Evaluation of a novel palatal suture maturation classification as assessed by CBCT imaging of a pre- and post-expansion treatment cohort

• Author / Creator

  Darren Matthew Isfeld

• Introduction: Evaluated is the novel midpalatal suture maturation classification and methodology proposed by Angelieri et al. (2013). Reliability testing was performed, followed by a retrospective observational longitudinal (cohort) study to evaluate the reliability and usefulness of this novel classification system to predict success of RME treatment. Methods: Reliability testing focused on a total of sixteen patients aged 9.5 -17 years old with early mixed to full permanent dentition, representing all proposed palatal maturation stages, with accessible pre-expansion CBCTs. The retrospective observational longitudinal (cohort) study evaluated 63 pre-adolescent and adolescent patients aged 11-17 years old with full permanent dentition treated with tooth-borne RME appliances who have CBCTs records taken at T1 pre- and T2 post-expansion. CBCT 3D landmarking produced skeletal and dental widths and dental angulations utilized to evaluate the extent of skeletal and/or dental expansion as it relates to the T1 palatal suture classification of each subject. Results: There was almost perfect intra-examiner agreement and slight to poor inter-examiner agreement, differing from previously reported reliability, affected by necessary operator calibration and the degree of post-acquisition image sharpness and clarity. Results of the cohort study were wholly unsupportive of the efficacy of the proposed palatal suture maturation classification. Further evaluation of its scientific basis determined that the classification was ill- founded. Conclusion: Clinicians should not consider this proposed classification as being factual, and halt employing its use to drive clinical decision making which will have real-world patient implications and outcomes.

• Subjects / Keywords

  • Palatal suture
  • Maturation
  • Expansion
  • CBCT imaging

• Graduation date

  Fall 2017

• Type of Item

  Thesis

• Degree

  Master of Science

• DOI

  https://doi.org/10.7939/R3VT1H49M

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.