{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:31:00Z","timestamp":1786336260619,"version":"build-2736575974"},"reference-count":19,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:00:00Z","timestamp":1786320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oral Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Structural predictors of success or failure in adult maxillary expansion remain poorly defined. This retrospective case-control pilot study aimed to evaluate the predictive capacity of pre-treatment craniofacial morphology\u2014specifically the palatal plane inclination (SN-PP)\u2014on final post-treatment maxillary skeletal morphology in adults undergoing 3D-Guided Midpalatal Piezocoticotomy Assisted Miniscrew-assisted rapid palatal expansion (3D-GMP MARPE).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of eighty skeletally mature patients were evaluated, comprising a control group (mean age: 35.7\u2009\u00b1\u20098.4 years) and a case group (mean age: 33.1\u2009\u00b1\u200910.1 years) exhibiting sleep-disordered breathing and\/or transverse maxillary deficiency underwent three-dimensional (3D) digitally guided midpalatal piezocoticotomy-assisted MARPE. Baseline metrics were derived from cone-beam computed tomography (CBCT) datasets in NemoFab software. Subjects were stratified based on their final absolute post-treatment morphology into cases (SN-PP &amp;gt;=11 degrees,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200915) or controls (SN-PP\u2009&amp;lt;\u200911degrees,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200965). Univariable and multivariable logistic regressions calculated crude and adjusted odds ratios (aOR) controlled for biological sex. Classification accuracy was evaluated using Receiver Operating Characteristic (ROC) curve analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline demographics, sagittal relationships, and soft-tissue thicknesses were statistically identical between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;gt;\u2009.05). Conversely, cases exhibited a significantly steeper baseline SN-PP_b angle than controls (11.5\u2009\u00b1\u20092.9\u00b0 vs. 7.3\u2009\u00b1\u20093.1\u00b0,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). Univariable regression revealed a 57% increase in the odds of case status per degree increase in SN-PP_b (OR=1.57; 95% CI: 1.23, 2.00;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&amp;lt;\u2009.001). This signal remained robustly significant after adjusting for sex in the multivariable model (aOR=1.51; 95% CI: 1.18, 1.94;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.001). ROC analysis demonstrated excellent diagnostic discrimination (AUC\u2009=\u20090.841), backed by a\n                      <jats:italic>post-hoc<\/jats:italic>\n                      statistical power of 99.7%.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>A steeper pre-treatment palatal plane angle is a powerful, sex-independent predictor of a high-angle post-treatment skeletal relationship. Integrating SN-PP into diagnostic protocols provides high classification accuracy for pre-operative risk stratification regarding final skeletal phenotype.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/froh.2026.1900614","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T04:22:25Z","timestamp":1786335745000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pre-expansion downward maxillary base rotation as a biomarker for post-expansion downward maxillary rotation in adults treated with 3D-guided midpalatal piezocorticotomy-assisted MARPE: a pilot case-control study"],"prefix":"10.3389","volume":"7","author":[{"given":"Svitlana","family":"Koval","sequence":"first","affiliation":[{"name":"DrKoval Orthodontics, Practice Limited to Orthodontics","place":["Boca Raton, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daria","family":"Chepanova","sequence":"additional","affiliation":[{"name":"DrKoval Orthodontics, Practice Limited to Orthodontics","place":["Boca Raton, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nika","family":"Stepanoff","sequence":"additional","affiliation":[{"name":"DrKoval Orthodontics, Practice Limited to Orthodontics","place":["Boca Raton, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrii","family":"Babii","sequence":"additional","affiliation":[{"name":"Nova Southeastern University","place":["Fort Lauderdale, FL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Wellman","sequence":"additional","affiliation":[{"name":"Division of Sleep and Circadian Disorders, Sleep Disordered Breathing Lab, Brigham and Women\u2019s Hospital and Harvard Medical School","place":["Boston, MA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"114","DOI":"10.1186\/s12903-022-02138-w","article-title":"Skeletal and alveolar changes in conventional rapid palatal expansion (RPE) and miniscrew-assisted RPE (MARPE): a prospective randomized clinical trial using low-dose CBCT","volume":"22","author":"Chun","year":"2022","journal-title":"BMC Oral Health"},{"key":"B2","doi-asserted-by":"publisher","first-page":"e44624","DOI":"10.1097\/MD.0000000000044624","article-title":"Midpalatal suture bone regeneration following customized miniscrew-assisted rapid palatal expansion in nongrowing patients: a retrospective observational study","volume":"104","author":"Thi Hong Thuy","year":"2025","journal-title":"Medicine 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