{"title":"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。","authors":"Wenyi Zhang , Miri Chung , Yifeng Qian , Yanfei Zhu , Lingyong Jiang","doi":"10.1016/j.ajodo.2024.12.006","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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<sub>sep</sub>), and MPS expansion at the anterior and posterior nasal spines (hemi-AME and hemi-PME) were determined. To analyze the plausibility of PPS<sub>sep</sub> as a mediating variable, regressions were performed to confirm the correlation between PPS<sub>sep</sub> and both MPS expansion and IDP. The optimal cut-off point of the IDP for predicting PPS<sub>sep</sub> (OC<sub>IDP</sub>) was obtained when Youden’s index reached a maximum. Finally, the correlation between the OC<sub>IDP</sub>-based PPS classification and the MPS expansion was analyzed using linear regression.</div></div><div><h3>Results</h3><div>Both hemi-AME and hemi-PME increased significantly with PPS separation (regression coefficient [b] = 0.88 and 1.25, respectively; <em>P</em> <0.01). IDP was negatively correlated with the probability of PPS separation (<em>P</em> <0.01), and the OC<sub>IDP</sub> was 1.90 mm (area under the curve = 0.901). The OC<sub>IDP</sub>-based PPS classification showed significant correlations with both hemi-AME and hemi-PME (b = −0.59 and −0.87, respectively; <em>P</em> <0.05).</div></div><div><h3>Conclusions</h3><div>PPS separation promotes skeletal expansion. The greater the IDP, the lower the probability of PPS separation. OC<sub>IDP</sub>-based PPS classification is an effective predictor of MPS expansion in miniscrew-assisted rapid palatal expansion-treated adults.</div></div>","PeriodicalId":50806,"journal":{"name":"American Journal of Orthodontics and Dentofacial Orthopedics","volume":"167 5","pages":"Pages 578-590"},"PeriodicalIF":3.0000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"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\",\"authors\":\"Wenyi Zhang , Miri Chung , Yifeng Qian , Yanfei Zhu , Lingyong Jiang\",\"doi\":\"10.1016/j.ajodo.2024.12.006\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><div>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.</div></div><div><h3>Methods</h3><div>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<sub>sep</sub>), and MPS expansion at the anterior and posterior nasal spines (hemi-AME and hemi-PME) were determined. To analyze the plausibility of PPS<sub>sep</sub> as a mediating variable, regressions were performed to confirm the correlation between PPS<sub>sep</sub> and both MPS expansion and IDP. The optimal cut-off point of the IDP for predicting PPS<sub>sep</sub> (OC<sub>IDP</sub>) was obtained when Youden’s index reached a maximum. Finally, the correlation between the OC<sub>IDP</sub>-based PPS classification and the MPS expansion was analyzed using linear regression.</div></div><div><h3>Results</h3><div>Both hemi-AME and hemi-PME increased significantly with PPS separation (regression coefficient [b] = 0.88 and 1.25, respectively; <em>P</em> <0.01). IDP was negatively correlated with the probability of PPS separation (<em>P</em> <0.01), and the OC<sub>IDP</sub> was 1.90 mm (area under the curve = 0.901). The OC<sub>IDP</sub>-based PPS classification showed significant correlations with both hemi-AME and hemi-PME (b = −0.59 and −0.87, respectively; <em>P</em> <0.05).</div></div><div><h3>Conclusions</h3><div>PPS separation promotes skeletal expansion. The greater the IDP, the lower the probability of PPS separation. OC<sub>IDP</sub>-based PPS classification is an effective predictor of MPS expansion in miniscrew-assisted rapid palatal expansion-treated adults.</div></div>\",\"PeriodicalId\":50806,\"journal\":{\"name\":\"American Journal of Orthodontics and Dentofacial Orthopedics\",\"volume\":\"167 5\",\"pages\":\"Pages 578-590\"},\"PeriodicalIF\":3.0000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American Journal of Orthodontics and Dentofacial Orthopedics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0889540625000095\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"DENTISTRY, ORAL SURGERY & MEDICINE\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Orthodontics and Dentofacial Orthopedics","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0889540625000095","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"DENTISTRY, ORAL SURGERY & MEDICINE","Score":null,"Total":0}
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
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 (PPSsep), and MPS expansion at the anterior and posterior nasal spines (hemi-AME and hemi-PME) were determined. To analyze the plausibility of PPSsep as a mediating variable, regressions were performed to confirm the correlation between PPSsep and both MPS expansion and IDP. The optimal cut-off point of the IDP for predicting PPSsep (OCIDP) was obtained when Youden’s index reached a maximum. Finally, the correlation between the OCIDP-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 OCIDP was 1.90 mm (area under the curve = 0.901). The OCIDP-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. OCIDP-based PPS classification is an effective predictor of MPS expansion in miniscrew-assisted rapid palatal expansion-treated adults.
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.