Relationship between maturation indices and morphology of the midpalatal suture obtained using cone-beam computed tomography images

Abstract

ObjectiveThe purpose of this study was to determine whether predicting maturation of the midpalatal suture is possible by classifying its morphology on cone-beam computed tomography (CBCT) images and to investigate relationships with other developmental age indices.MethodsThe morphology of the midpalatal suture was assessed by using CBCT images of 99 patients. Axial plane images of the midpalatal suture were classified into five stages according to the classification scheme. To make the assessment more accurate, the morphology and fusion of the midpalatal suture were additionally investigated on coronal cross-sectional planar images and volume-rendered images. Bone age was evaluated using the hand and wrist method (HWM) and cervical vertebrae method (CVM); dental age (Hellman's index), sex, and chronological age were also assessed. To evaluate relationships among variables, Spearman's rho rank test was performed along with crosstabs using contingency coefficients.ResultsThe HWM and CVM showed strong correlations with the maturation stage of the midpalatal suture, while other indices showed relatively weak correlations (p < 0.01). Through crosstabs, the HWM and CVM showed high association values with CBCT stage; the HWM demonstrated slightly higher values (p < 0.0001). Based on the HWM, the midpalatal suture was not fused until stage 6 in both sexes.ConclusionsAmong developmental age indices, the HWM and CVM showed strong correlations and high associations, suggesting that they can be useful in assessing maturation of the midpalatal suture.

Reliability and reproducibility of the method of assessment of midpalatal suture maturation: A tomographic study

“…This was not an aim of the present study because the method was previously validated in the literature. 3,26 Specifically, the individual assessment of midpalatal suture maturation was compared with hand-wrist and cervical vertebrae maturation and showed strong statistical association.…”

Retrospective Evaluation of Skeletal, Dentoalveolar, and Periodontal Changes of Microimplant Assisted Rapid Palatal Expansion (MARPE) In Skeletally Matured Patients

“…This means that the CVM method may be used to speculate on the maturation of the midpalatal suture according to its morphology and is a more useful index than either chronological or dental age. 58 Maxillary transverse growth spurt and growth completion, has been shown to follow distance and velocity curves similar to those for body height by implant studies. 10,19 The maturation of the cervical vertebrae, as assessed by the CVM method, has been considered a reliable biological indicator for skeletal maturity.…”

“…Existing studies have discussed treatment outcomes of MARPE in samples described by their chronological age without information on their skeletal or midpalatal suture maturation. It is generally known that chronological age is not a precise index in predicting skeletal maturation 58 and there is tremendous variability in the developmental stages of the midpalatal suture relative to chronological age. 7 While some authors noted fusion of the median palatal suture between ages 15 to 19 years old 19,78,89 , others reported a lack of fusion in this suture at age 32, 89 54, 62 and 71 63 .…”

“…Histological data suggested that patients who show an advanced stage of skeletal maturation at the midpalatal suture may have difficulty undergoing conventional maxillary expansion due to synostoses and numerous bony bridge formations across the suture. 11,78 In a recent investigation by Jang 58 et al, they found that the Cervical Vertebral Maturation (CVM) method have strong correlations and high associations with the maturation stage of the midpalatal suture on CBCT images. This means that the CVM method may be used to speculate on the maturation of the midpalatal suture according to its morphology and is a more useful index than either chronological or dental age.…”

“…Generally, it is known that chronological age is not a precise index in predicting skeletal maturation 58 and there is tremendous variability in the developmental stages of the midpalatal suture relative to chronological age. 7 Skeletal maturity may be assessed by the Cervical Vertebral Maturation (CVM) method, which have been shown to be able to detect the greatest mandibular and craniofacial growth increments.…”