Comparison of three-dimensional maxillary growth across spheno-occipital synchondrosis maturation stages

Abstract

Background This study aimed to three-dimensionally compare the maxillary growth among the spheno-occipital synchondrosis (SOS) maturation stages in both genders. Methods This is a cross-sectional study of a retrospective type in which cone-beam computed tomography (CBCT) images of 500 patients aged 6 to 25 years (226 males and 274 females) were analyzed. The SOS was evaluated using the four-stage scoring system; completely open, partially fused, semi-fused, or completely fused. The SOS scoring and three-dimensional cephalometric measurements were analyzed by Invivo 6.0.3 software. Descriptive and analytical statistics were performed and a P-value < 0.05 was considered statistically significant. Results There was a statistically significant difference in maxillary measurements among SOS maturation stages in both genders (P < 0.05). The mean differences in the maxillary growth among the SOS maturation stages between SOS stages 2 and 3 were higher than those between stages 1and 2 and stages 3 and 4 for maxillary length and height in both genders. However, the mean difference in the maxillary width was higher between SOS stages 1 and 2 than those stages 2 and 3 and stages 3 and 4. On other hand, there may be lesser maxillary growth between SOS stages 3 and 4 for maxillary width, length (in males), and height. The growth curves showed high active growth of the maxilla as the SOS was still fusing (especially stage 2 and 3) than those of the fused (stage 4). Moreover, the acceleration of growth occurred earlier in females than males regarding chronological age but not for SOS maturation stages. Conclusions The SOS maturation stages are valid and reliable maxillary skeletal maturation indicators for three-dimensional maxillary growth in both genders.

Feasibility of spheno‐occipital synchondrosis fusion stages as an indicator for the assessment of maxillomandibular growth: A mixed longitudinal study

“…In our study, we found that the RGR of maxillary length decreased in girls since SOS 4, whereas boys exhibited relatively stable growth until SOS 4, followed by significant deceleration starting from SOS 5. Al‐Gumaei et al 28 also analysed the relationship between SOS fusion and maxillary growth, suggesting that maxillary growth during the fusing SOS stage was more significant than during the open or fused status, showing a growth peak during the fusing period, partially different from our findings. However, it is worth noting that their study was cross‐sectional, and they directly compared growth increments between subsequent stages, disregarding the influence of the time span on the magnitude of growth, which may significantly affect result comparability.…”

“…However, the extended duration of fusing status made it challenging to pinpoint the growth peak accurately. Additionally, the cross‐sectional study conducted by Al‐Gumaei et al 28,29 compared SOS fusion stages with the maxillomandibular growth in three dimensions. However, it still suffered from the limitation of a wide span of SOS fusion stages, which made it difficult to precisely gauge growth dynamics.…”

“…Notably, SOS maturity also plays a pivotal role in subadult age estimations for forensic purposes 27 . Al‐Gumaei et al 28,29 further validated this hypothesis by evaluating the correlation between SOS stages and the three‐dimensional growth of the maxilla and mandible. However, their researches adopted cross‐sectional designs, encompassing wide time spans within the four‐stage SOS system, thereby limiting their clinical applicability.…”