Academic Journal
Can a cephalogram be used to estimate palatal suture maturity to inform expander selection.
| Τίτλος: | Can a cephalogram be used to estimate palatal suture maturity to inform expander selection. |
|---|---|
| Συγγραφείς: | Lu W; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China., Weng X; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China., Cao L; Department of Dentistry, Radboud University Nijmegen Medical Center, Nijmegen, Netherlands., Tang B; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China., Wang W; Shenzhen Key Laboratory of Visual Object Detection and Recognition, Harbin Institute of Technology, Shenzhen, China., He H; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China.; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China., Flores-Mir C; Mike Petryk School of Dentistry, Faculty of Medicine and Dentistry, College of Health Sciences, University of Alberta, Edmonton, Canada.; Departamento de Odontologia Social, Facultad de Estomatologia, Universidad Peruana Cayetano Heredia, Lima, Peru., Zhao T; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China. zhaott1991@whu.edu.cn., Hua F; State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China. huafang@whu.edu.cn.; Center for Orthodontics and Pediatric Dentistry at Optics Valley Branch, School & Hospital of Stomatology, Wuhan University, Wuhan, China. huafang@whu.edu.cn.; Hubei Provincial Clinical Research Center for Dentofacial Deformities in Children, School & Hospital of Stomatology, Wuhan University, Wuhan, China. huafang@whu.edu.cn.; Center for Evidence-Based Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, China. huafang@whu.edu.cn.; Division of Dentistry, School of Medical Sciences, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK. huafang@whu.edu.cn. |
| Πηγή: | Progress in orthodontics [Prog Orthod] 2026 Aug 31; Vol. 27 (1). Date of Electronic Publication: 2026 Aug 31. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Springer Country of Publication: Germany NLM ID: 100936353 Publication Model: Electronic Cited Medium: Internet ISSN: 2196-1042 (Electronic) Linking ISSN: 17237785 NLM ISO Abbreviation: Prog Orthod Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2013- : Heidelberg : Springer Original Publication: Copenhagen ; Malden, MA : Munksgaard, 2000- |
| Ιατρικοί όροι (MeSH): | Palatal Expansion Technique*/instrumentation , Cephalometry*/methods , Cranial Sutures*/diagnostic imaging , Cranial Sutures*/growth & development , Palate*/diagnostic imaging , Palate*/growth & development, Humans ; Cone-Beam Computed Tomography ; Algorithms ; Deep Learning |
| Περίληψη: | Introduction: The maturity of the mid-palatal suture (MPS) could largely determine the necessity of more invasive interventions for correcting transverse maxillary deficiency. CBCT, the most commonly used method for assessing MPS maturity, is not routinely available and exposes patients to higher levels of ionizing radiation than a cephalogram. Given the substantial number of morphological features contained in a cephalogram, this study aimed to estimate CBCT-defined MPS maturity using an entire cephalogram alone via deep learning (DL) algorithms. Methods: A total of 543 paired CBCT and cephalogram files available from two distinct hospital settings formed the internal and external datasets. Data augmentation and five-fold cross-validation strategies were applied. Six ResNet-based DL algorithms were initiated via transfer learning. The AdamW optimizer and an early-stopping strategy were employed during training. The models were subsequently tested on the held-out external dataset. The Grad-CAM technique was applied to offer insights into the models' decision-making process. Results: All algorithms exhibited promising classification performance, with area under the curve (AUC) values ranging from 0.91 to 0.97. The models with the TKSGA module demonstrated better discriminative ability, calibration, and clinical usefulness than their baseline counterparts. Models integrated with the TKSGA module exhibited an interpretable decision pattern. The heatmaps revealed that morphological characteristics of patients' dentition, cervical vertebrae, and nasopharyngeal airway were primary areas of interest for the DL models. Conclusions: When CBCT imaging is unavailable or not justified, a lateral cephalogram coupled with advanced DL algorithms, could be considered as a supplementary tool to inform palatal expander selection. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethical approval: This study was approved by the Ethics Committee of School & Hospital of Stomatology, Wuhan University (No. WDKQ2024-B86). Competing interests: Fang Hua is an Associate Editor of Progress in Orthodontics. He was not involved in the peer review or decision-making process for this manuscript. Above and beyond he has no actual or potential conflicts of interest. The other authors declare that they have no conflicts of interest to disclose. |
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| Entry Date(s): | Date Created: 20260831 Date Completed: 20260901 Latest Revision: 20260903 |
| Update Code: | 20260903 |
| PubMed Central ID: | PMC13529626 |
| DOI: | 10.1186/s40510-026-00641-2 |
| PMID: | 42675368 |
| Βάση Δεδομένων: | MEDLINE |
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