A Systematic Review of Methods Used to Assess Mid-Palatal Suture Maturation

Objectives Use of a reliable method to determine the degree of skeletal development of the mid-palatal suture is important in the choice of treatment between orthopedic maxillary expansion and surgical expansion in adolescents and young adults. The aim of this study was to review the new methods for evaluation of mid-palatal suture maturation.Methods Electronic search was conducted in PubMed and Scopus databases using the following key words: (“mid-palatal suture maturation” OR “mid-palatal suture ossification”) AND (“orthopedic treatment” OR “maxillary expansion” OR “orthodontic*”) to find studies published from 1990 to December 2018 in English that evaluated the mid-palatal suture maturation stage.Results Of 127 papers found, 28 articles met the inclusion criteria and their full texts were reviewed. Finally, 8 met the inclusion criteria. Five studies used cone-beam computed tomography (CBCT) as the imaging modality and examined the quality of the mid-palatal suture maturation and assessed the morphology of the suture. Two studies used bone density and one study used fractal dimensions.Conclusion Since all the innovative methods lack a gold standard and valid histological references, it is not possible to reach a comprehensive conclusion. It is therefore important that the clinicians use several diagnostic criteria for thorough evaluation of the development of mid-palatal suture and decide on the appropriate therapeutic modalit

A systematic review of methods to determine skeletal maturation based on cervical vertebrae

Introduction: Since the determination of skeletal maturation by surveying concavity on lower surface of cervical vertebrae and evaluating shape of vertebrae is a subjective and quantitative study, this systematic review was performed to evaluate new quantitative and objective methods by using cervical vertebrae for determining skeletal maturation. Material and Methods: Related keywords were searched in Pubmed and Cochran database in order to find studies that were published in English from January 2000 to January 2019 and evaluated skeletal maturation based on cervical vertebrae by modern methods. Also, the references of the included studies were search for other related studies. Results: From overall 1371 titles, 27 were selected by initial screening. Evaluation of the full texts resulted in inclusion of 13 articles. Among articles included in this review, three studies used CBCT images and another studies used lateral cephalogram. One study performed evaluation cervical vertebrae in the axial view of CBCT images while another evaluation was on sagittal view. Most of the studies used a regression model in order to determine bone age of vertebrae and then compared it with skeletal age obtained from hand wrist radiography. Conclusion: As the methods and measurements were different in the included studies it was not possible to reach a decisive conclusion regarding method for determining skeletal age based on cervical vertebrae. It is suggested to use a combination of maturation signs along with development stages of cervical vertebrae in order to determine skeletal maturation until a quantitative and valid method is presented