Quantitative evaluation of midpalatal suture maturation via fractal analysis.
OBJECTIVE
The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation.


METHODS
The study included 131 subjects aged over 18 years of age (range 18.1-53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve.


RESULTS
The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (-0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235.


CONCLUSIONS
There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation.
Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea.
Kyoung Ho
KH
Kwak
Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea.; Department of Orthodontics, School of Dentistry, Pusan National University, Yangsan, Korea.; Institute of Translational Dental Sciences, Pusan National University Dental Hospital, Yangsan, Korea.
Seong Sik
SS
Kim
Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea.; Department of Orthodontics, School of Dentistry, Pusan National University, Yangsan, Korea.; Institute of Translational Dental Sciences, Pusan National University Dental Hospital, Yangsan, Korea.
Yong-Il
YI
Kim
Department of Orthodontics, Dental Research Institute, Pusan National University Dental Hospital, Yangsan, Korea.; Department of Oral and Maxillofacial Surgery, Pusan National University Dental Hospital, School of Dentistry, Pusan National University, Yangsan, Korea.; Institute of Translational Dental Sciences, Pusan National University Dental Hospital, Yangsan, Korea.
Yong-Deok
YD
Kim
Cone-beam computed tomography; Fractal analysis; Midpalatal suture; Rapid palatal expansion
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