A Roentgenographic Comparative Investigation of The Midpalatal Suture Obliteration Evidenced Through Occlusal and Cone Beam CT Radiographs

Background: Assessing the midpalatal suture (MPS) maturation is crucial to successfully predict rapid maxillary expansion.  Therefore, radiographic measurement of the suture width is vital for treatment planning. This study compared MPS ossification using cross-sectional maxillary occlusal radiographs and cone-beam computed tomography (CBCT) scans to aid clinicians in making better treatment decisions.Methods: In this study, ۳۳ patients were selected as the study cohort and were categorized into two distinct groups according to their chronological age. Group I included individuals in the growth phase, aged between ۸ to ۱۶ years, while Group II encompassed post-adolescent and young adult participants aged between ۱۶ to ۲۵ years. The percentage of MPS ossification was calculated using the suture obliteration index calculated on axial cross-sectional images. Statistical analysis was performed utilizing the student t-test with a significance level set at ۰.۰۵.Results:  No significant difference was found between occlusal radiographs and CBCT scans in the assessment of MPS ossification in the anterior part (P>۰.۰۵). However, significant differences existed in the suture obliteration index in anterior part (P=۰.۰۳۱) and posterior part (P=۰.۰۳۵), with higher mean values obtained by occlusal radiographs. In contrast, significant differences favoring CBCT were found in the anterior part (P<۰.۰۰۱) with higher mean values; no significant difference was found in the posterior part. Lastly, significant difference did not exist in the posterior part between the two imaging modalities (P>۰.۰۵).Conclusion: For MPS assessment, both CBCT and occlusal radiography can provide predictable results. However, it is notable that CBCT still has an upper hand in providing better and more accurate results.

Keywords:

Cone-beam Computed Tomography , Cranial Sutures , Hard palate , Radiography