Evaluation of Midpalatal Suture Maturation using Cone-Beam Computed Tomography in Children and Adolescents

Abstract

This study aimed to analyze the association of midpalatal suture (MPS) maturation stages with skeletal maturation and age and to obtain references for establishing a treatment plan for rapid maxillary expansion (RME). Cone-Beam Computed Tomography (CBCT) images from 480 children (240 boys, 240 girls) aged 7-15 years were obtained. MPS maturation stages and cervical vertebral maturation indicator (CVMI) were evaluated, and the correlations between MPS maturation stages, CVMI, and age were determined using the Spearman's correlation test. The positive likelihood ratio (LHR) of CVMI for MPS maturation stages was calculated. MPS maturation stages and CVMI showed a strong correlation. Especially, CVMI 1-3 showed positive LHR greater than 10 for the diagnosis of stages A-C. MPS maturation stages and age were correlated strongly in girls and moderately in boys. Conventional RME produces the most favorable skeletal effect at CVMI 1-3 or those up to 12 years of age and fewer skeletal effects at CVMI 4 or at 13 years of age in girls and 13-15 years in boys. It is recommended to evaluate MPS maturation stages using CBCT before RME application at CVMI 5, 6 or at 14, 15 years of age in girls.

Evaluation of the Midpalatal Suture and its Correlation with the Cervical Vertebral Maturation Stages and Second Molar Mineralization Stages: A CBCT Study

“…Spearman correlation analysis showed a highly significant and positive correlation between MPS stage and CVM stage advocating that improvement (increase or decrease) in one may be directly associated with improvement (increase or decrease) in other. These findings were consistent with the findings of study done by Angelieri et al, 5 Jang et al, 20 and Lee et al 21…”

“…These findings were supported by the findings of the studies performed by Valdiva et al 14 and Tonello et al 19 Spearman correlation analysis showed a highly significant and positive correlation between MPS stage and CVM stage advocating that improvement (increase or decrease) in one may be directly associated with improvement (increase or decrease) in other. These findings were consistent with the findings of study done by Angelieri et al, 5 Jang et al, 20 and Lee et al 21 Highest sensitivity was found in pre-pubertal stages such as cervical vertebral maturation stage 1 and 2 for diagnosing MPS A and B, respectively. Skeletal maturity stages such as CVM stages 1, 2, and 3 had the likelihood ratio of more than 10, for MPS stage A, MPS stage B, and MPS stage C, respectively.…”

Midpalatal Suture Maturation Stage in 10- to 25-Year-Olds Using Cone-Beam Computed Tomography—A Cross-Sectional Study

“…Formerly, chronological age had traditionally guided the clinical decision between traditional RME and SARME, but it has been proven in literature that this is an unreliable indicator for determining the maturation status of MPS [ 1 , 6 , 12 , 48 ]. This assertion can be supported by the present study, leading to a paradigm shift in the treatment of maxillary constriction.…”

“…Skeletal expansion is the widening of the maxilla by opening the midpalatal suture, whereas dentoalveolar expansion involves dental tipping and bending of the alveolar process. RME is aimed at maximizing the skeletal effect and reducing dentoalveolar effect, which may be accompanied by side effects, such as loss of the periodontal attachment level, fenestration of the buccal cortical bone, root resorption and palatal tissue necrosis [ 12 , 13 , 14 , 15 , 16 , 17 , 18 ].…”

Assessment of Midpalatal Suture Maturation by Skeletal Maturity on Hand Wrist Radiographs

“…Recent studies have been conducted on relationships between the midpalatal suture maturation and skeletal development and reported that the maturation of the midpalatal suture is closely related to skeletal development [5][6][7][8]. These studies also have determined considerable variability in the chronologic age for ossification of the midpalatal suture [5,9].…”