Association between dental development and midpalatal suture maturation in growing patients: a CBCT-based study

This study aimed to investigate the relationship between midpalatal suture maturation and maxillary and mandibular first and second molar development in growing patients and to determine whether any observed association persisted after accounting for chronological age and sex. Cone-beam computed tomography records of 90 growing patients were retrospectively evaluated. Midpalatal suture maturation was classified using the Angelieri method, and molar development was assessed according to the Nolla classification. Associations were evaluated using Spearman rank correlation analysis in the total sample and separately by sex. Ordinal logistic regression was used as the main regression analysis, and binary logistic regression was additionally performed after grouping the stages as non-advanced and advanced maturation. First molars showed almost complete root development from Angelieri Stage B onward, whereas second molars demonstrated a more gradual increase across advancing sutural maturation stages. Mean Nolla values for second molars increased from approximately 6.4-8.0 in Stages A-B to 9.0 or above in Stages D-E. Significant positive correlations were found between midpalatal suture maturation and all evaluated molars, with the strongest correlation observed for the mandibular second molar, followed by the maxillary second molar. In regression analyses, molar development was associated with sutural maturation in unadjusted models; however, after adjustment for chronological age and sex, none of the molar-related associations remained statistically significant following correction for multiple comparisons. Chronological age remained the dominant factor associated with MPS maturation. Molar development, particularly second molar maturation, may reflect the overall maturational trajectory but showed limited independent predictive value and should not be used alone to estimate the morphological status of the midpalatal suture.