Cone Beam Computed Tomography evaluation of midpalatal suture maturation according to age and sex: A systematic review

Aim To systematically review and analyse the available evidence and assess if a correlation exists in children and young adults between the chronological age and the degree of midpalatal suture maturation as assessed according to the method proposed by Angelieri et al. [2013]. Methods A search was performed in Medline/Pubmed, Scopus, and Web of Science during October 2020 for published studies analysing midpalatal suture maturation through cone beam tomography according to the method proposed by Angelieri et al. [2013]. The review was performed according to the PRISMA protocol and the articles were selected according to the established inclusion and exclusion criteria. To assess the quality of reporting, the STROBE checklist was applied. Results The search retrieved a total of 308 articles. After the screening and eligibility phase, only 7 studies fulfilled the inclusion criteria. Most of the studies highlighted a higher prevalence of stages B and A in subjects below the age of 11; of stage C in the 11-14 years cohort, followed by stage B. In the 14-18 years cohort, the most frequent stage was C, followed by stage D. In all cohorts, females presented stages related to a higher maturation of the midpalatal suture than males. Retrieved data belong to studies of moderate quality, especially due to the methodological limitations. Conclusions The high variability of the maturational stages in the studied cohorts, highlights the poor correlation between suture maturation and chronological age in both genders, especially in young adults. According to our findings until the age of 14, the high prevalence of stages related to sutural opening does not justify CBCT assessment of the MPS and supports the use of a conventional protocol for maxillary expansion.