Angelieri F, Franchi L, Cevidanes L H S, Gonçalves J R, Nieri M, Wolford L M, McNamara J A
Department of Orthodontics, Guarulhos University, Guarulhos, Brazil; Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan, USA.
Department of Orthodontics and Pediatric Dentistry, School of Dentistry, The University of Michigan, Ann Arbor, Michigan, USA; Department of Surgery and Translational Medicine, The University of Florence, Florence, Italy.
Int J Oral Maxillofac Surg. 2017 Dec;46(12):1557-1561. doi: 10.1016/j.ijom.2017.06.021. Epub 2017 Jul 14.
The aim of this study was to evaluate midpalatal suture maturation in adults, as observed in cone beam computed tomography (CBCT) images. CBCT scans from 78 subjects (64 female and 14 male, age range from 18 to 66 years) were evaluated. Midpalatal suture maturation was verified on the central cross-sectional axial slice in the superior-inferior dimension of the palate, using methods validated previously. Intra-examiner agreement was analyzed by weighted kappa test. Multinomial logistic regression was used to test whether sex and chronological age (adults <30 years or ≥30 years) could be used as a predictor for the maturational stages of the midpalatal suture. The majority of the adults presented a fused midpalatal suture in the palatine (stage D) and/or maxillary bones (stage E). However, the midpalatal suture was not fused in 12% of the subjects. Sex and chronological age were not significant predictors of the maturational stages of the midpalatal suture. The individual assessment of midpalatal suture maturation by way of CBCT images may provide reliable information critical to making the clinical decision between rapid maxillary expansion and surgically assisted rapid maxillary expansion for the treatment of maxillary atresia in adults.
本研究的目的是评估在锥形束计算机断层扫描（CBCT）图像中观察到的成人腭中缝成熟情况。对78名受试者（64名女性和14名男性，年龄范围为18至66岁）的CBCT扫描进行了评估。使用先前验证过的方法，在腭部上下维度的中央横断面轴向切片上验证腭中缝成熟情况。通过加权kappa检验分析检查者内部一致性。采用多项逻辑回归来检验性别和实足年龄（成人<30岁或≥30岁）是否可作为腭中缝成熟阶段的预测指标。大多数成年人在腭骨（D期）和/或上颌骨（E期）中呈现融合的腭中缝。然而，12%的受试者腭中缝未融合。性别和实足年龄不是腭中缝成熟阶段的显著预测指标。通过CBCT图像对腭中缝成熟情况进行个体评估，可能为成人上颌闭锁治疗中在快速上颌扩弓和手术辅助快速上颌扩弓之间做出临床决策提供关键的可靠信息。
