An improved morphological staging method of midpalatal suture and its relationship with cervical vertebrate maturation (CVM) method

Abstract Background (1) Establish an improved morphological staging method of midpalatal suture. (2) Investigate the correlation between morphological stages of midpalatal suture (MPS stage) and cervical vertebrate maturation (CVM) stages. (3) Compare effects of traditional tooth-borne rapid maxillary expansion (RME) at different MPS stages. Methods 1076 CBCT images (675 females, 401 males, 6.0 to 21.0 years old) are included. MPS stages are classified based on observation of horizontal view. Correlation between MPS stage and CVM stage are investigated by Spearman correlation coefficient and diagnostic test analysis. Effects of traditional tooth-borne RME at different MPS stages were analyzed based on pre- and post-expansion dental casts. Results Five stages of midpalatal suture are established. Spearman coefficient between MPS stage and CVM stage is 0.803. Diagnostic pairs with the largest area under ROC curve (AUC) value are: CS 6 - MPS 5,CS 5 - MPS 4s2,CS 1 - MPS 1, CS 4 - MPS 4s1, CS 2 - MPS 1, CS 3 - MPS 3. 309/340 (90.9%) of individuals at CS 1-3 are at MPS 1-3, 31/340 (9.1%) are at MPS 4s1. 107/324 (31.2%) of individuals at CS 4 are at MPS 3, 151/324 (46.6%) are at MPS 4s1. Conclusion (1) An improved morphological staging method of midpalatal suture is established. (2) MPS stages have close relationship with CVM stages. (3) Pre-treatment CBCT is recommended for individuals at CS 4 to estimate the possibility of skeletal expansion with traditional tooth-borne RME.