8.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSong GH, Lee SM, Chung DH, Lee JW, Park JH. Expansion Pattern of Miniscrew Assisted Rapid Maxillary Expansion (MARPE) After Midpalatal Suture Separation: Clustering-Based Classification. 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Sagittal and Vertical Changes of the Maxilla after Surgically Assisted Rapid Palatal Expansion: A Systematic Review and Meta-Analysis. J Clin Med. 2023;12(10):3488.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eOliveira TFM, Pereira-Filho VA, Gabrielli MFR, Gon\u0026ccedil;ales ES, Santos-Pinto A. Effects of surgically assisted rapid maxillary expansion on mandibular position: a three-dimensional study. Prog Orthod. 2017;18(1):22.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFarfel V, Morea GC, Ferreira LM, Pereira MD. Evaluation of Sagittal and Vertical Changes in Maxillary Dental, Skeletal, and Soft Tissue Following Surgically Assisted Rapid Maxillary Expansion: A Retrospective Longitudinal Study. J Craniofac Surg. 2022;33(4):e398\u0026ndash;401.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eThi Hong Thuy P, Thu Trang P, Thi Thu Hang P, Viet H. 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Angle Orthod. 2025;95(3):283\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eQi Y, Ding L, Xue L, Xu S, Lin J. Analysis of changes and correlation in condyle-fossa relationship after maxillary skeletal expansion. Orthod Craniofac Res. 2024;27(5):681\u0026ndash;9.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCantarella D, Dominguez-Mompell R, Mallya SM, Moschik C, Pan HC, Miller J, et al. Changes in the midpalatal and pterygopalatine sutures induced by micro-implant-supported skeletal expander, analyzed with a novel 3D method based on CBCT imaging. Prog Orthod. 2017;18(1):34.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eColak O, Paredes NA, Elkenawy I, Torres M, Bui J, Jahangiri S, et al. Tomographic assessment of palatal suture opening pattern and pterygopalatine suture disarticulation in the axial plane after midfacial skeletal expansion. Prog Orthod. 2020;21(1):21.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShin H, Hwang CJ, Lee KJ, Choi YJ, Han SS, Yu HS. Predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in young adults: A preliminary study. Korean J Orthod. 2019;49(6):360\u0026ndash;71.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"MARPE, adults, 3D- guided piezocorticotomy, downward maxillary rotation, mandibular rotation","lastPublishedDoi":"10.21203/rs.3.rs-8824079/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8824079/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eIntroduction.\u003c/strong\u003e Despite the increasing success rate of MARPE in different age groups, the concern still exists regarding potential downward rotation of the maxillary complex and increase in the middle and lower anterior facial heights due to midfacial expansion. 3D-guided midpalatal piezocorticotomy (3D-GMP) assisted MARPE is intended to increase the success rate of MARPE in adults and eliminate the age and sex parameters as limitations along with improving outcomes of MARPE alone.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods.\u003c/strong\u003e This retrospective longitudinal study evaluated pre- and post-expansion lateral cephalometric radiographs following midfacial expansion with 3D- GMP MARPE. Images were rendered from the CBCTs of 80 adult patients with mean age 35.23 ± 8.76 years (male n = 28, female n = 52). Fifteen lateral cephalometric measurements were compared. Measurements included maxillary forward displacement, mandibular rotation, inclination of the maxillary plane, occlusal plane rotation, and linear measurements of the facial heights. Maxillary incisor position was measured relative to the maxillary plane.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults.\u003c/strong\u003e The angles SNA, ANB, and the linear measurement A-Nperp(FH) differed significantly between stages T0 and T1 indicating forward maxillary base movement following intervention. Multivariate linear regression analysis of the PPA value showed that the only predictor of the post-expansion PPA is the pre-expansion value of the same parameter, while sex, age, ANB, and the amount of midpalatal separation were not significantly associated with post-expansion inclination of the maxillary plane. Risk analysis demonstrated risk reduction of the downward maxillary rotation following the 3D- GMP MARPE.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions.\u003c/strong\u003e 3D- guided midpalatal piezocorticotomy assited MARPE may offer advantages in decreasing the risk of downward maxillary rotation along with maxillary protraction in adults. Forward maxillary movement was shown to be one of the consistent outcomes of 3D- GMP MARPE which is augmented with increased amount of midpalatal separation in adult patients.\u003c/p\u003e","manuscriptTitle":"Maxillary and Mandibular Changes with 3D-Guided Midpalatal Piezocorticotomy - Assisted MARPE in Adults: A Retrospective Longitudinal Study","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-02-10 11:49:46","doi":"10.21203/rs.3.rs-8824079/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7b14cd03-df86-4084-83fd-56f7edba949c","owner":[],"postedDate":"February 10th, 2026","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2026-03-21T07:55:27+00:00","versionOfRecord":[],"versionCreatedAt":"2026-02-10 11:49:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8824079","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8824079","identity":"rs-8824079","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}