Zygomaticomaxillary suture maturation evaluation in patients with and without cleft lip and palate

Abstract

The zygomaticomaxillary suture (ZMS) maturation evaluation is a reliable method for predicting the optimal timing of maxillary protraction. The objective of this study was to compare age distribution patterns of ZMS maturation stages between cleft lip and palate (CLP) patients and non-cleft lip and palate (non-CLP) patients to aid our comprehension in choosing the optimal timing of maxillary protraction. Samples of 216 non-CLP and 220 CLP Asian patients without orthodontic and orthognathic treatment aged 5-25 years were scanned to evaluate the ZMS maturation stage by 2 evaluators blindly. Evaluators' agreements and bilateral ZMS maturation consistency were assessed by weighted kappa tests. Age distribution patterns of each ZMS maturation stage were described. Gender effect and age distribution differences between groups were analyzed using an independent t-test. Evaluators'agreements and bilateral ZMS maturation consistency were satisfying (weighted kappa coefficient>0.90). At stages A and B, patients with CLP were 1.3 and 0.4 years older than patients in the non-CLP group (P<0.001 and P= 0.01). In contrast, at stage C, patients with CLP were approximately 1.2 years younger (P= 0.004). Gender barely played a role in the divergence of ZMS maturation (P>0.05). No statistically significant difference was observed between ZMS maturation of patients with unilateral or bilateral cleft lip and palate (UBCLP) and patients with unilateral or bilateral cleft lip (UBCL) (P>0.05). The ZMS development of patients with CLP was premature at stage C, whereas delayed at stages A and B.