CBCT evaluation of midpalatal suture maturation for expansion planning in a Turkish population aged 8–30 years: A single-center retrospective cross-sectional study
International Orthodontics, cilt.24, sa.3, 2026 (ESCI, Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 24 Sayı: 3
- Basım Tarihi: 2026
- Doi Numarası: 10.1016/j.ortho.2026.101150
- Dergi Adı: International Orthodontics
- Derginin Tarandığı İndeksler: Emerging Sources Citation Index (ESCI), Scopus, EMBASE, MEDLINE
- Anahtar Kelimeler: Midpalatal suture, Suture fusion, Age threshold, Skeletal maturity, Rapid maxillary expansion, Decision support
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objectives: To evaluate midpalatal suture (MPS) maturation in a Turkish sample using cone-beam computed tomography (CBCT)-based Angelieri staging and to derive a decision-support age alert point for selecting expansion strategies. Material and methods: This single-centre retrospective cross-sectional study analysed archived CBCT scans of 180 individuals aged 8–30years (96 females, 84 males) obtained for routine clinical indications unrelated to maxillary expansion planning between 2016 and 2025. The screening, exclusion, and final inclusion of eligible records were documented using a flow diagram. MPS maturation was staged A–E (Angelieri). Chronological age discrimination of early (A–B) versus advanced (D–E) stages was assessed using receiver operating characteristic (ROC) analysis; the optimal cut-off was determined by the Youden index, and sensitivity/specificity with 95% confidence intervals (CI) were reported. Independent associations of age and sex with maturation stage were examined using ordinal logistic regression. Results: Age showed strong discrimination between early and advanced maturation (area under the curve [AUC]=0.91). A 16-year cut-off yielded a sensitivity of 91.2% (95% CI 80.7–97.1) and specificity of 84.0% (95% CI 63.9–95.5). Age was an independent predictor of more advanced maturation (odds ratio [OR]=1.25 per year; 95% CI 1.18–1.33; P<0.001), whereas sex was not (P=0.778). Among participants aged ≥16years, 41.7% remained in Stage C. Conclusions: MPS maturation was strongly associated with age, and 16years may be interpreted as a decision-support alert point rather than a rigid surgical boundary. In late adolescents and young adults, CBCT-based Angelieri staging can support risk-aware selection between conventional rapid maxillary expansion (RME), miniscrew-assisted rapid palatal expansion (MARPE), and, when clinically indicated, surgically assisted protocols.