Measurement of the midpalatal suture width

Fricke-Zech, Susanne; Gruber, Rudolf; Dullin, Christian; Zapf, Antonia; Kramer, Franz‐Josef; Kubein-Meesenburg, Dietmar; Hahn, Wolfram

doi:10.2319/040311-238.1

Cited by 29 publications

(16 citation statements)

References 44 publications

(54 reference statements)

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“…In addition, these results are consistent with those reported by Reveolo et al, who showed that, although there is a significant relationship between completion of growth and initiation of ossification of the midpalatal suture, there are wide variations between the individuals in the ossification process (29). In a study by Fricke-Zech et al, it was reported that morphologic changes in suture are wide in different individuals and are not related to age only (13). In the present study, evaluation of the suture morphology did not reveal any significant differences between males and females, which is consistent with the results of a study by Revelo et al on 84 subjects (39 males and 45 females) with an age range of 8 to 18 years (29).…”

Section: Discussionmentioning

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%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Assessment of midpalatal suture ossification using cone-beam computed tomography

Haghanifar¹,

Mahmoudi²,

Foroughi³

et al. 2017

Electron physician

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show abstract

“…[ 1 ] It is presumed that palatal halves will eventually interdigitated to that degree that even heavy forces driven by hyrax will be of no benefit, nevertheless, surgical separation of maxillary vault from midline, so called surgically assisted RPE (SARPE) is the current possible option. [ 2 ] The latter is currently performed beyond the age of 19–20, when palatal shelves could be no more separated by in-office forces and appliances. [ 2 ]…”

Section: Introductionmentioning

confidence: 99%

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

Mir¹,

Mir²,

Mir³

et al. 2016

Indian J Dent

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The premise of complete ossification of midpalatal suture in early adulthood still has its popularity, though conflicting data are emerging in the literature. A 49-year-old male and a 54-year-old female Iranian patient, both dentulous, were referred to a Maxillofacial Radiology Center to be evaluated for implant insertion. In cone-beam computed tomography (CBCT) evaluation, an in-ossified suture was found in anterior two-third of midpalatal region of both individuals. The application of clinical vignettes from CBCT findings for maxillofacial orthodontic and orthopedic purposes is of value. Existing cases of successful nonsurgical rapid palatal expansion of maxilla in adults could surrogate this dogma about timing for ossification of midpalatal suture which is considered as a purely chronologic-related phenomenon and transmitted masticatory forces may be one possible cause (functional hypothesis).

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“…The thickness of the cortical bone was modeled according to a study by Farnsworth et al20; the thickness of the periodontal ligament was 0.2 mm21; and the width of the maxillofacial sutures was 0.5 mm 22. The mechanical properties of the cortical bone, cancellous bone, tooth, mini-plates, mini-screws, stainless steel (SS) wires, periodontal ligament, and sutures in the 3D finite element model were prepared in accordance with those described in previous investigations (Table 1).…”

Section: Methodsmentioning

confidence: 99%

Displacement and stress distribution of the maxillofacial complex during maxillary protraction using palatal plates: A three-dimensional finite element analysis

et al. 2018

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ObjectiveThe purpose of this study was to analyze initial displacement and stress distribution of the maxillofacial complex during dentoskeletal maxillary protraction with various appliance designs placed on the palatal region by using three-dimensional finite element analysis.MethodsSix models of maxillary protraction were developed: conventional facemask (Type A), facemask with dentoskeletal hybrid anchorage (Type B), facemask with a palatal plate (Type C), intraoral traction using a Class III palatal plate (Type D), facemask with a palatal plate combined with rapid maxillary expansion (RME; Type E), and Class III palatal plate intraoral traction with RME (Type F). In Types A, B, C, and D, maxillary protraction alone was performed, whereas in Types E and F, transverse expansion was performed simultaneously with maxillary protraction.ResultsType C displayed the greatest amount of anterior dentoskeletal displacement in the sagittal plane. Types A and B resulted in similar amounts of anterior displacement of all the maxillofacial landmarks. Type D showed little movement, but Type E with expansion and the palatal plate displayed a larger range of movement of the maxillofacial landmarks in all directions.ConclusionsThe palatal plate served as an effective skeletal anchor for use with the facemask in maxillary protraction. In contrast, the intraoral use of Class III palatal plates showed minimal skeletal and dental effects in maxillary protraction. In addition, palatal expansion with the protraction force showed minimal effect on the forward movement of the maxillary complex.

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Measurement of the midpalatal suture width

Cited by 29 publications

References 44 publications

Assessment of midpalatal suture ossification using cone-beam computed tomography

Assessment of midpalatal suture ossification using cone-beam computed tomography

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

Displacement and stress distribution of the maxillofacial complex during maxillary protraction using palatal plates: A three-dimensional finite element analysis

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