BACKGROUND: Constricted maxillary bone is a common skeletal deformity, which may lead to crowding and posterior crossbite. Mid-palatal suture expansion is often used to increase the maxillary width, but its skeletal effects are limited and tend to relapse, even with prolonged retention. We hypothesized that parathyroid hormone (PTH) may reduce the relapse of maxillary expansion.
METHODS: We established a novel rat maxillary expansion model using palatal tubes with an insertable \"W\"-shaped spring which can be repeatedly activated. A total of 32 male healthy Wistar rats were randomly divided into six groups: the control group, the PTH group, the expansion group, the expansion + PTH group, the expansion + relapse group and the expansion + PTH + relapse group. All animals in the first 4 groups were killed after 10 days and the 2 relapse groups were killed after 15 days. The maxillary arch widths and histological staining were used to assess the expansion and relapse effects. The immunohistochemical staining, micro-CT, RT-qPCR and Western blot were used to evaluate the bone remodeling during expansion.
RESULTS: The suture width was increased by the expansion device, and the repeated activation maxillary expansion rat model showed better expansion effects than the conventional model. PTH significantly promoted the expansion width and reduced the relapse ratio. Meanwhile, in the expansion + PTH group, histological and immunohistochemical staining showed that osteoblasts, osteoclasts, new cartilage and osteoid were significantly increased, micro-CT showed increased bone mass, and PCR and Western blot results confirmed up-regulation of RANKL, β-catenin, type II collagen and OCN.
CONCLUSIONS: The novel repeated activation maxillary expansion rat model has better effects than the conventional model. PTH enhances the maxillary expansion and reduces its relapse by regulating Wnt/β-catenin and RANKL pathways. PTH administration may serve as an adjunctive therapy in addition to mechanical expansion for treatment of maxillary constriction.

Simvastatin belongs to the family of statins and is found to have some osteopromotive properties in recent years. The aim of the present study was to investigate the potential effects of simvastatin on bone formation of the expanded mid-palatal suture of rats. Forty-five Wistar rats were randomly divided into three groups: control (C), expansion (EP), and expansion plus simvastatin (ES) groups. Rats in the ES group were administrated with simvastatin (20 mg/kg/d body weight). According to the schedule of sacrifice (days 3, 7 and 14), the suture width and bone volume changes of the region of interest (ROI) were detected by micro-computed tomography during RME. Besides, morphological changes and bone morphogenetic protein 2 (BMP-2) expression in the mid-palatal suture were observed by hematoxylin and eosin (HE) and immunohistochemical staining. Kruskal-Wallis one-way analysis of variance (ANOVA) and LSD method were applied to analyze the data at P<0.05 level. By the RME appliance, the suture was successfully widened. On days 7, 14, the bone volume of ROI in the ES group was more than that in the EP group (P<0.05). Besides, histological examinations also demonstrated that more bone regeneration and capillaries in the suture in the ES group were observed than that in the EP group. The BMP-2 expression in the ES group was more (P<0.05) than that in the EP and C groups on days 3, 7, 14. Consequently, those findings showed that simvastatin can induce a favorable effect on bone regeneration in the mid-palatal suture of rats during RME.