A unique functional craniofacial suture that may normally never ossify: A cone-beam computed tomography-based report of two cases

Mir, Karim Poorsattar Bejeh; Mir, Arash Poorsattar Bejeh; Mir, Morvarid Poorsattar Bejeh; Haghanifar, Sina

doi:10.4103/0975-962x.179375

Cited by 10 publications

(10 citation statements)

References 7 publications

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“…The results of the present study in relation to the degree of ossification of the suture in the 10-year age groups showed that ossification increased with aging; however, some cases of completely open sutures were observed in the >20-year age groups. The results of the present study are consistent with those of previous studies ( 10 , 11 , 18 , 25 ). Nguyen (2008) carried out a study on 20 patients over 70 years of age and reported that the midpalatal suture is the only suture that might not close completely even in the elderly ( 11 ).…”

Section: Discussionsupporting

confidence: 94%

“…Rapid maxillary expansion (RME) is a procedure with a long history and is the most effective orthopedic approach for expanding and increasing the transverse dimension and correcting the transverse discrepancies through increasing the intermolar width, opening the midpalatal suture and separating the two halves of the maxillary bone with the use of forces of large magnitude ( 1 – 9 ). Gradually, the two halves of the maxillary bone interdigiated to some extent and cannot be separated from each other even with force and in-office appliances; the only way to separate the two halves is through surgery or surgically assisted rapid maxillary expansion (SARME) ( 10 ). Contrary to other cranial sutures, the midpalatal suture in human beings is the only suture that might not close up in the elderly ( 11 ); thus, decision to carry out SARME or RME should not be made only based on the chronological age ( 10 , 12 , 13 ).…”

Section: Introductionmentioning

confidence: 99%

“…Gradually, the two halves of the maxillary bone interdigiated to some extent and cannot be separated from each other even with force and in-office appliances; the only way to separate the two halves is through surgery or surgically assisted rapid maxillary expansion (SARME) ( 10 ). Contrary to other cranial sutures, the midpalatal suture in human beings is the only suture that might not close up in the elderly ( 11 ); thus, decision to carry out SARME or RME should not be made only based on the chronological age ( 10 , 12 , 13 ). Although SARME is possible at any age, it is a more aggressive approach and imposes extra costs and gives rise to problems for both the patient and the orthodontist ( 3 ).…”

Section: Introductionmentioning

confidence: 99%

“…Although SARME is possible at any age, it is a more aggressive approach and imposes extra costs and gives rise to problems for both the patient and the orthodontist ( 3 ). Different studies on the morphology and degree of fusion of the suture and its initiation time in different individuals have yielded wide variations at the time of initiation and progression of the closure of the suture ( 3 , 14 – 16 ); some cases of completely open sutures have been reported in subjects over 18 years of age ( 10 , 14 , 17 , 18 ). Based on a study by Melsen, the morphology of the suture changes at each stage of development ( 19 ).…”

Section: Introductionmentioning

confidence: 99%

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Assessment of midpalatal suture ossification using cone-beam computed tomography

Haghanifar¹,

Mahmoudi²,

Foroughi³

et al. 2017

Electron physician

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Background and ObjectiveThe degree of ossification of the midpalatal suture is an important factor in the selection of treatment procedure, especially in young individuals. Considering the discrepancies in the results of studies on the exact time of the closure of this suture, the present study was undertaken to evaluate ossification and morphology of the suture with the use of CBCT.MethodsIn the present cross-sectional study, the CBCT images of the maxilla in 144 Iranian subjects (72 males, 72 females) with an age range of 10 to 70 years, referring to a private radiology center in Sari, Iran, were evaluated. The CBCT images were evaluated in the axial cross-sectional slice at 1 mm intervals to determine morphology and the maturation stage of the suture and its degree of ossification. The six developmental stages that were observed were as follows: stage A, a direct line without disturbances; stage B, a scalloped appearance in the suture; stage C, two parallel lines with a scalloped appearance that were connected at some points; stage CD, the anterior portion was similar to stage C, and the posterior region was similar to stage D; stage D, ossification only in the palatine bone; stage E, complete ossification of the suture. The degree of ossification of the suture was calculated with the use of the ratio of the length of the ossified segment to the entire length of the suture. Data were analyzed with Spearman’s correlation test, Chi-squared test, t-test, ANOVA, Mann-Whitney U, and Kruskal-Wallis test. Intra-observer agreement was calculated with the use of weighted kappa coefficient. Data were analyzed with SPSS 17.ResultsThere was a strong correlation between the age groups and the developmental stages of the midpalatal suture in both genders (r=0.681, p<0.001). The ossification process occurred in the posterior to anterior direction in 98% of the cases. There was a significant relationship between aging and the degree of ossification (p<0.001); however, the difference was not significant between the two genders (p=0.193).ConclusionAlthough the rate of suture closure increased with aging, age was not a reliable factor alone to determine the developmental stage of the suture. Use of CBCT is necessary in all the patients to determine the degree of ossification and morphology of the midpalatal suture.

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Section: Discussionsupporting

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Assessment of midpalatal suture ossification using cone-beam computed tomography

Haghanifar¹,

Mahmoudi²,

Foroughi³

et al. 2017

Electron physician

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“…Such studies support the theory that the midpalatal suture may be the only cranial suture that does not achieve full ossification because of the constant mechanical stress that is applied to it. 35 , 36 Histological studies have demonstrated that caution should be taken when defining the stage of ossification using imaging exams. 35 , 37 …”

Section: Discussionmentioning

confidence: 99%

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Brunetto

Sant'Anna

Machado

et al. 2017

Dental Press J. Orthod.

163

103

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Introduction: Maxillary transverse deficiency is a highly prevalent malocclusion present in all age groups, from primary to permanent dentition. If not treated on time, it can aggravate and evolve to a more complex malocclusion, hindering facial growth and development. Aside from the occlusal consequences, the deficiency can bring about serious respiratory problems as well, due to the consequent nasal constriction usually associated. In growing patients, this condition can be easily handled with a conventional rapid palatal expansion. However, mature patients are frequently subjected to a more invasive procedure, the surgically-assisted rapid palatal expansion (SARPE). More recently, researches have demonstrated that it is possible to expand the maxilla in grown patients without performing osteotomies, but using microimplants anchorage instead. This novel technique is called microimplant-assisted rapid palatal expansion (MARPE). Objective: The aim of the present article was to demonstrate and discuss a MARPE technique developed by Dr. Won Moon and colleagues at University of California - Los Angeles (UCLA).Methods: All laboratory and clinical steps needed for its correct execution are thoroughly described. For better comprehension, a mature patient case is reported, detailing all the treatment progress and results obtained.Conclusion: It was concluded that the demonstrated technique could be an interesting alternative to SARPE in the majority of non-growing patients with maxillary transverse deficiency. The present patient showed important occlusal and respiratory benefits following the procedure, without requiring any surgical intervention.

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Comparison of the Effects of Different Palatal Morphology on Maxillary Expansion via RME and MSE: A Finite Element Analysis

Pan,

Peng,

Wang

2024

Clinical & Exp Dental Res

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ObjectivesThis study aims to compare and analyze the biomechanical effect and the displacement trend of RME and MSE on the maxillofacial complex under different palatal shapes by using finite element analysis.MethodsThe three‐dimensional model of maxillofacial complex was obtained from a computed tomography image of a person with a normal palate. Then, we modified the shape of the palate to obtain the model with a high palate. Additionally, two expander devices were considered. MSE and RME were created and four models were made: Model 1: Normal‐palate craniomaxillofacial complex with RME expander; Model 2: Normal‐palate craniomaxillofacial complex with MSE expander; Model 3: High‐palate craniomaxillofacial complex with RME expander; Model 4: High‐palate craniomaxillofacial complex with MSE expander. Then, lateral forced displacement was applied and the analysis results were obtained.ResultsThe lateral displacement of the palatal suture of Model 3 is greater than that of Model 1, and the maxilla has more rotation. The crown/root ratio of Model 1 is significantly greater than that of the other three groups. Compared with Model 1, Model 3 has greater stress concentration in the superstructure of the craniomaxillofacial complex. Both of them have greater stress in the anchorage area than Model 2 and Model 4.ConclusionDifferent shapes of the palate interfere with the effects of RME and MSE, and its influence on the stress distribution and displacement of the craniomaxillary complex when using RME is greater than MSE. The lateral displacement of the palatal suture of MSE is significantly larger than that of RME. It is more prone to tipping movement of the anchor teeth using RME under normal palate, and MSE may manage the vertical control better due to the smaller crown/root ratio than RME and intrusive movement of molars.

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A unique functional craniofacial suture that may normally never ossify: A cone-beam computed tomography-based report of two cases

Cited by 10 publications

References 7 publications

Assessment of midpalatal suture ossification using cone-beam computed tomography

Assessment of midpalatal suture ossification using cone-beam computed tomography

Non-surgical treatment of transverse deficiency in adults using Microimplant-assisted Rapid Palatal Expansion (MARPE)

Comparison of the Effects of Different Palatal Morphology on Maxillary Expansion via RME and MSE: A Finite Element Analysis

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