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Advisory Committee Chair

Nada Souccar

Advisory Committee Members

William Harrell

Amjad Javed

Chung H Kau

Document Type

Thesis

Date of Award

2021

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Rapid palatal expansion (RPE) is a gold standard treatment for posterior unilateral and bilateral crossbites or limited buccal overjet in patients with constricted maxilla. Midpalatal suture fusion is a limitation for obtaining the skeletal results and avoiding dental side effects. It is generally believed that midpalatal suture interlock increases significantly after the pubertal growth spurt. However, in the literature there are reported cases of successful midpalatal suture split in older adults. Individual cone-beam computed tomography (CBCT) assessment of midpalatal suture maturation was proposed by Angelieri et al. Since RPE treatment approach is commonly used it is important to understand the possibility of finding non-fused suture in older patients.Objective: To determine the prevalence of midpalatal suture maturation stages in patients 16-35 years old and within the age subgroups and to compare the midpalatal suture maturation stages between male and female in corresponding age subgroups. Methods: For this cross-sectional study 232 CBCT scans of adult male and female patients aged between 16 and 35 years old were evaluated. These patients had CBCT taken as a part of their pre-orthodontic records. Patients excluded from this study had a history of previous orthodontic treatment that included any palatal expansion or maxillary surgery, patients with syndromes, patients with cleft lip and/or palate, patients with systemic disease or medications affecting bone metabolism, maxillofacial trauma, presence of noise or blurry images on CBCT scans. The CBCTs that fulfill the criteria will be divided into subgroups based on two criteria, their sex (female, male) and age (16-20, 21-25, 26-30, 31-35). Patients were also classified according to their growth pattern to normodivergent, hypodivergent and hypedivergent subgroups. Results: The prevalence of stage C was the highest and accounted for 44.8%. The prevalence of stage E was 28.9%. The prevalence stage D was 24.6%. The prevalence of stage B was 1.7%. None of the evaluated sample had stage A. There is a correlation (p = 0.03) between midpalatal suture maturation and the age group. There is no significant difference between males and females group. There is a trend that in hypodivergent samples, midpalatal suture matures faster. Conclusions: In samples aged 16-25, the majority of the samples have a non-fused midpalatal suture. In samples aged 26-35, the majority of the samples have a fused midpalatal suture. Hypodivergent samples’ midpalatal sutures tend to mature faster than normodivergent and hyperdivergent groups.

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