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Journal of Peking University (Health Sciences) ›› 2021, Vol. 53 ›› Issue (1): 133-138. doi: 10.19723/j.issn.1671-167X.2021.01.020

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Chinese morphological stages of midpalatal suture and its correlation with Demirjian dental age

GAO Lu,GU Yan()   

  1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2020-08-12 Online:2021-02-18 Published:2021-02-07
  • Contact: Yan GU E-mail:guyan96@126.com
  • Supported by:
    National Natural Science Foundation of China(81970979);Ministry of Science and Technology of China(2018FY101005)

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Abstract:

Objective: To investigate the correlation between morphological stages of midpalatal suture (MPS) and Demirjian dental age.Methods: In this retrospective study, 1 076 cone-beam CT (CBCT) images (female: 675, male: 401; age range: 6.0 to 21.0 years) were included. Horizontal view of each sample’s CBCT images was observed, each sample’s MPS stage was recorded, and dental age. MPS stage and dental age were ordered with categorical variables. Therefore, their correlation was investigated through Spearman correlation coefficient analysis and diagnostic test analysis.Results: (1) For left lower second premolar: 95.2% of those in dental age stage B-D were in MPS 1-2, accounting for the largest proportion. 85.3% of those in dental age stage E were in MPS 1-2, still accounting for the largest proportion. Another 14.7% were in MPS 3. 45.1% of those in dental age stage F were in MPS 3, 46.1% in MPS 1-2, and another 8.8% in MPS 4s1. 49.8% of those in dental age stage G were in MPS 3. 24.9% in MPS 4s1, and 18.9% in MPS 1-2. 80.1% of those in dental age stage H were in MPS 4-5. Another 16.3% were in MPS 3. (2) For left lower second molar: 89.7% of those in dental age stage B-D were in MPS 1-2, accounting for the largest proportion. 67.4% of those in dental age stage E were in MPS 1-2, still accounting for the largest proportion. Another 26.1% were in MPS 3. 55.3% of those in dental age stage F were in MPS 3, 34.2% in MPS 1-2, and another 10.5% in MPS 4s1. 50.7% of those in dental age stage G were in MPS 3, 24.3% in MPS 4s1, and 16.8% in MPS 1-2. 83.8% of those in dental age stage H were in MPS 4-5, another 14.2% were in MPS 3. (3) To diagnose MPS stage with dental age, diagnostic pairs with good performance included: Dental age of left lower second molar-MPS: H-4s2, H-5, D-1; Dental age of left lower second premolar-MPS: H-4s2, H-5, G-3. Other diagnostic pairs were of ordinary diagnostic efficiency. (4) For dental age-MPS Spearman correlation analysis, dental age of left lower second molar-MPS had the highest Spearman coefficient (0.68), dental age of left lower second premolar-MPS was the second high (0.64). (5) Dental age stage H of left lower second molar or left lower second premolar indicated that the individual was later than MPS 4s2.Conclusion: Dental age’s diagnostic efficiency for MPS stage is ordinary on the whole, except for some pairs with good performance. Therefore, pre-treatment CBCT examination should be considered as assistance for evaluating maturation and fusion status of midpalatal suture.

Key words: Midpalatal suture, Cone-beam computed tomography, Demirjian dental age, Diagnostic efficiency

CLC Number: 

  • R783.5

Table 1

Frequency distribution of MPS stage and dental age"

MPS stage Dental age of left lower second premolar Dental age of left lower second molar
B C D E F G H Total B C D E F G H Total
1 1 1 13 21 29 30 11 106 1 3 37 16 18 27 4 106
2 0 0 5 8 18 17 13 61 0 0 11 15 8 18 9 61
3 0 0 1 5 46 124 109 285 0 0 6 12 42 136 89 285
4s1 0 0 0 0 6 62 195 263 0 0 0 2 8 65 188 263
4s2 0 0 0 0 2 14 261 277 0 0 0 1 0 18 258 277
5 0 0 0 0 1 2 81 84 0 0 0 0 0 4 80 84
Total 1 1 19 34 102 249 670 1 076 1 3 54 46 76 268 628 1 076

Table 2

Spearman correlation analysis between MPS stage and dental age"

Items Left lower canine Left lower first premolar Left lower second premolar Left lower second molar
Spearman P value Spearman P value Spearman P value Spearman P value
Female 0.578 <0.001 0.557 <0.001 0.602 <0.001 0.667 <0.001
Male 0.668 <0.001 0.662 <0.001 0.676 <0.001 0.699 <0.001
Total 0.618 <0.001 0.605 <0.001 0.636 <0.001 0.683 <0.001

Figure 1

Diagnostic test analysis between MPS stage and dental age: ROC curve A, left lower canine; B, left lower first premolar; C, left lower second premolar; D, left lower second molar. DA, dental age; MPS, midpalatal suture."

Table 3

Diagnostic test analysis between MPS stage and dental age: diagnostic efficiency indexes"

Index Left lower canine Left lower first premolar
DA H-MPS 4s2 DA G-MPS 3 DA H-MPS 5 DA H-MPS 4s2 DA H-MPS 5 DA G-MPS 3
AUC 0.696 0.662 0.649 0.678 0.660 0.642
PLR 1.710 3.066 1.471 1.605 1.488 3.025
Sensitivity 0.946 0.481 0.929 0.946 0.976 0.425
Specificity 0.447 0.843 0.369 0.411 0.344 0.860
Index Left lower second premolar Left lower second molar
DA H-MPS 4s2 DA H-MPS 5 DA G-MPS 3 DA H-MPS 4s2 DA H-MPS 5 DA D-MPS 1
AUC 0.715 0.685 0.639 0.734 0.700 0.666
PLR 1.841 1.624 2.753 2.011 1.724 19.917
Sensitivity 0.942 0.964 0.435 0.931 0.952 0.349
Specificity 0.488 0.406 0.842 0.537 0.448 0.982
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