Evaluation of Midpalatal Suture Ossification Using Cone-Beam Computed Tomography: A Digital Radiographic Study

Cone beam computed tomography (CBCT) imaging techniques are the recent rage in the field of oral diagnostic imaging modality. It is noninvasive, faster and lacks anatomic superimposition. Earlier maxillary occlusal radiographs were used to assess and evaluate the mid palatal suture, but being a two dimensional imaging modality it could not assess the ossification process which takes place in multiple planes mostly due to curved nature of the palate. In this study we assessed the mid palatal suture morphology and classify them according to the variants using CBCT images.

A total of 200 CBCT scans (95 males and 105 females) were evaluated in the present study from the archives of an imaging center. As per Angelieri classification the midpalatal suture was classified into five categories (A-E) depending on the degree of ossification that had taken place. Statistical analysis was done by Chi Square test using SPSS version 23.0.

There is statistically significant difference present in the stages of maturity of mid palatal suture in various age groups with Stage B is most common in Group 1 (50%), Stage C most common in Group 2 (60%) and Group 3 (40%) and Stage E more common in Group 4 (50%).

The results of the present study showed a wide variation in the initiation time and the degree of ossification and morphology of the midpalatal suture in different age groups. Although there was an increase in the closure of the suture with aging, age is not a reliable criterion for determining the open or closed nature of the suture. This finding is important in providing an idea as to how diverse is the ossification of maxillary sutures.