Midpalatal suture maturation in 15- to 35-year-olds: morphological assessment in the coronal plane using CBCT—an exploratory study

Tannia Villarroel, Sharime Yagnam, Daniela Vicuña, Guillermo Concha, Rodrigo Oyonarte*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Rapid maxillary expansion (RME) is used in patients presenting transverse maxillary deficiency. However, RME may be unpredictable after late adolescence if the midpalatal sutural maturation stage (MPMS) is in late stage. Since MPMS evaluation is influenced by the expertise of the operator and image quality, this classification method could be complemented. Therefore, this study aimed to analyze the morphology of the midpalatal suture (MPS) and its surrounding bone in the coronal plane using cone beam computed tomography (CBCT) images of adolescents and young adults and to correlate the findings with their respective MPMS status. CBCT scans of 200 patients aged 15–35 years of both sexes were evaluated. MPS and surrounding bone tissue characteristics in the coronal and axial sections were analyzed, and MPMS was evaluated (A to E). Six categories were identified for the coronal evaluation, analyzing it in 2 standardized locations. Sutural morphology: I, hypodense sutural line limited by 2 hyper-dense para-sutural lines; II, hypodense sutural line; and III, suture not visible. The presence of para-sutural cancellous bone: CB0, compact bone; CB1, dense cancellous tissue; CB2, spaced cancellous bone. Midpalatal bone thickness (MBTh) was also measured. ANOVA–Bonferroni, chi-square, logistic regression and t-tests were used. MPMS increased with age. Sutural morphology I and CB0 bone were the most prevalent. Here we show that sutural morphology, para-sutural bone characteristics, and MPSM were significantly associated. The coronal evaluation of the MPS can complement the information from the MPSM assessment, allowing the identification of patent MPS even in the presence of late MPSM.

Original languageEnglish
Pages (from-to)647–656
Number of pages10
JournalOdontology / the Society of the Nippon Dental University
Issue number2
StateAccepted/In press - 2023

Bibliographical note

Publisher Copyright:
© 2023, The Author(s), under exclusive licence to The Society of The Nippon Dental University.


  • Cone-beam computed tomography
  • Coronal evaluation of the midpalatal suture
  • Midpalatal bone thickness
  • Midpalatal suture maturation stages
  • Parasutural bone morphology


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