Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion
Midpalatal suture maturation: Classification method for individual assessment before rapid maxillary expansion
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DOI：
10.1016/j.ajodo.2013.04.022
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发表时间：
2013-11-01
影响因子：
3
通讯作者：
McNamara, James A., Jr.
中科院分区：
文献类型：
--
作者：
Angelieri, Fernanda;Cevidanes, Lucia H. S.;McNamara, James A., Jr.
简介：在这项研究中，我们提出了一种新的分类方法，个别评估腭中缝形态。研究方法：对140名受试者（年龄5.6-58.4岁）的锥形束计算机断层扫描图像进行检查，以确定腭中缝成熟的放射学分期。腭中缝的发育可分为5个阶段：A阶段，高密度的直缝，没有或只有很少的交错，B阶段，高密度缝呈扇形，C阶段，两条平行的扇形高密度缝相互靠近，在某些区域被小的低密度间隙隔开，B阶段，高密度缝呈平行的扇形，C阶段，高密度缝呈平行的扇形。D期，在腭骨中完成融合，没有缝合的证据; E期，在上颌骨中向前融合。通过加权kappa检验评估检查者内和检查者间的一致性。结果如下：A期和B期通常在13岁以下观察到，而C期主要在11至17岁观察到，但偶尔在较年轻和较年长的年龄组中观察到。只有女孩在11岁后完成了腭中缝的腭（D期）和上颌（E期）区域的融合。从14岁到17岁，13名男孩中有3名（23%）仅在腭骨中显示融合（D期）。结论：这种新的分类方法有可能避免快速上颌扩张失败或不必要的手术辅助快速上颌扩张晚期青少年和年轻人的副作用。
Introduction: In this study, we present a novel classification method for individual assessment of midpalatal suture morphology. Methods: Cone-beam computed tomography images from 140 subjects (ages, 5.6-58.4 years) were examined to define the radiographic stages of midpalatal suture maturation. Five stages of maturation of the midpalatal suture were identified and defined: stage A, straight high-density sutural line, with no or little interdigitation; stage B, scalloped appearance of the high-density sutural line; stage C, 2 parallel, scalloped, high-density lines that were close to each other, separated in some areas by small low-density spaces; stage D, fusion completed in the palatine bone, with no evidence of a suture; and stage E, fusion anteriorly in the maxilla. Intraexaminer and interexaminer agreements were evaluated by weighted kappa tests. Results: Stages A and B typically were observed up to 13 years of age, whereas stage C was noted primarily from 11 to 17 years but occasionally in younger and older age groups. Fusion of the palatine (stage D) and maxillary (stage E) regions of the midpalatal suture was completed after 11 years only in girls. From 14 to 17 years, 3 of 13 (23%) boys showed fusion only in the palatine bone (stage D). Conclusions: This new classification method has the potential to avoid the side effects of rapid maxillary expansion failure or unnecessary surgically assisted rapid maxillary expansion for late adolescents and young adults.