Computational protocol: Relationship between maturation indices and morphology of the midpalatal suture obtained using cone-beam computed tomography images

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Protocol publication

[…] Before the study commenced, we estimated the sample size needed to reach statistical significance. A power analysis with G*Power 3.1.9.2 (Universitåt Düsseldorf, Germany) showed that 93 subjects would be needed for a statistical power of more than 85% to detect significant differences with a 0.5 effect size and a significance level of α = 0.05 (actual power = 0.851; critical chi-square = 31.41; noncentrality parameter λ = 23.25). Institutional review board approval was granted by the Wonkwang University Daejeon Dental Hospital (Daejeon, Korea) to conduct this study (IRB No. W1404/004-001).From August 2009 to February 2014, patients between the ages of 7 and 20 years who visited the Department of Orthodontics, Wonkwang University Sanbon Dental Hospital (Gunpo, Korea) for orthodontic treatment and who underwent CBCT were selected. Among 319 patients in this group, 99 patients without any exclusion factors were selected for this study. The average ages of the sample groups were 14.3 ± 3.27 years (ages 8–18 years) and 13.56 ± 3.12 years (ages 6–20 years) for male and female subjects, respectively. The total distributions for sex and age are shown in . We collected data that had been obtained from each patient for orthodontic diagnosis including CBCT images for assessment of the midpalatal suture, hand-wrist and cephalometric radiographs for bone age, and panoramic radiographs for dental age. The exclusion criteria were as follows: Any experience with orthodontic treatmentDisease or medicine intake affecting bone metabolismOmission of any diagnostic data, including CBCT imagesPoor-quality images that were difficult to distinguish (e.g., blurry images)More than 2 months' difference between the dates when CBCT and other radiographs were acquired Any experience with orthodontic treatmentDisease or medicine intake affecting bone metabolismOmission of any diagnostic data, including CBCT imagesPoor-quality images that were difficult to distinguish (e.g., blurry images)More than 2 months' difference between the dates when CBCT and other radiographs were acquiredCBCT (PaX-Zenith3D; Vatech Korea Ind. Co., Gyeong-gido, Korea) images were taken using the following parameters: 105 kVp, 6.2 mAs, 15–24 second scan time, 0.2 and 0.3 mm voxel sizes, and field-of-view, 16 cm × 14 cm. The images were converted to Digital Imaging and Communication in Medicine (DICOM) format. DICOM files were reconstructed into a three-dimensional image by multiplanar reformatting and volume rendering using imaging software (InVivoDental 5.0; Anatomage, San Jose, CA, USA). Cephalometric radiographs, panoramic radiographs, and hand-wrist radiographs were evaluated by using an exclusive imaging program (PiViewSTAR; Infinitt, Seoul, Korea).All measurements were blind-tested by one orthodontist. A screen capture of every slide and image was taken and saved in JPEG file format for this study. Every slide and image was arranged on a black background and assessed on a 27-inch high-resolution (1,920 × 1,018 pixel) monitor using a viewer program (ACDSee Pro 6.2; ACD Systems International Inc., Victoria, BC, Canada). There was no modification made on the monitor or to the saved images, such as changing the brightness or contrast. [...] All statistical calculations were performed with IBM SPSS Statistics software ver. 22.0 (IBM Co., Armonk, NY, USA). The distribution and percentage of each measurement and age were calculated. After measurement, 30 samples were selected randomly from the same patient group after 2 months and re-assessed with the same method. The intra-class correlation coefficient (ICC) was calculated to test the reliability of the CBCT stage, and developmental age indices were determined by one investigator. There was high intrarater reliability according to the results of ICC. ICC values were 0.995 (p < 0.05) for CBCT stage, 0.996 (p < 0.05) for the HWM, 0.991 (p < 0.05) for the CVM, and 0.992 (p < 0.05) for Hellman's index.To observe correlations between CBCT stages and each maturation index, Spearman's rho rank order correlation analysis was performed. Additionally, the same analyses were performed to test for differences between the sexes. A crosstab analysis by contingency coefficients was performed to determine associations between CBCT stages and each maturation index. Assessment was performed by using gamma (γ) and Kendall's tau-b (τ-b) as association measures. Additionally, crosstab analyses between the sexes were performed to find any sex differences. […]

Pipeline specifications

Software tools G*Power, SPSS
Application Miscellaneous
Organisms Homo sapiens