Comparison of Cervical Vertebrae Maturation Stage using Lateral Cephalometric Radiography versus Cone-Beam Computed Tomography: A Retrospective Study Public Deposited

Downloadable Content

Download PDF
Last Modified
  • March 22, 2019
  • Wilson, Michael
    • Affiliation: School of Dentistry, Department of Orthodontics
  • Introduction: The Cervical Vertebrae Maturation(CVM) method has been proposed by Baccetti et al to be a useful technique in assessing skeletal maturity that does not require any additional radiation exposure to the patient other than the standard two-dimensional(2D) lateral cephalograph. Several studies have called into question the accuracy of this method. We explored the use of 3D imaging to assess if reliability is improved across examiners compared to the use of traditional 2D images with the implication that increased reliability might improve the timing of treatment with growth modification, and lead to an improved treatment response. Methods: A sample of 25 previously treated orthodontic patients in the UNC Graduate Orthodontic Clinic were included. De-identified 2D cephalographs and 3D models of the patients' cervical vertebrae were evaluated by research personnel who are trained in using the CVM technique. Using an electronic survey, dental professionals used the CVM method to evaluate de-identified 2D images and 3D models and results were compared to a silver standard CVM stage. Radiographs were also manipulated to simulate sagittal head roll and evaluated by examiners to quantify its effect on CVM technique. Results: There was a statistically significant difference in accuracy of the CVM technique when using 2D image vs 3D models (p= <0.0001). There was no significant difference in CVM technique accuracy with head roll of 10 degrees (p=0.89) or 20 degrees(p=0.80). Intra-rater reproducibility weighted kappa coefficients ranged from 0.50-0.78 in the 2D view, and 0.50-.76 in the 3D view. Conclusion: The use of the CVM technique with 3D models of the cervical vertebrae to assess skeletal maturity appears to be less accurate when compared to the traditional 2D lateral cephalograph, and thus may not be advantageous to utilize in patient evaluation. Patient head tilt of up to 20 degrees in the coronal plane does not affect CVM staging accuracy.
Date of publication
Resource type
  • Jackson, Tate
  • Koroluk, Lorne
  • Nguyen, Tung
  • Master of Science
Degree granting institution
  • University of North Carolina at Chapel Hill Graduate School
Graduation year
  • 2018

This work has no parents.