Abstract

ObjectivesThe purpose of this study was to quantify the symmetry of the alveolar process of the maxilla and palate during the first year of life in healthy infants with the help of a semiautomatic segmentation technique.Materials and methodsMaxillary plaster models of seventy healthy babies at 0, 3, 6, 9, and 12 months were collected and digitized. A semiautomatic segmentation tool was used to extract the alveolus and palate. The resulting model was aligned within a reference frame and mirrored on its medial plane. Distance maps were created and analyzed to compare and quantify the differences between the two hemispheres. Additional hemispherical width and area measurements were performed. An ANOVA test with additional post hoc tests was performed to check if the symmetry changed during development. Finally, the results were tested on intra- and interobserver variability.ResultsThe absolute mean inter-surface distance between the original and mirrored models in each age group ranged between 0.23 and 0.30 mm. Width and area analysis showed a small but significant larger left palatal hemisphere. ANOVA and post hoc tests showed no significant difference in symmetry between groups. Reliability analysis showed no significant differences between observers.ConclusionsThis study showed that in this infant population, only a small degree of palatal asymmetry was present, which can be considered as normal and clinically irrelevant.Clinical relevanceThe data from this study can be used in future comparative studies as reference data. Furthermore, modeling of these data can help in predicting the growth pattern, which may lead to improved treatment protocols for children with craniofacial anomalies.

Highlights

  • The human body tends to be symmetrical with respect to its vertical midline

  • Some studies even conclude that intubation in the neonatal phase could cause palatal asymmetry during development

  • The ANOVA test showed no significant change of the inter-surface distance during the first-year development in infants (p = 0.33)

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Summary

Introduction

The human body tends to be symmetrical with respect to its vertical midline. Perfect symmetry is extremely rare in living organisms due to genetic imperfections, environmental factors, and functional deviations. The symmetry of both the maxillary and mandibular arch is needed for a normal transversal occlusion [3]. Some studies even conclude that intubation in the neonatal phase could cause palatal asymmetry during development. A study of Kopra et al [6] showed significant asymmetry in the posterior part of the palate in children between 3 and 5 year old who were intubated as neonates. These studies are not all unanimous [6, 7]. Orthodontic treatment and in some cases rapid maxillary expansion or surgical treatment is needed [2]

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