Online ISSN: 2515-8260

Keywords : Maxillary Expansion


BONE DENSITY ASSESSMENT OF MIDPALATAL SUTURE USING GRAYSCALE VALUES-A CBCT STUDY

Akshay Mohan; Shanthasundari K K; Ashwin George Mathew; Arthi Balasubramaniam

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 592-606

Objective
To assess the predictability of grayscale values in a CBCT scan to assess the level of
maturation of midpalatal suture density using CBCT modality
Materials and Methods:
The 58 CBCT images of maxillary arch of subjects belonging to the age group 5-32 years were
evaluated to assess morphologic stages of the midpalatal suture maturation stages A to E
based on the Angeliere classification using the grayscale values. One-way ANOVA test was
used to check the variation of grayscale in different groups of mid palatal suture
classification. Pearson's correlation test was used to determine the correlation between the age
of the subjects and grayscale values. An arithmetic calculation was done to convert the
grayscale values into Hounsfield units to assess bone density according to the Misch’s
Classification.
Results- Mean and standard deviation of the grayscale value corresponding to the palatal
maturation stage were assessed and its Hounsfield units (HU) were obtained by using the
mathematicalformula. There was a statistically significant difference among the stages. No
significant difference was observed between stage D and E (p-value >0.05). There was a
significant correlation between the age of the patient and the corresponding grayscale value (r
=0.599, p=0.00).
Conclusion- A statistically significant difference between the ossification stages of the mid
palatine suture and grayscale values was obtained from CBCT and can be hence used as an
alternate method for checking bone density. There is an increase in grayscale value observed
as the age of the subjects increases.

CBCT Evaluation Of Bicortical Thickness Of The Mid Palate For Micro-Osteo Perforation In Patients Undergoing Treatment With Miniscrew Assisted Rapid Palatal Expansion.

Akshay Mohan; S.Harish Babu; Arvind. S; Ashwin Mathew George

European Journal of Molecular & Clinical Medicine, 2020, Volume 7, Issue 10, Pages 198-209

Objective: To evaluate the anatomical variations in bicortical thickness of the mid palatine region in order to calibrate the maximum depth of micro osteoperforation permissible at various sites along the midpalate.
Design: This was a retrospective cone-beam computed tomography study
Setting: The study was conducted in Department of Orthodontics and Dentofacial Orthopedics
Methods: CBCT images of 60 subjects between the age of 14-28 years were taken up for evaluation from the records of the dental hospital. The sixty scans were from 37 males and 23 females. The CBCT images of subjects were evaluated by two investigators to assess the bicortical thickness of bone in the midpalatal region using fixed reference points and planes. Mean and standard deviation of bicortical thickness at various fixed landmarks were calculated. One-way ANOVA was done to check for variation of bicortical thickness among various sites in males and females. Intra operator reliability was checked by the paired T- test and Kappa statistics were used to evaluate inter-operator reliability between the observations by two observers (A.M, H.B).
Results: A mean value of 8.93+/-1.67mm, 6.37+/-1.56mm, 4.42+/-1.40mm, 3.11+/-1.21mm, 2.47+/-0.95mm, 2.07+/-0.93mm was obtained for reference points A, B, C, D, E and F respectively in males. It was observed that a mean value of 7.93+/-1.56mm, 5.48+/-1.39mm, 3.66+/-1.01mm, 2.81+/-1.06mm, 2.35+/-1.08mm, 2.09+/-1.18 mm was obtained for points A, B, C, D, Eand Frespectively in females. Statistically significant difference was observed between the six points (ANOVA test; p value- 0.00). The Intra operator reliability was assessed using a paired T-test and was estimated to be 0.93 and the inter-operator reliability by Kappa statistics was 0.321.
Conclusion: The bicortical thickness of the mid palate varies showing more thickness anteriorly and progressively getting thinner posteriorly. The anterior segment showed more variations in the thickness compared to the posteriors. Micro osteoperforation of palate can be done upto a depth of 8.93 mm in males and 7.93mm in females and a minimum depth of 3.11 mm in males and 3.66mm in females is possible in the anterior half of the palate.