COMPARISON OF DIAGNOSTIC PERFORMANCE OF MID-PALATAL AND TRANSVERSE PALATINE SUTURE MATURATION ASSESSMENT ACCORDING TO CONE-BEAM COMPUTED TOMOGRAPHY RESOLUTION.

Objective: The aim was to assess the diagnostic performance of the qualitative maturational assessment of the mid-palatal and transverse palatine suture and to verify whether it is influenced by the cone-beam computed tomography (CBCT) image resolution.

Materials and methods: A total of 120 (60 medium and 60 high-resolution) CBCT images for the mid-palatal suture (62 males, 58 females, mean age 28.6 ± 18.6) and transverse palatine suture (61 males, 59 females, mean age 29.0 ± 18.7) maturity assessment was selected. Three examiners, who successfully completed training, assessed the maturation of both sutures, separately. Diagnostic performance parameters according to different CBCT resolution and assessment session were calculated.

Results: The examiners presented slightly higher intra and inter-examiner agreements when assessing medium-resolution compared to high-resolution CBCT images, for both sutures. Stages B and E (for both sutures) showed the highest agreement with the reference standard, while stages C and D showed the lowest, regardless of resolution and assessment session. However, for transverse palatine suture, the agreement was overall poorer. The diagnostic parameters were generally similar between the different resolutions and assessment sessions. For each mid-palatal suture maturation stage, the diagnostic accuracy values were above 91.6 %, while transverse palatine suture showed lower values, above 91.8 % for stages B and E and 77.7 % for stages C and D.

Conclusion: Assessment of both sutures' maturational stages proves to be accurate and repeatable to a satisfactory level with no significant difference between medium and high-resolution CBCT images. From a clinical standpoint, using medium-resolution CBCT scans is advisable to reduce radiation exposure risks in most cases.