• Journal of Korean Dental Science
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• v.11 no.1
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• pp.1-4
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• 2018

Purpose: The aim of this study was to evaluate the ossification and maturation of the midpalatal suture in young Koreans using cone-beam computed tomography (CBCT). Materials and Methods: The study sample consisted of 40 patients with ages from 8.2 to 23.6 years who visited the Department of Orthodontics, Chung-Ang University Dental Hospital. CBCT images were taken for diagnosis. From the CBCT image, morphological stages and Hounsfield units (HU) of midpalatal suture were obtained to evaluate the midpalatal suture maturation. Spearman's correlation coefficients were calculated to analyze relationships between chronological age, morphological stage, and HU. Result: There was a wide variation in the morphology of the midpalatal suture in each age group. It showed a modest relationship between the chronological age and the degree of morphological stages. Also there was a modest relationship between the chronological age and HU. In contrast, there was a significant relationship between morphological stages and HU of midpalatal suture (P<0.01). Conclusion: CBCT images can be used for the evaluation of midpalatal suture maturation. For the estimation of the prognosis of rapid maxillary expansion, CBCT may be reliable for the assessment of the maturation of the midpalatal suture.

• The korean journal of orthodontics
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• v.11 no.2
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• pp.135-142
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• 1981

This study was performed to observe the gross reactions of surrounding maxillary sutures to the widening of midpalatal suture in the dog. Three healthy dog were chosen for the experiment. One animal was used as control, and two were used as experimental animals. Midpalatal suture was expanded total 7mm with screw for 10 days. The following results were obtained : 1. Midpalatal suture was expanded with the most width, in which anterior was be more expanded than the posterior, and shape was wedge form. 2. Interincisive suture was definitely expanded. 3. Internasal suture and interfrontal suture were slightly expanded. 4. Expansion of frontomaxillary suture, frontoparietal suture, frontonasal suture, zygomatico temporal suture, zygomatico frontal suture, zygomatico maxillary suture, occipito mastoid suture, occipito parietal suture, naso incisive suture, naso maxillary suture, and incisive maxillary suture were not observed.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.345-355
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• 2016

Objective: The purpose of this study was to determine whether predicting maturation of the midpalatal suture is possible by classifying its morphology on cone-beam computed tomography (CBCT) images and to investigate relationships with other developmental age indices. Methods: The morphology of the midpalatal suture was assessed by using CBCT images of 99 patients. Axial plane images of the midpalatal suture were classified into five stages according to the classification scheme. To make the assessment more accurate, the morphology and fusion of the midpalatal suture were additionally investigated on coronal cross-sectional planar images and volume-rendered images. Bone age was evaluated using the hand and wrist method (HWM) and cervical vertebrae method (CVM); dental age (Hellman's index), sex, and chronological age were also assessed. To evaluate relationships among variables, Spearman's rho rank test was performed along with crosstabs using contingency coefficients. Results: The HWM and CVM showed strong correlations with the maturation stage of the midpalatal suture, while other indices showed relatively weak correlations (p < 0.01). Through crosstabs, the HWM and CVM showed high association values with CBCT stage; the HWM demonstrated slightly higher values (p < 0.0001). Based on the HWM, the midpalatal suture was not fused until stage 6 in both sexes. Conclusions: Among developmental age indices, the HWM and CVM showed strong correlations and high associations, suggesting that they can be useful in assessing maturation of the midpalatal suture.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.31-41
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• 2021

The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman's correlation coefficient, ϒ_S = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒ_S = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒ_S = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

• The korean journal of orthodontics
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• v.49 no.6
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• pp.360-371
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• 2019

Objective: We sought to determine the predictors of midpalatal suture expansion by miniscrew-assisted rapid palatal expansion (MARPE) in young adults. Methods: The following variables were selected as possible predictors: chronological age, palate length and depth, midpalatal suture maturation (MPSM) stage, midpalatal suture density (MPSD) ratio, the sella-nasion (SN)-mandibular plane (MP) angle as an indicator of the vertical skeletal pattern, and the point A-nasion-point B (ANB) angle for anteroposterior skeletal classification. For 31 patients (mean age, 22.52 years) who underwent MARPE treatment, palate length and depth, MPSM stage and MPSD ratio from the initial cone-beam computed tomography images, and the SN-MP angle and ANB angle from lateral cephalograms were assessed. The midpalatal suture opening ratio was calculated from the midpalatal suture opening width measured in periapical radiographs and the MARPE screw expansion. Statistical analyses of correlations were performed for the entire patient group of 31 subjects and subgroups categorized by sex, vertical skeletal pattern, and anteroposterior skeletal classification. Results: In the entire patient group, the midpalatal suture opening ratio showed statistically significant negative correlations with age, palate length, and MPSM stage (r = -0.506, -0.494, and -0.746, respectively, all p < 0.01). In subgroup analyses, a strong negative correlation was observed with the palate depth in the skeletal Class II subgroup (r = -0.900, p < 0.05). Conclusions: The findings of this study indicated that age, palate length, and MPSM stage can be predictors of midpalatal suture expansion by MARPE in young adults.

• The korean journal of orthodontics
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• v.11 no.2
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• pp.161-168
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• 1981

This study was undertaken to observe the histologic changes of surrounding maxillary sutures to the widening of midpalatal suture, using two adult dogs, weighing about 10 kg, for experimental, and one for control group. After widening of the midpalatal suture with expansion screw for ten days was performed, and followed by sacrifice of experimental animals. Tissues were excised from 5 surrounding maxillary suture portions such as, internasal, interfrontal, midsagittal, zygomatrco-temporal, and midpalatal sutures. After that, the specimens were fixed and decalcified in $10\%$ formalin sol. and $5\%$ nitric acid. Embedding in paraffin and serial sections at a thickness of 5 micron was done, After Hematoxylin-Eosin staining and light microscopic examination, Following results were obtained: 1. In midpalatal suture area, which showed most prominent histologic change, High degree of fibronlastic and osteoblastic proliferation lining the bony trabeculae with osteoid tissue projection into the fibrous connective tissue were observed. 2. In interfrontal suture area, moderate degree of fibroblastic and osteoblastic proliferation was observed. 3. In internasal suture area, active osteoblastic and osteoclastic proliferation lining the bony trabeculae was observed, and separation of fibrous connective tissue was also observed. 4. In midsagittal and zygomatico-temporal suture areas, no histologic changes can be observed.

• The korean journal of orthodontics
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• v.46 no.5
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• pp.323-330
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• 2016

Objective: The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. Methods: The study included 131 subjects aged over 18 years of age (range 18.1-53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. Results: The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (-0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. Conclusions: There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation.

• The korean journal of orthodontics
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• v.12 no.2
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• pp.109-117
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• 1982

The author has observed the gross reactions of surrounding maxillary sutures to the widening of midpalatal suture in comparison of young dog with adult dog. Experimental animals used was two young dog and two adult dog with normal palate. After midpalatal suture was seperated with rapid palatal expansion device, experimental animals were sacrificed to observe the surrounding maxillary sutures. The following results were obtained. 1. In adult dog, nasoincisive suture was not expanded, while in young dog it was expanded. 2. In adult dog, pterygopalatine suture was hardly expanded, while in young dog it was expanded definitely. 3. In adult dog, frontomaxillary suture was not expanded, while in young dog it was expanded unilaterally. 4. In adult dog, palatoethmoidal suture was not expanded, while in young dog it was expanded unilateraily.

• The korean journal of orthodontics
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• v.34 no.1 s.102
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• pp.63-70
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• 2004

The midpalatal suture area has some advantages for supporting miniscrews : it has no specific anatomical structure, it is composed of thick cortical bone, and covered with attached gingiva. So it is suitable area for inserting miniscrews. However, the midpalatal suture area appears thinner when seen in ceph. As a result, Clinicians can misunderstand that inserting miniscrews cause the problem, both the risk of perforation and the decrease of stability. The purpose of this article is measuring the vertical bone thickness of the midpalatal suture area for inserting miniscrews. The total of 25patient (male : 13, female : 12), who are in their twenties, were taken CT. The vertical bone thickness of the midpalatal suture area was measures from the transverse section of CT. As a result, We reached a conclusion from the differences of each area. It is as follows: 1. There is no significant difference between the thickness of male group and that of female group. 2. In coronal section, Bone thickness becomes thinner from the midpalatal suture to Left & Right side, in sagittal section, Bone thickness becomes thinner from incisive foramen to PNS. 3. The area that is within 3mm of left and right from the midpalatal suture area transversely and within 25mm backward from the incisive foramen sagittaly is enough for inserting miniscrews.

• The korean journal of orthodontics
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• v.47 no.6
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• pp.384-393
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• 2017

Fusion of teeth is a developmental anomaly. It occurs at the stage of tooth formation, which determines the shape and size of the tooth crown, when one or more teeth fuse at the dentin level during the morphodifferentiation of the dental germs. Such teeth show macrodontia and may cause crowding, as well as esthetic and endodontic problems. In this article, we report a rare case of a maxillary central incisor fused to a supernumerary tooth showing labial and palatal talon cusps, which was orthodontically moved across the midpalatal suture. A 13-year-old Caucasian boy sought treatment for the unesthetic appearance of his maxillary central incisor and anterior crowding. He was rehabilitated successfully via a multidisciplinary approach involving orthodontic, nonsurgical endodontic, periodontal, and prosthodontic treatments. After a 26-month treatment period, the patient's macroesthetics and microesthetics were improved. The overall improvement of this macrodontic tooth and its surrounding tissues through multidisciplinary treatment was documented using cone-beam computed tomography.