Rapid palatal expansion in patients with craniosynostosis: a case report.

The craniosynostoses represent a group of pathologies characterised by the premature fusion (during prenatal or perinatal stages or early infancy) of one or more of the cranial sutures. Its genetic origins are not completely clear although mutations in the genes that code for fibroblast growth factor receptors have been described; depending upon the gene involved, the type of mutation and the embryological period in which the mutation itself occurs, a type of craniosynostosis arises that may involve one or more cranial sutures. The premature fusion results in a lack of growth in the regions corresponding to the cranial vaults, with compensatory growth occurring in other regions and the consequent deformation of the skull. Here, a case report is presented of a Caucasian male child affected by craniostenosis of the sagittal suture with a orthodontic-orthopedic diagnosed ogival palate and insufficient space for the eruption of the superior canines. The patient was treated by fitting a rapid palatal protractor, an orthopedic device that acts upon the median palatine suture of the palate increasing the transverse diameter of the upper jaw and causes the widening and lowering of the floor of the nasal cavity. The results obtained were equivalent to those obtained in subjects with no past medical history of craniosynostosis. This clinical study demonstrated that the premature fusion of the mid-sagittal suture of the skull, that characterises sagittal craniosynostoses, can occur without the involvement of the median suture of the palate, rendering expansion possible by means of orthopedic treatment.