Evaluation of maxillary and mandibular growth patterns with cephalometric analysis based on cervical vertebral maturation: A Japanese cross-sectional study

Abstract

Background Appropriate maxillofacial growth and development evaluation is important for effective orthodontic treatment. Growth evaluation is based on physiological age determined by individual development, but not chronological age. One strategy for determining physiological age is using the cervical vertebral bone age. Objectives This study aimed to clarify the standard size of the upper and lower jawbones in Japanese patients using the cervical vertebral maturation stages (CVMS) as an index and clarify the growth pattern. And to use the cervical spine age as a diagnostic aid in orthodontic treatment. Material and methods Random sampling was performed from the outpatients who visited the Orthodontics department, Tokyo Medical and Dental University Dental Hospital, and 400 patients were enrolled before treatment. Lateral cephalometric radiographs were obtained to measure the height and length of the mandible and the maxilla length with cephalometric analysis. Standard values were calculated for each cervical-spine-age group to analyze changes during mandibular and maxillary growth. Furthermore, we compared the differences between males and females. The Kruskal–Wallis test was used to compare cervical-spine-age groups, and the Steel–Dwass test was used for multiple comparisons. The reliability of CVMS was confirmed by calculating the weighted kappa coefficient (κ). Results κ for the degree of intra-evaluator agreement and the degree of the inter-evaluator agreement were calculated, and both indicated almost perfect agreement. We found that the distance between the anterior nasal spine (ANS) and posterior nasal spine (PNS) (i.e., ANS–PNS) increased significantly between CVMS II and CVMS III in males. The distance between Articulare (Ar) and Gonion (Go) (i.e., Ar–Go) and the distance between Go and Pogonion (Pog) (i.e., Go–Pog) increased significantly between CVMS III and CVMS IV in males. Conclusion The findings suggested that CVMS is a reliable indicator of the growth stage of the maxilla and mandible.

Validation of Machine Learning Models for Craniofacial Growth Prediction

“…In the modern era, obtaining lateral cephalometric radiographs of patients who have not received orthodontic treatment solely for research purposes is ethically difficult. Consequently, only a few studies have tracked the longitudinal craniofacial growth of individuals, and individual patient predictions have not reached the accuracy level required in clinical practice [30,44]. Meanwhile, AI has advanced in numerous fields in recent years, including medicine.…”

“…However, these approaches do not account for individual differences, and the average annual growth rate applies to all patients. Manabe et al [30] cited the inability of individuals to follow continuing growth as a limiting factor in their study and stated that, ideally, a longitudinal study would be desirable.…”

Comparison of spheno-occipital synchondrosis maturation stages with three-dimensional assessment of mandibular growth

“…However, the challenges of acquiring high sample numbers for a longitudinal study, the related increase in the number of radiographic exposures, and the ethical considerations are likely to rule out this approach and use the crosssectional direction. So, the cross-sectional design was selected based on similar published study about maxillary and mandibular growth [28]. Also, this study might be considered as primary reporting in this field, and we hope there more detailed studies in future of a longitudinal design.…”

“…This cross-sectional study of a retrospective type was approved by the Ethics Committee of the School of Stomatology at Lanzhou University in a group of the Chinese population (No: LZUKQ-2019-042). The sample size primarily depended on previous studies [27,28], the G* power 3.0.10 software (ver. 3.1.9.7; Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany) was used to calculate the sample size based on the length of mandible (the primary outcome of this study).…”

Comparison of three-dimensional maxillary growth across spheno-occipital synchondrosis maturation stages

“…This cross-sectional study of a retrospective type was approved by the Ethics Committee of the School of Stomatology at Lanzhou University in a group of the Chinese population (No: LZUKQ-2019–042). The sample size primarily depended on previous studies [ 27 , 28 ]. Because, either unilateral or bilateral maxillary constriction are commonly seen in daily orthodontic practice and the early intervention of this form of malocclusion in proper timing using either slow or rapid palatal expansion is always applicable and resulted in a great improvement and prevents further aggressive interventions in the adult age [ 29 , 30 ], so maxillary width variable was selected for sample size calculation.…”