Assessment of the correlation between midpalatal suture maturation stages and palatal thickness in cone-beam computed tomography scans
Palate; Cone-Beam Computed Tomography; Palatal Expansion Technique
Introduction: Maturation of the midpalatal suture seems to be influenced by intrinsic factors, such as age and sex. However, there is a lack of knowledge whether the palatal thickness might influence the sutural maturation process. Objective: To correlate the stages of maturation of the midpalatal suture (MPS) with the thickness of the palate using cone-beam computed tomography (CBCT) scans. Material and methods: A total of 145 CBCT scans of maxilla of individuals of both sexes, aged between 15 and 40 years, will be equally divided into five age groups: 15-20 years, 21-25 years, 26-30 years, 31-35 years and 36-40 years. The RadiAnt DICOM Viewer® software will be used to assess the SPM maturation stage and palate thickness. The stage of maturation of the SPM can be classified as A, B, C, D or E based on the observation of the axial sections of the maxilla on the CBCT. The thickness of the palate will be measured in the sagittal plane at 2 mm intervals from the most posterior margin of the incisive canal towards the posterior nasal spine up to 34 mm. At each of these sites, the thickness will be measured perpendicular to the bone surface, from the outer edge of the palatine cortical bone to the outer edge of the cortical bone of the incisive canal or the floor of the nasal cavity. The anterior region of the palate will be represented by the sites from 0 to 10 mm; the intermediate region, from 12 to 22 mm; and the posterior region, from 24 to 34 mm. The intra-examiner and inter-examiner agreement for the maturation of the midpalatal suture will be assessed using the Kappa coefficient, while the measurements of the palatal thickness will be analyzed using the Intraclass Correlation Coefficient (ICC). The correlation between SPM maturation stages and palatal thickness will be assessed using Spearman's correlation test. For all tests, a significance level of 5% (p≤0.05) will be adopted.