Application of a novel form of structural classification of the pterygopalatine suture for predicting midpalatal suture expansion by miniscrew-assisted rapid palatal expansion in adults: A cohort study

IF 3 2区医学 Q1 DENTISTRY, ORAL SURGERY & MEDICINE

American Journal of Orthodontics and Dentofacial Orthopedics Pub Date : 2025-05-01 DOI:10.1016/j.ajodo.2024.12.006

Wenyi Zhang , Miri Chung , Yifeng Qian , Yanfei Zhu , Lingyong Jiang

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引用次数: 0

Abstract

Introduction

This study proposes a novel structural parameter, the insertion depth of the pyramidal process into the pterygoid notch (IDP), as a measure of pterygopalatine suture (PPS) resistance during palatal expansion and aims to evaluate the correlation between the IDP-based PPS classification and midpalatal suture (MPS) expansion.

Methods

Preexpansion and postexpansion cone-beam computed tomography images of 23 adults treated with miniscrew-assisted rapid palatal expansion were superimposed. After superimposition, the IDP, sagittal position of the expander, bone thickness penetrated by the miniscrews, PPS separation status (PPS_sep), and MPS expansion at the anterior and posterior nasal spines (hemi-AME and hemi-PME) were determined. To analyze the plausibility of PPS_sep as a mediating variable, regressions were performed to confirm the correlation between PPS_sep and both MPS expansion and IDP. The optimal cut-off point of the IDP for predicting PPS_sep (OC_IDP) was obtained when Youden’s index reached a maximum. Finally, the correlation between the OC_IDP-based PPS classification and the MPS expansion was analyzed using linear regression.

Results

Both hemi-AME and hemi-PME increased significantly with PPS separation (regression coefficient [b] = 0.88 and 1.25, respectively; P <0.01). IDP was negatively correlated with the probability of PPS separation (P <0.01), and the OC_IDP was 1.90 mm (area under the curve = 0.901). The OC_IDP-based PPS classification showed significant correlations with both hemi-AME and hemi-PME (b = −0.59 and −0.87, respectively; P <0.05).

Conclusions

PPS separation promotes skeletal expansion. The greater the IDP, the lower the probability of PPS separation. OC_IDP-based PPS classification is an effective predictor of MPS expansion in miniscrew-assisted rapid palatal expansion-treated adults.

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查看原文本刊更多论文

应用翼状腭缝线的一种新型结构分类方法预测成人中腭缝线通过微型辅助快速扩张进行扩张：一项队列研究。

摘要：本研究提出了一种新的结构参数，即锥体突插入翼状切迹（IDP）的深度，作为腭扩张过程中翼腭缝合（PPS）阻力的测量指标，旨在评估基于IDP的PPS分类与中腭缝合（MPS）扩张之间的相关性。方法：对23例成人行微辅助快速腭扩张术的扩张前和扩张后锥形束ct图像进行叠加分析。叠加后，测定IDP、扩张器矢状位、微型螺钉穿透骨厚度、PPS分离状态（PPSsep）和前后鼻棘MPS扩张（半ame和半pme）。为了分析PPSsep作为中介变量的合理性，我们进行了回归来证实PPSsep与MPS扩张和IDP之间的相关性。当约登指数达到最大值时，得到预测PPSsep的最佳截断点IDP （OCIDP）。最后，利用线性回归分析了基于ocidp的PPS分类与MPS扩展之间的相关性。结果：PPS分离后，半ame和半pme均显著升高(回归系数[b]分别为0.88和1.25；P IDP为1.90 mm（曲线下面积= 0.901）。基于ocidp的PPS分类与半ame和半pme均呈显著相关（b = -0.59和-0.87）；结论：PPS分离促进骨扩张。IDP越大，PPS分离的概率越低。基于ocidp的PPS分类是微型辅助快速腭扩张治疗成人MPS扩张的有效预测因子。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Orthodontics and Dentofacial Orthopedics 医学-牙科与口腔外科

CiteScore

4.80

自引率

13.30%

发文量

432

审稿时长

66 days

期刊介绍： Published for more than 100 years, the American Journal of Orthodontics and Dentofacial Orthopedics remains the leading orthodontic resource. It is the official publication of the American Association of Orthodontists, its constituent societies, the American Board of Orthodontics, and the College of Diplomates of the American Board of Orthodontics. Each month its readers have access to original peer-reviewed articles that examine all phases of orthodontic treatment. Illustrated throughout, the publication includes tables, color photographs, and statistical data. Coverage includes successful diagnostic procedures, imaging techniques, bracket and archwire materials, extraction and impaction concerns, orthognathic surgery, TMJ disorders, removable appliances, and adult therapy.