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Allam A, Ahmed B, Ab Rahman N. Why does maxillary skeletal expansion work with some adults and fail with Others?: A narrative review. Saudi Dent J 2024; 36:984-989. [PMID: 39035558 PMCID: PMC11255948 DOI: 10.1016/j.sdentj.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 07/23/2024] Open
Abstract
Maxillary skeletal expansion is considered a challenging treatment modality in adult ages. Mini-screw-assisted rapid palatal expansion (MARPE) is considered a pioneer in providing a solution for maxillary deficiency in adults away from any surgical interventions. If we consider patient cooperation and motivation, together with operator skills, as constant factors during MARPE, and exclude all hygiene and soft tissue complications that jeopardise the appliance's stability, there is a percentage of expansion failure recorded in different studies with no emphasis on what makes mid-facial diastema appear in some, rather than others. Electronic databases including PubMed, Scopus, Google Scholar, and Web of Science, were searched for literature published in English till 2023. Failure was related in some literature to different criteria, as of yet, no verifiable indicators would allow us to determine success or failure in advance. This review highlighted the most common reasons for failure discussed in different literature: Chronological Age, Mid-palatal suture maturation, Bone density, Sex, Race, Appliance design, and Expansion technique used. This study could be considered an attempt to make candidate selection for non-surgical maxillary skeletal expansion at this old age easier, time-saving, and cost less.
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Affiliation(s)
- Amira Allam
- School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
- Teaching Assistant at King Salman International University (KSIU), Tur Sinai, Egypt
| | - Basaruddin Ahmed
- Biostatistics and Dental Public Health Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
| | - Norma Ab Rahman
- Orthodontic Unit, School of Dental Sciences, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia
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Hoang TH, Nguyen KCT, Kaipatur NR, Alexiou M, La TG, Lagravère Vich MO, Major PW, Punithakumar K, Lou EH, Le LH. Ultrasonic mapping of midpalatal suture - An ex-vivo study. J Dent 2024; 145:105024. [PMID: 38670332 DOI: 10.1016/j.jdent.2024.105024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 04/05/2024] [Accepted: 04/24/2024] [Indexed: 04/28/2024] Open
Abstract
OBJECTIVE Rapid maxillary expansion is a common orthodontic procedure to correct maxillary constriction. Assessing the midpalatal suture (MPS) expansion plays a crucial role in treatment planning to determine its effectiveness. The objectives of this preliminary investigation are to demonstrate a proof of concept that the palatal bone underlying the rugae can be clearly imaged by ultrasound (US) and the reconstructed axial view of the US image accurately maps the MPS patency. METHODS An ex-vivo US scanning was conducted on the upper jawbones of two piglet's carcasses before and after the creation of bone defects, which simulated the suture opening. The planar images were processed to enhance bone intensity distribution before being orderly stacked to fuse into a volume. Graph-cut segmentation was applied to delineate the palatal bone to generate a bone volume. The accuracy of the reconstructed bone volume and the suture opening was validated by the micro-computed tomography (µCT) data used as the ground truth and compared with cone beam computed tomography (CBCT) data as the clinical standard. Also included in the comparison is the rugae thickness. Correlation and Bland-Altman plots were used to test the agreement between the two methods: US versus µCT/CBCT. RESULTS The reconstruction of the US palatal bone volumes was accurate based on surface topography comparison with a mean error of 0.19 mm for pre-defect and 0.15 mm and 0.09 mm for post-defect models of the two samples, respectively when compared with µCT volumes. A strong correlation (R2 ≥ 0.99) in measuring MPS expansion was found between US and µCT/CBCT with MADs of less than 0.05 mm, 0.11 mm and 0.23 mm for US, µCT and CBCT, respectively. CONCLUSIONS It was possible to axially image the MPS opening and rugae thickness accurately using high-frequency ultrasound. CLINICAL SIGNIFICANCE This study introduces an ionizing radiation-free, low-cost, and portable technique to accurately image a difficult part of oral cavity anatomy. The advantages of conceivable visualization could promise a successful clinical examination of MPS to support the predictable treatment outcome of maxillary transverse deficiency.
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Affiliation(s)
- Trang H Hoang
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | - Kim-Cuong T Nguyen
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | | | - Maria Alexiou
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Thanh-Giang La
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada
| | | | - Paul W Major
- School of Dentistry, University of Alberta, Edmonton, AB, Canada
| | | | - Edmond H Lou
- Department of Electrical and Computing Engineering, University of Alberta, Edmonton, AB, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada
| | - Lawrence H Le
- Department of Radiology and Diagnostic Imaging, University of Alberta, Edmonton, AB, Canada; School of Dentistry, University of Alberta, Edmonton, AB, Canada; Department of Biomedical Engineering, University of Alberta, Edmonton, AB, Canada; Department of Physics, University of Alberta, Edmonton, AB, Canada.
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Çoban Büyükbayraktar Z, Eninanç İ. Assessment of mandibular trabecular structure and cervical vertebral maturation using fractal analysis. Technol Health Care 2024; 32:1211-1221. [PMID: 38043029 DOI: 10.3233/thc-231100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
BACKGROUND Changes in bone trabeculae occur during skeletal maturation. Fractal analysis is a technique for assessing changes in the internal structure of the bone. OBJECTIVE The aim of this study was to investigate correlation of bone trabeculation measured on panoramic and lateral cephalometric radiographs with cervical vertebral maturation stages (CVMS). METHODS CVMS was evaluated on lateral cephalometric radiographs of 120 individuals aged 6 to 18 years. The subjects were divided into 6 groups (n= 20 each) according to CVMS. On panoramic and lateral cephalometric radiographs, fractal dimension (FD) analyses were performed in mandibular corpus, gonial and condylar regions and cervical vertebral bodies (C2, C3, C4). RESULTS FD measurements from the mandibular corpus region bilaterally and C2-C4 vertebral bodies showed significant positive correlations with CVMS (r= 0.418, r= 0.412, r= 0.324, r= 0.304, r= 0.263, respectively). Significant differences were found in the FD values of the right/left mandibular corpus and C2 and C3 vertebrae compared to CVMS (P< 0.001, P< 0.001, P= 0.005, P= 0.019, respectively). CONCLUSION Significant positive moderate correlations between the FD values of the right and left mandibular corpus and CVMS suggest that fractal analysis may be useful in determining skeletal maturity stage. The significant FD values obtained from the right/left mandibular corpus, and C2 and C3 vertebra indicate that the complexity of the internal trabecular structure increases with maturation.
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Affiliation(s)
| | - İlknur Eninanç
- Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Sivas Cumhuriyet University, Sivas, Turkey
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Liu H, Feng L, Wang L. Diagnostic value of cervical vertebral maturation stages for midpalatal suture maturation assessment: a study in the Chinese population. BMC Oral Health 2023; 23:504. [PMID: 37474915 PMCID: PMC10360312 DOI: 10.1186/s12903-023-03220-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023] Open
Abstract
PURPOSE To evaluate the correlation between cervical vertebral maturation stages (CVMS) and midpalatal suture maturation stages (MPSMS), and to analyze the diagnostic value of CVMS for the assessment of MPSMS. METHODS Cone beam computed tomography (CBCT) images of 233 subjects (8-20 years) were selected. The CVMS was determined using the McNamara and Franchi method, while the MPSMS was evaluated using the Angelieri method. Spearman rank correlation was used to analyze the results, and positive likelihood ratios were calculated to evaluate the diagnostic value of CVMS in identifying MPSMS. RESULTS Spearman rank correlation results showed a strong positive correlation (r = 0.867, P < 0.001) between CVMS and MPSMS. The positive likelihood ratios of CS12, CS4, and CS56 for the identification of stages AB, C, and DE were 12.17, 7.64, and 7.79, respectively. The values of the positive likelihood ratios of the other groups were less than five. CONCLUSION CS12 of the CVMS can be used as a reliable indicator for the assessment of MPSMS stage AB. From CVMS stage 4 forward, midpalatal suture maturation should be evaluated using CBCT.
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Affiliation(s)
- Henglang Liu
- Department of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32# W. Sec 2, 1st Ring Rd., Chengdu, Sichuan Province, 610072, China
| | - Linjing Feng
- Chengdu Stomatological Hospital, No.17 Chunxi Road South, Chengdu, Sichuan Province, 610000, China
| | - Lili Wang
- Department of Stomatology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, 32# W. Sec 2, 1st Ring Rd., Chengdu, Sichuan Province, 610072, China.
- School of Medicine, University of electronic science and technology of china, No.4, Section 2, North Jianshe Road, Chengdu, 610054, China.
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Shayani A, Sandoval Vidal P, Garay Carrasco I, Merino Gerlach M. Midpalatal Suture Maturation Method for the Assessment of Maturation before Maxillary Expansion: A Systematic Review. Diagnostics (Basel) 2022; 12:diagnostics12112774. [PMID: 36428834 PMCID: PMC9689184 DOI: 10.3390/diagnostics12112774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 10/25/2022] [Accepted: 10/27/2022] [Indexed: 11/15/2022] Open
Abstract
Assessment of midpalatal suture maturation is crucial before deciding which type of maxillary expansion technique will be performed to treat transverse discrepancies. In 2013, Angelieri et al. proposed a new method to evaluate midpalatal maturation using cone-beam computed tomography. The aim of this study was to systematically identify, evaluate, and provide a synthesis of the existing literature about this new method and to rigorously assess the methodological quality of these articles. A bibliographic search was carried out using PubMed, Cochrane Library, SciELO, LILACS, Web of Science, and Scopus using the terms midpalatal suture, cranial sutures, palate, maturation, interdigitation, ossification, maxillary expansion, evaluation, assessment, and assess. Quality assessment was performed using the Observational Cohort and Cross-Sectional Studies tool developed by the National Heart, Lung, and Blood Institute. Hence, 56 articles were obtained, of which only 10 met the selection criteria. We could not include any of the data into an analysis because of the large variation of the data collected and high methodological heterogeneity found among studies. Of all the studies included, 10% had poor quality, 70% fair, and 20% good quality, respectively. Even though age and sex play a role in midpalatal suture obliteration, there is a poor correlation between these variables. Thus, every patient should be assessed individually before choosing the best protocol for maxillary expansion. The midpalatal suture maturation method has the potential to be used for diagnostic purposes, but clinicians should be cautious of routinely using it because an extensive training and calibration program should be performed prior.
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Affiliation(s)
- Anis Shayani
- Master Program in Dental Science, Faculty of Dentistry, Universidad de la Frontera, Temuco 4780000, Chile
- School of Dentistry, Faculty of Medicine, Universidad Austral de Chile, Valdivia 5090000, Chile
| | - Paulo Sandoval Vidal
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
- Correspondence:
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Gao L, Chen Z, Zang L, Sun Z, Wang Q, Yu G. Midpalatal Suture CBCT Image Quantitive Characteristics Analysis Based on Machine Learning Algorithm Construction and Optimization. Bioengineering (Basel) 2022; 9:bioengineering9070316. [PMID: 35877367 PMCID: PMC9311955 DOI: 10.3390/bioengineering9070316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/20/2022] [Accepted: 07/01/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Midpalatal suture maturation and ossification status is the basis for appraising maxillary transverse developmental status. Methods: We established a midpalatal suture cone-beam computed tomography (CBCT) normalized database of the growth population, including 1006 CBCT files from 690 participants younger than 24 years old. The midpalatal suture region of interest (ROI) labeling was completed by two experienced clinical experts. The CBCT image fusion algorithm and image texture feature analysis algorithm were constructed and optimized. The age range prediction convolutional neural network (CNN) was conducted and tested. Results: The midpalatal suture fusion images contain complete semantic information for appraising midpalatal suture maturation and ossification status during the fast growth and development period. Correlation and homogeneity are the two texture features with the strongest relevance to chronological age. The overall performance of the age range prediction CNN model is satisfactory, especially in the 4 to 10 years range and the 17 to 23 years range, while for the 13 to 14 years range, the model performance is compromised. Conclusions: The image fusion algorithm can help show the overall perspective of the midpalatal suture in one fused image effectively. Furthermore, clinical decisions for maxillary transverse deficiency should be appraised by midpalatal suture image features directly rather than by age, especially in the 13 to 14 years range.
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Affiliation(s)
- Lu Gao
- Department of Stomatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
| | - Zhiyu Chen
- School of Software Engineering, North University of China, Taiyuan 030051, China;
| | - Lin Zang
- Pharmacovigilance Research Center for Information Technology and Data Science, Cross-Strait Tsinghua Research Institute, Xiamen 361000, China;
| | - Zhipeng Sun
- National Engineering Laboratory for Digital and Material Technology of Stomatology, Beijing Key Laboratory of Digital Stomatology, Department of Oral and Maxillofacial Radiology, Peking University School and Hospital of Stomatology, Beijing 100081, China;
| | - Qing Wang
- Pharmacovigilance Research Center for Information Technology and Data Science, Cross-Strait Tsinghua Research Institute, Xiamen 361000, China;
- Department of Automation, Tsinghua University, Beijing 100084, China
- Correspondence: (Q.W.); (G.Y.)
| | - Guoxia Yu
- Department of Stomatology, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China;
- National Clinical Research Center for Respiratory Diseases, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing 100045, China
- Correspondence: (Q.W.); (G.Y.)
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Gao L, Sun J, Zhou X, Yu G. In vivo methods for evaluating human midpalatal suture maturation and ossification: An updated review. Int Orthod 2022; 20:100634. [DOI: 10.1016/j.ortho.2022.100634] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 03/15/2022] [Accepted: 03/15/2022] [Indexed: 11/28/2022]
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A CBCT Evaluation of Midpalatal Bone Density in Various Skeletal Patterns. SENSORS 2021; 21:s21237812. [PMID: 34883821 PMCID: PMC8659514 DOI: 10.3390/s21237812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 11/17/2021] [Accepted: 11/19/2021] [Indexed: 11/18/2022]
Abstract
The purpose of this study was to evaluate midpalatal bone density (BD) by using cone-beam computed tomography (CBCT) according to gender, age, and vertical and horizontal skeletal patterns. CBCT images from 126 subjects (64 females and 62 males) were reoriented and analyzed in order to attain BD values at the midpalatal suture. Four age groups were used for classification (adolescence, 10 ≤ early < 14 years, 14 ≤ middle ≤ 17 years, and 17 < late ≤ 21 years; adult > 21 years). Vertical skeletal pattern categories were differentiated by the Frankfort horizontal line to mandibular plane angle (hypodivergent < 22°, 22° ≤ normovergent ≤ 28°, and 28° < hyperdivergent). Horizontal skeletal pattern differentiation was defined by ANB angle (Class III < 0°, 0° ≤ Class I ≤ 4°, and 4° < Class II). Females showed significantly higher BD than males (p < 0.001). As age increased, BD increased significantly (p < 0.001). There were no significant differences between vertical skeletal patterns. Class II showed significantly less BD than Class III (p < 0.05). With this information, clinicians can better understand BD trends of the midpalatal suture and, thus, better understand our patient’s anatomy and potential hurdles in successful treatment.
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Midpalatal suture density ratio after rapid maxillary expansion evaluated by cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 161:238-247. [PMID: 34563427 DOI: 10.1016/j.ajodo.2020.07.040] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 07/01/2020] [Accepted: 07/01/2020] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Identifying the stage of midpalatal suture (MPS) fusion is essential for rapid maxillary expansion (RME). The objective of this study was to evaluate the relationship between MPS density ratio and the skeletal response after RME using cone-beam computed tomography (CBCT). METHODS CBCT scans of 64 patients (age, 13.81 ± 1.68 years; 42 females and 22 males) who underwent RME as part of comprehensive orthodontic treatment were used for this study. Two CBCT records were made at T1 (pre-RME) and T2 (post-RME). MPS density was assessed by gray scale and the skeletal effects through linear measurements: greater palatine foramina, the width of the nasal cavity (NW), infraorbital foramina. The data were collected at 4 different times: baseline, 24 hours, 48 hours, and 4 weeks. RESULTS There was no statistically significant correlation between MPS density ratio and greater palatine foramina or infraorbital foramina. Negative correlations with MPS density ratio are presented with the difference of age post-RME and pre-RME (r = -0.46, P = 0.033) in males, and NW (r = -0.41, P = 0.007) in females. A significant association between gender and the MPS density ratio was found (P = 0.015) in females. CONCLUSIONS There is a weak negative correlation between the MPS density ratio and the difference of age post-RME and pre-RME in males and the NW in females. Females presented greater density ratios than males. MPS density ratio through CBCT does not appear to be an adequate parameter to predict the skeletal effect in adolescent patients and young adults.
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Oliveira RDS, de Oliveira CJM, Panzarella FK, Cintra Junqueira JL. Maturation stages of the sutures in the median palatine evaluated with cone-beam computed tomography. Am J Orthod Dentofacial Orthop 2021; 160:567-572. [PMID: 34274199 DOI: 10.1016/j.ajodo.2020.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 04/01/2020] [Accepted: 05/01/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION This study aimed to evaluate the influence of age, sex, and facial growth patterns on the maturation stage of midpalatal sutures. METHODS We selected 90 total skull cone-beam computed tomography scans and divided them into the following 3 groups: brachyfacial (n = 30), mesofacial (n = 30), and dolichofacial (n = 30). These groups were determined using Ricketts VERT 3-dimensional cephalometric analysis. All patients were aged ≥18 years and were divided into those aged ≥30 years and >30 years. The maturational stage of the median palatine sutures was determined by evaluating the central transverse axial dimension in the maxillary-mandibular palate. Maturational stages were classified as A, B, C, D, and E. RESULTS Of the 90 images reviewed, 55 (61.1%) were female patients, and 35 were male patients (38.9%). The age of patients ranged from 18 to 59 years, with 55 patients aged <30 years (61.1%) and 35 aged ≥30 years (38.9%). Regarding the maturational stages, 3.3% of brachyfacial, 6.7% of mesiofacial, and 16.7% of dolichofacial subjects (P = 0.032) were classified as stages B and C. CONCLUSIONS The patients' facial patterns were found to be a significant signal for the maturation stage of midpalatal sutures. Adult dolichofacial patients are the most likely to have stage B and C.
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Affiliation(s)
- Rudyard Dos Santos Oliveira
- Department of Dentistry, Postgraduate Program in Orthodontics, São Leopoldo Mandic Institute and Research Center, Campinas, São Paulo, Brazil.
| | | | - Francine Kühl Panzarella
- Department of Dentistry, Postgraduate Program in Imaging and Oral Radiology, São Leopoldo Mandic College, Campinas, São Paulo, Brazil
| | - José Luiz Cintra Junqueira
- Department of Dentistry, Postgraduate Program in Imaging and Oral Radiology, São Leopoldo Mandic College, Campinas, São Paulo, Brazil
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Evaluation of the Relationship Between Midpalatal Suture Maturation Indicators as Predictors for Surgically-Assisted and Conventional Rapid Maxillary Expansion. J Craniofac Surg 2021; 32:678-681. [PMID: 33705008 DOI: 10.1097/scs.0000000000007323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Rapid maxillary expansion (RME) is an effective orthopedic procedure to correct maxillary transversal deficiency in young patients. In cases of sutural closure, surgically assisted RME is used to reduce the resistance to sutural disjunction. Foundation of a diagnostic relationship between maturation indices and the expected skeletal response to expansion can enable clinicians to identify the need for surgically assisted RME prospectively. The primary aim of this study was to assess the correlation between the amount of achieved skeletal expansion with midpalatal suture density on computed tomography images, and the secondary aim was to assess the correlation between the amount of achieved skeletal expansion with the recently suggested midpalatal suture maturation indicators: cervical vertebral maturation (CVS), midpalatal suture maturation stage (MPSM) and midpalatal suture density ratio. Forty Digital Imaging and Communications in Medicine data from the archived computed tomography scans of 20 patients (mean age: 15.55 years) before RME (T1) and after 3-month retention period (T2) were analyzed. The tested maturity indicators did not show statistically significant correlation between the skeletal effect proportions. However, clinically and radiologically effective RME was seen in MPSMs A, B, and C and also cervical vertebra stages CVS5 and CVS6. More research is needed to determine a diagnostic predictor for the skeletal effects of maxillary expansion treatment modalities.
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Association of the mid-palatal suture morphology to the age and to its density: A CBCT retrospective comparative observational study. Int Orthod 2021; 19:235-242. [PMID: 33785290 DOI: 10.1016/j.ortho.2021.03.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 03/08/2021] [Accepted: 03/09/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE The twofold aim of the present investigation was to: 1. evaluate the degree of mid-palatal suture (MPS) maturation via CBCT in relation to patient age, and 2. to determine whether there was a correlation between quantitative (i.e., suture density) and qualitative (i.e., suture morphology) analysis. MATERIALS AND METHODS The stage of mid-palatal suture maturation and suture density ratio were assessed for 160 subjects on CBCTs using five qualitative stages proposed by Angelieri with the addition of three additional stages (i.e., B/C, C/D and D/E) and quantitative grey density scores of Grünheid MPS1,2,3,4 with the addition of parasutural bone and soft palate. The repeatability of both methods was evaluated using Cohen's K.The relationship between midpalatal suture maturation and age was assessed using ANOVA and Classification and Regression Trees (CART) analysis and tabulation and a χ2 test for quantitative and qualitative analysis respectively. Statistical significance was assessed using a 5% threshold. RESULTS The final sample included 160 CBCTs (80 male,80 female; mean age 23.2±13.5). Both methods were found to be correlated and highly repeatable. In addiction they showed an age-related correlation in MPS morphology. CONCLUSION The mid-palatal suture density ratio and the stage of mid-palatal suture maturation has the potential to become useful in clinical practice. In fact, despite the correlation between MPS maturation stage and age, the latter parameter cannot be used as a clinical discriminator due to the great variability between subjects. It is therefore advisable to assess each patient individually on CBCT scans in order to determine treatment choices.
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Caplin J, Han MD, Miloro M, Allareddy V, Markiewicz MR. Interceptive Dentofacial Orthopedics (Growth Modification). Oral Maxillofac Surg Clin North Am 2019; 32:39-51. [PMID: 31699583 DOI: 10.1016/j.coms.2019.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Although all dentofacial deformities involve deviation of skeletal and dental units that require correction, the timing and method of treatment can vary considerably. Growth is a key consideration when managing dentofacial deformities, because it has a direct impact on the timing and method of management. Some deformities may be intercepted and managed during growth, whereas others can only be definitively managed after cessation of growth. This article focuses on clinical considerations of growth in managing dentofacial deformities, and discusses methods of growth evaluation and interceptive orthodontic management strategies in different types of dentofacial deformities.
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Affiliation(s)
- Jennifer Caplin
- Department of Orthodontics, University of Illinois at Chicago, 801 South Paulina Street, M/C 841, Chicago, IL 60612, USA.
| | - Michael D Han
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, 801 South Paulina Street, M/C 835, Chicago, IL 60612, USA
| | - Michael Miloro
- Department of Oral and Maxillofacial Surgery, University of Illinois at Chicago, 801 South Paulina Street, M/C 835, Chicago, IL 60612, USA
| | - Veerasathpurush Allareddy
- Department of Orthodontics, University of Illinois at Chicago, 801 South Paulina Street, M/C 841, Chicago, IL 60612, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, 112 Squire Hall, Buffalo, NY 14214, USA
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Sayar G, Kılınç DD. Rapid maxillary expansion outcomes according to midpalatal suture maturation levels. Prog Orthod 2019; 20:27. [PMID: 31304569 PMCID: PMC6626764 DOI: 10.1186/s40510-019-0278-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 05/23/2019] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND This study aims to compare the relationship between skeletal and dental outcomes of rapid maxillary expansion (RME) treatment on cone beam computed tomography (CBCT) images between pre-pubertal peak (pre-peak) and post-pubertal peak (post-peak) patients. The null hypothesis was that there was no difference in the outcomes of RME treatment between the groups. METHODS Thirty-two patients who underwent RME treatment were classified according to midpalatal suture maturation levels and then divided into two groups as pre-peak and post-peak. Skeletal and dental measurements were performed on the CBCT images at T0 (pre-treatment stage) and at T1 (post-treatment stage). Paired sample t test was used to evaluate normally distributed data and P < 0.05 was taken as the significance level. RESULTS There were significant differences between T0 and T1 within the groups, but the changes between the pre-peak and post-peak patient groups were not statistically significant. CONCLUSION Non-significant changes were found between the two groups, and the null hypothesis was excepted.
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Affiliation(s)
- Gülşilay Sayar
- Department of Orthodontics, School of Dentistry, Istanbul Medipol University, Atatürk Bulvarı No: 27, 34083, Unkapanı-Fatih/Istanbul, Turkey.
| | - Delal Dara Kılınç
- Department of Orthodontics, School of Dental Medicine, Bahçeşehir University, Istanbul, Turkey
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