1
|
Gonca M, Sert MF, Gunacar DN, Kose TE, Beser B. Determination of growth and developmental stages in hand-wrist radiographs : Can fractal analysis in combination with artificial intelligence be used? J Orofac Orthop 2024; 85:1-15. [PMID: 38252312 DOI: 10.1007/s00056-023-00510-1] [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: 06/03/2023] [Accepted: 12/01/2023] [Indexed: 01/23/2024]
Abstract
PURPOSE The goal of this work was to assess the classification of maturation stage using artificial intelligence (AI) classifiers. METHODS Hand-wrist radiographs (HWRs) from 1067 individuals aged between 7 and 18 years were included. Fifteen regions of interest were selected for fractal dimension (FD) analysis. Five predictive models with different inputs were created (model 1: only FD; model 2: FD and Chapman sesamoid stage; model 3: FD, age, and sex; model 4: FD, Chapman sesamoid stage, age, and sex; model 5: Chapman sesamoid stage, age, and sex). The target diagnoses were accelerating growth velocity, very high growth velocity, and decreasing growth velocity. Four AI algorithms were applied: multilayer perceptron (MLP), support vector machine (SVM), gradient boosting machine (GBM) and C 5.0 decision tree classifier. RESULTS All AI algorithms except for C 5.0 yielded similar overall predictive accuracies for the five models. In order from lowest to highest, the predictive accuracies of the models were as follows: model 1 < model 3 < model 2 < model 5 < model 4. The highest overall F1 score, which was used instead of accuracy especially for models with unbalanced data, was obtained for models 1, 2, and 3 based on SVM, for model 4 based on MLP, and for model 5 based on C 5.0. Adding Chapman sesamoid stage, chronologic age, and sex as additional inputs to the FD values significantly increased the F1 score. CONCLUSION Applying FD analysis to HWRs is not sufficient to predict maturation stage in growing patients but can be considered a growth rate prediction method if combined with the Chapman sesamoid stage, age, and sex.
Collapse
Affiliation(s)
- Merve Gonca
- Faculty of Dentistry, Department of Orthodontics, Recep Tayyip Erdoğan University, Menderes Boulevard No 612, 53020, Rize, Turkey.
| | - Mehmet Fatih Sert
- Department of Business Administration (Quantitative Methods), Gaziantep University, Gaziantep, Turkey
| | - Dilara Nil Gunacar
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Taha Emre Kose
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Recep Tayyip Erdoğan University, Rize, Turkey
| | - Busra Beser
- Faculty of Dentistry, Department of Orthodontics, Recep Tayyip Erdoğan University, Menderes Boulevard No 612, 53020, Rize, Turkey
| |
Collapse
|
2
|
Ferrillo M, Daly K, Pandis N, Fleming PS. The effect of vertical skeletal proportions, skeletal maturation, and age on midpalatal suture maturation: a CBCT-based study. Prog Orthod 2024; 25:4. [PMID: 38311670 PMCID: PMC10838892 DOI: 10.1186/s40510-023-00504-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Midpalatal suture (MPS) maturation may be influenced by a range of parameters including age, gender, and vertical skeletal pattern. We therefore aimed to evaluate the effect of Frankfurt-mandibular angle (FMA), skeletal maturation, and age on the timing of MPS maturation. METHODS In this cross-sectional study, cone-beam computed tomography (CBCT) and lateral cephalograms were used to assess the MPS and cervical vertebral maturation (CVM) stage. A proportional odds logistic regression model was used to assess associations between age adjusted for gender and MPS maturation, and a regression analysis was performed to analyze the effect of vertical pattern on these associations. RESULTS A total of 201 patients (84 male and 117 female) with a mean age of 13.48 (SD 1.94) were included. With increasing age, the odds of belonging to a higher maturation stage increased (OR: 2.14; 95% CI 1.789; 2.567; P < 0.001); however, no association between FMA and MPS maturation was observed (OR: 1.01; 95% CI 0.964; 1.051; P = 0.76). A strong correlation between MPS maturation and CVM stage was not reported. Males had a higher probability of belonging to a lower MPS maturation stage (OR: 0.24; 95% CI 0.136; 0.415; P < 0.001). CONCLUSIONS Based on this cross-sectional analysis, midpalatal sutural maturation classification is associated with chronological age and occurs later in males. Neither CVM staging nor variation in vertical skeletal proportions were useful predictors of midpalatal maturation stage.
Collapse
Affiliation(s)
- Martina Ferrillo
- Dentistry Unit, Department of Health Sciences, University of Catanzaro "Magna Graecia", Catanzaro, Italy
- Dublin Dental University Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | | | - Nikolaos Pandis
- Department of Orthodontics and Dentofacial Orthopedics, Dental School, Medical Faculty, University of Bern, Bern, Switzerland
| | - Padhraig S Fleming
- Dublin Dental University Hospital, Trinity College Dublin, The University of Dublin, Dublin, Ireland.
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Ramirez-Diaz RE, Watanabe Kanno GA. [Skeletal maturation of the hand and wrist and ossification of the mid palate suture in adolescents: a literature review]. REVISTA CIENTÍFICA ODONTOLÓGICA 2023; 11:e167. [PMID: 38287998 PMCID: PMC10809972 DOI: 10.21142/2523-2754-1103-2023-167] [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: 07/03/2023] [Accepted: 09/05/2023] [Indexed: 01/31/2024] Open
Abstract
Introduction The evaluation of skeletal age is an important factor in orthodontic planning to anticipate changes in growth, with the analysis of hand and wrist radiographs showing the degree of bone and facial growth potential. The objective was to evaluate the relationship between skeletal maturation of the hand and wrist and ossification of the midpalatal suture (MPS) in adolescents. Materials and methods A search was carried out in four databases such as Pubmed, Scopus, Science Direct and Embase were reviewed until December 13, 2022. The included studies were descriptive and comparative articles on the skeletal maturation of the hand and wrist and ossification of the midpalatal suture of patients aged 7 to 18 years. Two researchers carefully selected the articles evaluated and analyzed the different key topics related to the topic. Results Four articles were included in this study; According to the studies, it was found that the greater the degree of bone maturation there is an increase in the approximation of the SMP, especially in late stages, with high and positive correlations; Furthermore, there were greater evaluation results with the Fishman analysis method as opposed to the Hagg and Taranger and Björk methods. The critical limit stages in SMI7-9, a greater approach to the closure of SMP compatible with stage D-E was found. The completion of maturation in women occurs up to 2 years earlier than in men. Conclusions Diagnostic evaluation methods using carpal analysis can be used for predictive evaluations of the maturation stage of SMP; However, the results were not absolute in all cases so they cannot be generalized.
Collapse
Affiliation(s)
- Ruth Elizabeth Ramirez-Diaz
- . Division of Orthodontic, School of Dentistry, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Division of Orthodontic School of Dentistry Universidad Científica del Sur Lima Peru
| | - Gustavo Adolfo Watanabe Kanno
- . Division of Orthodontic, School of Dentistry, Universidad Científica del Sur. Lima, Perú. , Universidad Científica del Sur Division of Orthodontic School of Dentistry Universidad Científica del Sur Lima Peru
| |
Collapse
|
5
|
Shayani A, Merino-Gerlach MA, Garay-Carrasco IA, Navarro-Cáceres PE, Sandoval-Vidal HP. Midpalatal Suture Maturation Stage in 10- to 25-Year-Olds Using Cone-Beam Computed Tomography-A Cross-Sectional Study. Diagnostics (Basel) 2023; 13:diagnostics13081449. [PMID: 37189552 DOI: 10.3390/diagnostics13081449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/01/2023] [Accepted: 02/03/2023] [Indexed: 05/17/2023] Open
Abstract
In this study, we aimed to evaluate the frequency of midpalatal maturational stages in a Chilean urban sample of adolescents, post-adolescents and young adults, associated with chronological age and sex, by assessing CBCT scan images. Tomographic images in axial sections of the midpalatal sutures from 116 adolescents and young adults (61 females and 55 males, 10-25 years old) were classified according to their morphologic characteristics in five maturational stages (A, B, C, D and E), as proposed by Angelieri et al. The sample was divided into three groups: adolescents, post-adolescents and young adults. Three previously calibrated examiners (radiologist, orthodontist and general dentist) analyzed and classified the images. Stages A, B and C were considered to be an open midpalatal suture, and D and E were considered to be a partially or totally closed midpalatal suture. The most frequent stage of maturation was D (37.9%), followed by C (24%) and E (19.6%). The possibility of finding closed midpalatal sutures in individuals of 10 to 15 years was 58.4%, and in subjects aged 16 to 20 and 21 to 25 years, it was 51.7% and 61.7%, respectively. In males, Stages D and E were present in 45.4%; for females, this prevalence was 68.8%. Individual assessment of the midpalatal suture in each patient is of crucial importance before making the clinical decision of which is the best maxillary expansion method. Due to the extensive calibration and training required, it is advisable to always request a report from a radiologist. Individual evaluation with 3D imaging is recommended because of the great variability observed in the ossification of midpalatal sutures in adolescents, post-adolescents and young adults.
Collapse
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
| | | | | | - Pablo Eliseo Navarro-Cáceres
- Centro de Investigación en Ciencias Odontológicas (CICO), Departamento de Odontología Integral de Adultos, Facultad de Odontología, Universidad de La Frontera, Temuco 4780000, Chile
- Universidad Autónoma de Chile, Temuco 4780000, Chile
| | - Héctor Paulo Sandoval-Vidal
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, Universidad de La Frontera, Temuco 4780000, Chile
| |
Collapse
|
6
|
Correlation between cervical vertebrae maturation and midpalatal suture fusion in patients aged between 10 and 20 years: A cross-sectional and 3D study. Int Orthod 2022; 20:100659. [DOI: 10.1016/j.ortho.2022.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 05/27/2022] [Accepted: 05/27/2022] [Indexed: 11/15/2022]
|
7
|
Solano Mendoza P, Aceytuno Poch P, Solano Reina E, Solano Mendoza B. Skeletal, Dentoalveolar and Dental Changes after "Mini-Screw Assisted Rapid Palatal Expansion" Evaluated with Cone Beam Computed Tomography. J Clin Med 2022; 11:jcm11164652. [PMID: 36012886 PMCID: PMC9410327 DOI: 10.3390/jcm11164652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 07/28/2022] [Accepted: 07/29/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to evaluate skeletal, dentoalveolar and dental changes after Mini-screw Assisted Rapid Palatal Expansion (MARPE) using tooth bone-borne expanders in adolescent patients after analyzing different craniofacial references by Cone beam computed tomography (CBCT) and digital model analysis. This prospective, non-controlled intervention study was conducted on fifteen subjects (mean age 17 ± 4 years) with transversal maxillary deficiency. Pre (T1) and post-expansion (T2) CBCTs and casts were taken to evaluate changes at the premolars and first molar areas. To compare means between two times, paired samples t- or Wilcoxon test were used following criteria. Significant skeletal changes were found after treatment for Nasal width and Maxillary width with means of 2.1 (1.1) mm and 2.5 (1.6) mm (p < 0.00005). Midpalatal suture showed a tendency of parallel suture opening in the axial and coronal view. For dentoalveolar changes, a significant but small buccal bone thickness (BBT) reduction was observed in all teeth with a mean reduction of 0.3 mm for the right and left sides, especially for the distobuccal root of the first molar on the left side (DBBTL1M) [IC95%: (−0.6; −0.2); p = 0.001] with 0.4 (0.4) mm. However, a significant augmentation was observed for the palatal bone thickness (PBT) on the left side. The buccal alveolar crest (BACL) and dental inclination (DI) showed no significant changes after treatment in all the evaluated teeth. MARPE using tooth bone-borne appliances can achieve successful skeletal transverse maxillary expansion in adolescent patients, observing small dentoalveolar changes as buccal bone thickness (BBT) reduction, which was not clinically detectable. Most maxillary expansions derived from skeletal expansion, keeping the alveolar bone almost intact with minor buccal dental tipping.
Collapse
|
8
|
Age dependence of the maturation of the midpalatal suture in the stability of orthodontic anchoring screws. Am J Orthod Dentofacial Orthop 2022; 161:809-819. [DOI: 10.1016/j.ajodo.2021.01.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 01/01/2021] [Accepted: 01/01/2021] [Indexed: 11/22/2022]
|
9
|
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.
Collapse
|
10
|
Christovam IO, Lisboa CDO, Vilani GNL, Brandão RCB, Visconti MAPG, Mattos CT, Ruellas ACDO. Tomographic analysis of midpalatal suture prior to rapid maxillary expansion. Dental Press J Orthod 2021; 26:e2119300. [PMID: 34231834 PMCID: PMC8279114 DOI: 10.1590/2177-6709.26.3.e2119300.oar] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 03/04/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION In Orthodontics and Facial Orthopedics, the timing of treatment onset may be critical and individual analysis should be applied to promote a favorable treatment planning. In this study, individual analysis of midpalatal suture (MS) and palatal measurements were performed in teenagers and young adult patients treated with rapid maxillary expansion (RME). DESCRIPTION Twenty-six patients submitted to RME with a tooth-supported appliance (Hyrax) were evaluated. The inclusion criteria were: minimum age of 14 years, presenting all posterior teeth, diagnosed with transverse maxillary discrepancy, and with a clinical indication for maxillary expansion. The pretreatment CBCT scans of these patients were assessed to obtain the stages of MS maturation (MSM); density ratio (MSD); and palatal length, thickness (anterior, intermediate and posterior) and sagittal area. RESULTS The maturation stages present were C, D or E; the density ranged from 0.6 to 1, and lower density (MSD < 0.75) and higher density (MSD ≥ 0.75) groups were determined. Individuals with higher MSD presented smaller sagittal area, compared to the lower density group. Individuals in D and E MSM stages presented smaller sagittal area and intermediate thickness, compared to stage C. CONCLUSIONS Smaller palatal sagittal area was observed in the high MSD groups and in the stages D and E of MSM.
Collapse
Affiliation(s)
- Ilana Oliveira Christovam
- Universidade Federal do Rio de Janeiro, Faculdade de Odontologia, Departamento de Ortodontia (Rio de Janeiro/RJ, Brazil)
| | | | | | | | | | - Claudia Trindade Mattos
- Universidade Federal Fluminense, Faculdade de Odontologia, Departamento de Ortodontia (Niterói/RJ,Brazil)
| | | |
Collapse
|
11
|
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.
Collapse
|
12
|
Chávez-Sevillano MG, Tenorio Estrada J, Blanco-Victorio DJ, Lagravère Vich MO, Abdo Quintão CC, Palomino-Gómez SP. Evaluation of the suture ossification level according to age and sex in children, adolescents, and adults. A cross-sectional and observational 3D study. Int Orthod 2021; 19:67-75. [PMID: 33531276 DOI: 10.1016/j.ortho.2020.12.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 12/07/2020] [Accepted: 12/13/2020] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the ossification level of the midpalatal suture (MPS) in children, adolescents and adults from a Peruvian sample; according to the method proposed by Angelieri et al. with cone-beam computed tomographies (CBCTs). MATERIAL AND METHODS The sample consisted of 315 CBCTs of 168 females and 147 males. The total sample was divided into 3 groups according to age and sex: children (n=77), adolescents (n=113) and adults (n=125). The images were mainly assessed in the axial plane using the Real Scan 2.0 software. The different periods of ossification of the MPS at the level of the vertical half of the palate was defined according to the five stages of Angieleri method (from A to E). The Student t-Test, Chi-square test, Kruskal-Wallis test and Spearman's Rho test were applied. RESULTS Chi2 test results showed that the stages of MPS ossification depended on the age of the patient by age ranges (P<0.005). Multiple comparison tests affirmed that male and female subjects in the children group had fewer ossification stages than the adolescent and adult groups (P<0.001). Meanwhile, there were no statistically significant differences between the two older age groups. Finally, there was a moderate positive correlation between the stages of ossification of the MPS and the age in the male group (Rho=0.511). CONCLUSIONS The onset of MPS ossification was significantly related to subjects up to 12 years of age and more frequently in stages B and C in both sexes. There was no difference in MPS ossification in adolescents and adult subjects.
Collapse
|
13
|
Mahdian A, Safi Y, Dalaie K, Kavousinejad S, Behnaz M. Correlation assessment of cervical vertebrae maturation stage and mid-palatal suture maturation in an Iranian population. J World Fed Orthod 2020; 9:112-116. [PMID: 32800572 DOI: 10.1016/j.ejwf.2020.05.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 05/12/2020] [Accepted: 05/13/2020] [Indexed: 11/19/2022]
Abstract
AIM The aim of the current study was to evaluate the correlation of skeletal age based on cervical vertebrae maturation (CVM) stage and mid-palatal suture (MPS) maturation in an Iranian population. MATERIAL AND METHODS This was a cross-sectional analytic study. A total number of 93 samples were included. Samples were taken from patients who were in CS3 to CS6 stages of CVM who had cone-beam computed tomography and lateral cephalometry based on inclusion criteria. The maturation of MPS was assessed based on the cone-beam computed tomography images. In the classification of maturation of MPS, there are five stages (A-E) and the suture fusion occurs in stage D. In stage E, the suture is fused completely. The CVM stage (CS1-6) was also assessed based on the lateral cephalograms. Data were analyzed using Spearman correlation with a significance level of 0.05. RESULTS A total of 51 female individuals with a mean age of 14.98 ± 4.806 and 42 male individuals with a mean age of 15.79 ± 5.135 participated in this study. The correlation coefficient between the CVM stage and MPS maturation was 0.691 in female and 0.754 in male individuals (P < 0.001). Stage D was correlated with CS4. CONCLUSION The results demonstrated that CVM stages had a significant but moderate positive correlation with the maturation of MPS. Until CS3, the MPS has not been fused and in CS6 the MPS is fused definitely.
Collapse
Affiliation(s)
- Arezoo Mahdian
- Assistant Professor, Orthodontic Research Center, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Yaser Safi
- Associate Professor, Oral and Maxillofacial Radiology Department, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kazem Dalaie
- Assistant Professor, Department of Orthodontics, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shahab Kavousinejad
- Postgraduate Student, Department of Orthodontics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Behnaz
- Dental Research Center, Research Institute of Dental Research, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
14
|
Jimenez-Valdivia LM, Malpartida-Carrillo V, Rodríguez-Cárdenas YA, Dias-Da Silveira HL, Arriola-Guillén LE. Midpalatal suture maturation stage assessment in adolescents and young adults using cone-beam computed tomography. Prog Orthod 2019; 20:38. [PMID: 31591660 PMCID: PMC6779683 DOI: 10.1186/s40510-019-0291-z] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 09/11/2019] [Indexed: 11/17/2022] Open
Abstract
Background The aim of this study was to evaluate the midpalatal suture maturation stages in adolescents and young adults using cone-beam computed tomography (CBCT). Methods The sample comprised 200 CBCT scans of individuals aged 10 to 25 years old (95 males and 105 females) divided into three groups, adolescents (n = 48), post-adolescents (n = 52), and young adults (n = 100). The Planmeca ProMax 3D software was used for the midpalatal suture maturation stage evaluation according to Angieleri’s method, using cross-sectional axial slice. Two previously calibrated examiners analyzed the images and classified according to five different maturation stages. A, B, and C stages were considered with open midpalatal suture, and D and E were considered without open midpalatal suture. Association tests were performed using chi-square test also, and a binary logistic regression was evaluated (P < 0.05). Results The possibility to find open midpalatal suture in individuals of 10 to 15 years old was 70.8%, in subject aged 16 to 20 and 21 to 25 years old was 21.2% and 17%, respectively. Furthermore, this possibility in individuals older than 16 years was greater in males than in females. Conclusions The possibility to find open midpalatal suture in post-adolescents and young adults is greater than the orthodontists considered years ago. Furthermore, men are more likely to find midpalatal suture opening. These implications might be considered by the orthodontists when maxillary expansion is required. Besides, the ossification of the middle palatal suture is very variable, and therefore, the use of CBCT might be recommended to clarify this possibility.
Collapse
Affiliation(s)
| | | | | | | | - Luis Ernesto Arriola-Guillén
- Division of Orthodontics and Division of Oral and Maxillofacial Radiology, School of Dentistry, Universidad Científica del Sur, Lima, Peru.
| |
Collapse
|
15
|
Barbosa NMV, Castro ACD, Conti F, Capelozza-Filho L, Almeida-Pedrin RRD, Cardoso MDA. Reliability and reproducibility of the method of assessment of midpalatal suture maturation: A tomographic study. Angle Orthod 2018; 89:71-77. [PMID: 30230376 DOI: 10.2319/121317-859.1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES To assess reliability and reproducibility of the individual assessment of midpalatal suture maturation in computed tomography among orthodontists and radiologists for potential diagnosis application. MATERIALS AND METHODS Sixty axial slices from cone-beam computed tomography and multi-slice CT scans of patients aged between 11 and 21 years old (33 females and 27 males) were selected. For the investigation of reliability and reproducibility of the method, two groups of examiners were established. The first group consisted of 11 orthodontists and the second consisted of 10 radiologists. Each group examined the images and performed individual assessment of the midpalatal suture maturation method twice within an interval of 21 days. During the first and second analyses, the sequence of images was randomized to reduce potential bias. Weighted Cohen's kappa was performed to assess inter- and intra-examiners' agreement. The percentage of perfect agreement and the number of stages apart for each disagreement were calculated. The significance level was P < .05. RESULTS The overall inter-examiner agreement was satisfactory in the first (kappaw: 0.37) and the second (kappaw: 0.34) analyses. Intra-examiner agreement outcomes were similar between orthodontists (kappaw: 0.44) and radiologists (kappaw: 0.41). The percentage of perfect agreement was 43.2%. CONCLUSIONS The method for individual assessment of midpalatal suture maturation revealed potential reliability and reproducibility. However, the agreement rate observed in the present study was not high enough for a method designed for routine clinical applications.
Collapse
|
16
|
Ngan P, Nguyen UK, Nguyen T, Tremont T, Martin C. Skeletal, Dentoalveolar, and Periodontal Changes of Skeletally Matured Patients with Maxillary Deficiency Treated with Microimplant-assisted Rapid Palatal Expansion Appliances: A Pilot Study. APOS TRENDS IN ORTHODONTICS 2018. [DOI: 10.4103/apos.apos_27_18] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction
Microimplant-assisted rapid palatal expansion (MARPE) has recently been offered to adult patients for correcting maxillary transverse deficiency. However, there is limited information in the literature on the success of this appliance and its skeletal and dental effects on skeletally matured patients. The purpose of this study was to investigate the immediate skeletal, dentoalveolar, and periodontal response to MARPE appliance using cone-beam computed tomography in a skeletally matured patient as assessed by the cervical vertebral maturation method.
Materials and Methods
Eight consecutively treated patients (2 females, 6 males; mean age of 21.9 ± 1.5 years) treated with a maxillary skeletal expander were included in the study. Measurements were taken before and after expansion to determine the amount of midpalatal suture opening, upper facial bony expansion, alveolar bone bending, dental tipping, and buccal bone thickness (BBT). Data were analyzed using a one-way ANOVA and matched-pair t-test (α = 0.05).
Results
Midpalatal suture separation was found in 100% of the patients with no dislodged microimplants. Total maxillary expansion was attributed to 41% skeletal, 12% alveolar bone bending, and 48% dental tipping. Pattern of midpalatal suture opening was found to be parallel in both the coronal and axial planes. On average, the absolute dental tipping ranged from 4.17° to 4.96° and the BBT was reduced by an average of 39% measured at the premolars and molars.
Conclusions
The MARPE appliance can be a clinically acceptable, nonsurgical treatment option for correcting mild to moderate maxillary transverse discrepancies for skeletally matured adult patients with a healthy periodontium.
Collapse
Affiliation(s)
- Peter Ngan
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, WV, USA
| | | | - Tung Nguyen
- Department of Orthodontics, University of North Carolina School of Dentistry, Chapel Hill, North Carolina, USA
| | - Timothy Tremont
- Department of Orthodontics, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Chris Martin
- Department of Orthodontics, West Virginia University School of Dentistry, Morgantown, WV, USA
| |
Collapse
|
17
|
Lim HM, Park YC, Lee KJ, Kim KH, Choi YJ. Stability of dental, alveolar, and skeletal changes after miniscrew-assisted rapid palatal expansion. Korean J Orthod 2017; 47:313-322. [PMID: 28861393 PMCID: PMC5548712 DOI: 10.4041/kjod.2017.47.5.313] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 04/02/2017] [Accepted: 04/24/2017] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Miniscrew-assisted rapid palatal expansion (MARPE) is a means for expanding the basal bone without surgical intervention in young adults. Here, we assessed the differences in dental, alveolar, and skeletal measurements taken before (T0), immediately after (T1), and 1 year after (T2) MARPE. METHODS Twenty-four patients (mean age, 21.6 years) who had undergone MARPE and cone-beam computed tomography at T0, T1, and T2 were included. Changes in the following parameters were compared using paired t-tests: intercusp, interapex, alveolar, nasal floor, and nasal cavity widths; inclination of the first molar (M1) and its alveolus; and thickness and height of the alveolar bone. A linear mixed-effects model was used to determine variables that affected periodontal changes in the M1. RESULTS MARPE produced significant increases in most measurements during T0-T2, despite relapse of some measurements during T1-T2. The alveolar thickness decreased on the buccal side, but increased on the palatal side. The alveolar crest level at the first premolar moved apically. Changes in the thickness and height of the alveolar bone were affected by the corresponding initial values. CONCLUSIONS MARPE can be used as an effective tool for correcting maxillomandibular transverse discrepancy, showing stable outcomes 1 year after expansion.
Collapse
Affiliation(s)
- Hyun-Mook Lim
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Young-Chel Park
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kee-Joon Lee
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Kyung-Ho Kim
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| | - Yoon Jeong Choi
- Department of Orthodontics, Institute of Craniofacial Deformity, College of Dentistry, Yonsei University, Seoul, Korea
| |
Collapse
|