Age-Dependent Three-Dimensional Evaluation of Circummaxillary Sutures Maturation in Normal Population Using Cone-Beam Computed Tomography: Early Childhood Through Adolescence.

Abstract

Initiation time of dentofacial orthopedics is as important as the choice of treatment protocol. Morphology and degree of fusion of circummaxillary sutures differ in various populations; hence, the aim of this study was to evaluate the exact age of ossification of the most important maxillary suture using cone-beam computed tomography to find the appropriate age to start orthopedic treatment. This cross-sectional retrospective study was performed on 517 cone-beam computed tomography images of patients aged 6 to 18 years old. Patients with obvious pathology or fractures were excluded from the study. Two independent observers scored the radiographs. The ossification stage of the zygomatico-maxillary suture (ZMS) was classified into 5 stages and each suture was classified according to age and sex of the patients. Kendall Taub, Kruskal-Wallis, Mann-Whitney U test, and Bayesian analysis were used for statistical analysis. Statistical significance was set at P value < 0.05. In this study, 517 samples consisting of 260 females (50.3%) and 257 males (49.7%) with a mean age of 12.03 ± 3.74 years old were examined. A significant difference did not exist between the 2 sexes regarding the stages of ZMS ossification except for in stage E. The ZMS transitional stage from B to C was found to occur at the age of 11.8 in boys and 12.6 in girls. According to the transitional age of ZMS maturation from stage B to C, it seems that orthopedic treatments of the maxilla are not much effective after the age of 12. Therefore, the authors should start orthopedic treatment of the maxilla before the age of 12 in both sexes.