Comparison of three-dimensional maxillary growth across spheno-occipital synchondrosis maturation stages.

BACKGROUND: This study aimed to three-dimensionally compare the maxillary growth among the spheno-occipital synchondrosis (SOS) maturation stages in both genders. METHODS: This is a cross-sectional study of a retrospective type in which cone-beam computed tomography (CBCT) images of 500 patients aged 6 to 25 years (226 males and 274 females) were analyzed. The SOS was evaluated using the four-stage scoring system; completely open, partially fused, semi-fused, or completely fused. The SOS scoring and three-dimensional cephalometric measurements were analyzed by Invivo 6.0.3 software. Descriptive and analytical statistics were performed and a P-value < 0.05 was considered statistically significant. RESULTS: There was a statistically significant difference in maxillary measurements among SOS maturation stages in both genders (P < 0.05). The mean differences in the maxillary growth among the SOS maturation stages between SOS stages 2 and 3 were higher than those between stages 1and 2 and stages 3 and 4 for maxillary length and height in both genders. However, the mean difference in the maxillary width was higher between SOS stages 1 and 2 than those stages 2 and 3 and stages 3 and 4. On other hand, there may be lesser maxillary growth between SOS stages 3 and 4 for maxillary width, length (in males), and height. The growth curves showed high active growth of the maxilla as the SOS was still fusing (especially stage 2 and 3) than those of the fused (stage 4). Moreover, the acceleration of growth occurred earlier in females than males regarding chronological age but not for SOS maturation stages. CONCLUSIONS: The SOS maturation stages are valid and reliable maxillary skeletal maturation indicators for three-dimensional maxillary growth in both genders.

Tridimensional Analysis of Incisive Canal and Upper Central Incisor Approximation.

OBJECTIVE: The present study aimed to estimate the location of the incisive canal (IC) concerning the upper central incisor roots (U1) in order to explore the amount of incisor retraction as per the envelope of discrepancy amongst Chinese patients with different vertical facial growth patterns. METHODS: This is a cross-sectional study that used a total of 207 pretreatment cone-beam computed tomography (CBCT) scans of adults with a skeletal class I relationship. Sixty-nine cases were included in each of the normodivergent, hypodivergent, and hyperdivergent facial groups. The IC volume was measured using Mimics 21 software. The IC width and IC-U1 proximity were measured using in vivo 6 software. Linear measurements were conducted at 3 vertical levels. RESULTS: The IC has shown a larger volume in the hyperdivergent group and male patients. Overall, the IC has recorded linear width greater than the inter-root distance of U1 in 59.1%, 66%, and 68.8% amongst the normodivergent, hypodivergent, and hyperdivergent facial groups, respectively, and in 58.3% of males and 70.8% of females. The overall sagittal distances between the U1 and IC were 4.00 ± 0.82 mm, 4.60 ± 0.83 mm, and 3.60 ± 0.80 mm amongst the normodivergent, hypodivergent, and hyperdivergent facial groups, respectively. CONCLUSIONS: The maximum sagittal distances between U1 and IC were 4.8 mm, 5.4 mm, and 4.4 mm amongst the normodivergent, hypodivergent, and hyperdivergent facial groups, respectively. Thereby, our findings have revised the retraction aspect of the envelope of discrepancy as per the different vertical facial growth patterns, which could serve a reference for the clinical practice involved considerable incisors movement, especially among Chinese patients.

Evaluation of Spheno-occipital Synchondrosis Fusion in Chinese Population Using CBCT: A Cross-sectional Study.

AIM: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese population using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This is a cross-sectional study in which data were randomly collected based on the pre-existing institutional records. Following selection criteria, the CBCT images of 500 patients aged 6-25 years (226 males and 274 females) were analyzed. Three-dimensional virtual models were oriented at a standardized position, then adjusted to the median sagittal plane (MSP) view. A four-stage scoring system was used; completely open, partially fused, semi-fused, or completely fused. The student's t-test, one-way ANOVA, Pearson correlation, and linear regression analysis were used and the significant level was set at ≤0.05. RESULTS: The mean age of closure of stages 1, 2, 3, and 4 were 7.44, 9.62, 12.94, and 19.03 years in females, and 8.79, 11.13, 14.82, and 20.18 years in males, respectively. There was significantly strong positive correlation between spheno-occipital fusion and age (female: r = 0.853, male: r = 0.879; p <0.001), with 1.47 ± 0.33 years earlier fusion in females. All inter- and intra-stages mean ages were statistically significant in both genders. The transition age model demonstrated a mean age (in years) between stages 1-2 (10.1), stages 2-3 (12.79), and stage 3-4 (17.93) for males, and stages 1-2 (8.96), stages 2-3 (11.45), and stage 3-4 (16.69) for females. CONCLUSIONS: The present findings of SOS stages of fusion in both genders could guide age estimation and assessment of normal skeletal growth patterns and active skeletal growth period in the Chinese population. CLINICAL SIGNIFICANCE: There is still controversy about the time to closure of the SOS because of population and assessment technique variations. This study could be used as a reference for the specific examined population during planning for dentofacial orthopedic and/or orthognathic surgery and dental implant prosthesis for both genders. Moreover, these finding may be useful for medical purposes.