Assessment of midpalatal suture ossification using cone-beam computed tomography

Sina Haghanifar; Sadaf Mahmoudi; Ramin Foroughi; Arash Poorsattar Bejeh Mir; Abas Mesgarani; Ali Bijani

doi:10.19082/4035

Assessment of midpalatal suture ossification using cone-beam computed tomography

Electron Physician. 2017 Mar 25;9(3):4035-4041. doi: 10.19082/4035. eCollection 2017 Mar.

Authors

Sina Haghanifar¹, Sadaf Mahmoudi², Ramin Foroughi³, Arash Poorsattar Bejeh Mir⁴, Abas Mesgarani⁵, Ali Bijani⁶

Affiliations

¹ DDS, MS, Associate Professor, Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
² DDS, Dentist, Dental Faculty, Babol University of Medical Sciences, Babol, Iran.
³ DDS, MS, Assistant Professor, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran.
⁴ DDS, Researcher, Dental Materials Research Center, Dentistry School, Babol University of Medical Sciences, Babol, Iran.
⁵ DDS, MS, Assistant Professor, Department of Endodontics, Faculty of Dentistry, Mazandaran University of Medical Sciences, Sari, Iran.
⁶ M.D, General Practitioner, Non Communicable Pediatric Diseases Research Center, Babol University of Medical Sciences, Babol, Iran.

PMID: 28461882
PMCID: PMC5407240
DOI: 10.19082/4035

Abstract

Background and objective: The 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.

Methods: In 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.

Results: There 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).

Conclusion: Although 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.

Keywords: Cone-beam computed tomography; Maxillary expansion; Ossification; Suture.