Cone beam computed tomography evaluation of midpalatal suture maturation in adults

Angelieri, Fernanda; Franchi, Lorenzo; Cevidanes, Lúcia Helena Soares; Gonçalves, João Roberto; Nieri, Michele; Wolford, Larry M.; McNamara, James A.

doi:10.1016/j.ijom.2017.06.021

Cited by 60 publications

(62 citation statements)

References 28 publications

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“…Our findings are consistent with those of Korbmacher et al 16 who showed that the extent of interdigitation of the MPS was independent of chronological age. Similarly, Angelieri et al 23 and Haghanifar et al 24 showed that chronological age is not a statistically significant predictor of the MPS maturation stage.…”

Section: Discussionmentioning

confidence: 93%

Relationship between midpalatal suture maturation and age and maturation of cervical vertebrae: radiographic evaluation

Coşkuner

Atik

Taner

2018

Acta Odontologica Turcica

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OBJECTIVE: To evaluate the stages of midpalatal suture (MPS) maturation in patients older than 15 years, and to determine the correlation between the stage of MPS maturation and age and cervical vertebral maturation (CVM). MATERIALS AND METHOD: Cone-beam computed tomography (CBCT) scans of 50 patients (29 female and 21 male; mean age, 19.79 ± 4.09 years) were evaluated. Good quality CBCT images from 15-30-year-old patients for evaluation of impacted canines or determination of orthognathic surgery were selected. The CBCT images were evaluated at two different time intervals for determination of the stages of MPS and CVM. The stages of MPS maturation were classified as A, B, C, D, or E using the axial sections by using a method validated previously. The stages of CVM were classified using sagittal sections of the CBCT images. Intra-examiner agreement was assessed using the Kappa test. The correlations between MPS maturation and chronological age and CVM were assessed using Spearman's rank correlation analysis. RESULTS: The Kappa coefficients for intra-examiner agreement were 0.837 and 0.865 for classification of the stages of MPS maturation and CVM, respectively. No significant correlation was observed between chronological age and maturation of MPS (r = 0.212, p = 0.139) and between the stages of CVM and maturation of MPS (r = 0.030, p = 0.839). CONCLUSION: The limitation of our study was a small sample size, and, on the basis of our results, neither CVM nor chronological age could be used as a convenient tool to determine the stage of MPS maturation in 15-30-year-old patients.

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Section: Discussionmentioning

confidence: 93%

Relationship between midpalatal suture maturation and age and maturation of cervical vertebrae: radiographic evaluation

Coşkuner

Atik

Taner

2018

Acta Odontologica Turcica

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“…To classify, the evaluators used morphological parameters described in previous studies. 4,10,12 The ability to accompany the palatine anatomy and maintain equidistance from the buccal and nasal cortical bones are the main characteristics that distinguish this proposed method from the original method published. 4 To demonstrate these differences, the sagittal and axial cuts of a same patient To verify the reliability of the method used to classify the palatine suture maturation "status", all images were again evaluated by a second examiner (FG), to obtain the interexaminer error, and 42 images were again evaluated after 30 days by the first evaluator to determine intra-examiner error.…”

Section: Methodsmentioning

confidence: 99%

“…10,11 In this method cone-beam computed tomography (CBCT) scans are applied in order to classify the MPS stage of maturation, and it seems to correlate well with clinical reports. 4,[10][11][12] Nevertheless, some controversies still remain and require clarification.…”

Section: Introductionmentioning

confidence: 99%

Modification of the Maxilla Axial Cut for Tomographic Evaluation of Midpalatal Suture Maturation

et al. 2020

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Abstract This study aimed at modifying the method for obtaining an axial cut of the maxilla, considering the palatine anatomy, for evaluation of the maturation stage of the midpalatal suture (MPS) and to compare this modified method with the original one.The sample consisted of 84 cone-beam computed tomography (CBCT) scans of 40 boys and 44 girls, aged 11 to 15 years. The files were exported to the Nemotec Dental Studio program, which was used to obtain axial cuts of the maxilla so as to follow the palatine anatomy, keeping the buccal and nasal cortical bones centralized and equidistant. Two previously calibrated evaluators classified the axial images of the MPS into 5 maturational stages (A, B, C, D, and E) according to suture morphology. Kappa test was used to test intra and inter-examiner agreement and the sign test was used to compare the results of this study with those from the original method. Statistical significance level was set at 0.05%. The kappa values for intra and inter-examiner agreement were 0.88 and 0.69, respectively. The modified method was able to evaluate the MPS maturation status and could demonstrate stages of maturation in more detail than the original method. Classification of the MPS maturation with the curved suture axial cut of this method is similar to the original method, with the advantage of allowing evaluation of maturation in the midline of the palate, even when the palate was curved and/or thick. Keywords: Sutures. Maxilla. Palatal Expansion Technique. Resumo Este estudo visou modificar o método para a obtenção de um corte axial da maxila, considerando a anatomia do palato, para avaliação da maturação da sutura palatina (SPM) e para comparar este método modificado com o original. A amostra foi composta de 84 tomografias computadorizadas (TCFC) de 40 meninos e 44 meninas, com idades entre 11 a 15 anos. Os arquivos foram exportados para o programa Nemotec Dental Studio, que foi usado para obter cortes axiais da maxila de modo a acompanhar a anatomia do palato, mantendo a cortical óssea vestibular e nasal centralizada e equidistante. Dois avaliadores previamente calibrados, classificaram as imagens axiais da SPM em 5 fases de maturação (A, B, C, D, e E) de acordo com a morfologia da sutura. O Teste Kappa foi usado para testar concordância intra e inter-examinador e o teste do sinal foi utilizado para comparar os resultados deste estudo com os do método original. O nível de significância estatística foi de 0,05%. Os valores de kappa para concordância intra e inter-examinador foram 0,88 e 0,69, respectivamente. O método modificado foi capaz de avaliar o estágio de maturação da SPM e pode demonstrar estágios de maturação em mais detalhe do que o método original. A classificação da maturação da SPM com o corte axial curvo deste método é semelhante ao método original, com a vantagem de permitir a avaliação da maturação na linha média do palato, mesmo quando o palato for curvo e/ou espesso. Palavras-chave: Suturas. Maxila. Técnica de Expansão Palatina.

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“…En conclusión, la expansión rápida maxilar asistida con microimplantes podría ser una alternativa más para solucionar problemas de deficiencia transversal maxilar en especial en pacientes adultos jóvenes. sutura media palatina a través de un corte tomográfico axial para tomar una decisión clínica entre la expansión maxilar rápida y la expansión maxilar rápida asistida quirúrgicamente para el tratamiento de la atresia maxilar en adultos 3,4 . Estas investigaciones describen cinco etapas, ordenándolas en A, B, C, D y E; cada una de ellas está en relación con la resistencia que ofrece la sutura a su separación.…”

Section: Cirugía Oral Y Maxilofacialunclassified

Expansión rápida maxilar asistida con microimplantes

Aguilar-Salas

Benavides-Febres

2019

j.maxilo

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Recibido el 03 de diciembre de 2018 Aceptado el 22 de diciembre de 2018 Sr. Director: En referencia con el artículo publicado en la Revista Española de Cirugía Oral y Maxilofacial, Volumen 40, Número 1, titulado "Indicación de las distintas técnicas de expansión rápida del paladar quirúrgicamente asistida y comparativa de la estabilidad", es preciso mencionar que la expansión rápida maxilar (ERM) o disyunción maxilar es un procedimiento muy utilizado por los ortodoncistas y odontopediatras para el tratamiento de la deficiencia transversal maxilar, con limitaciones y complicaciones que no suelen ser tomadas en cuenta pero que, con los avances en tecnología y mecánica, pueden ser identificados y minimizados, además de la posibilidad de ampliar los límites de la ortodoncia tradicional.Se entiende por disyunción o ERM al procedimiento que tiene como objetivo separar la sutura media palatina. Los distintos disyuntores, llámense Hyrax, Hass o Mc Namara, cuando son aplicados en pacientes jóvenes no solo tienen efectos positivos a nivel de esta sutura palatina, sino también efectos negativos a nivel de los dientes generando expansión. Se entiende por expansión al procedimiento que mueve los dientes a través del hueso, vestibulizándolos e inclinándolos. El problema principal de este procedimiento reside en decidir hasta qué edad se puede utilizar con seguridad este tipo de disyuntores, también conocidos como híbridos (disyunción y expansión). Muchos consideran que los 15 años es el límite, pero la edad no es un indicador preciso de maduración de la sutura media palatina, ya que la maduración se presenta más tempranamente en mujeres que en varones. El segundo problema que nos muestra la investigación a través de la tomografía de haz cónico es que en los dientes de soporte de estos disyuntores, después de ser activados, se produce una pérdida de hueso alveolar en altura y espesor por efecto de la expansión dentaria 1,2 . Ante estas limitaciones, la evidencia científica sugiere que es necesario utilizar la expansión palatina rápida asistida quirúrgicamente (SARPE) con sus distintas variantes y así vencer la resistencia de la sutura palatina ya "fusionada".Ante tal situación se podría evaluar otra posibilidad. Tal como lo sugiere Angelieri, Mc Namara y otros, deberíamos establecer de manera individual el grado de maduración de la www.revistacirugiaoralymaxilofacial.es Revista Española deCirugía Oral y Maxilofacial

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Cone beam computed tomography evaluation of midpalatal suture maturation in adults

Cited by 60 publications

References 28 publications

Relationship between midpalatal suture maturation and age and maturation of cervical vertebrae: radiographic evaluation

Relationship between midpalatal suture maturation and age and maturation of cervical vertebrae: radiographic evaluation

Modification of the Maxilla Axial Cut for Tomographic Evaluation of Midpalatal Suture Maturation

Expansión rápida maxilar asistida con microimplantes

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