Correlation between Chronological Age and Cervical Vertebrae Morphology in Adolescents with Class I, II and III Malocclusions

Abstract

Background: Predicting the best treatment time is an important factor for treating different malocclusions and growth modification treatments. The aim of this study is to compare the mean age of adolescent growth spurt and duration of pubertal growth peak in Class I, Class II and Class III patients according to Baccetti's cervical vertebral analysis. Material & Methods: In this retrospective cross-sectional study, 310 lateral cephalograms (198 girls and 112 boys) aged between 7 and 17 years were examined. The evaluation of skeletal maturation stage was performed by visual analysis of morphological features of the cervical vertebrae (C2, C3, and C4). The skeletal malocclusion was determined by Steiner analysis performed and calibrated independently by two orthodontists. The Kappa coefficient was done to calculate the intra and inter-observer error. Results: This study showed high correlation coefficient between chronological age and skeletal age with class I and II malocclusion, in girls were 0.78 and 0.74 and in boys 0.78 and 0.70 respectively. The results of the study showed a higher correlation coefficient in class III malocclusion, both in girls and boys, (0.83 and 0.82, respectively). In girls the average duration of growth spurt was 1.5 years in class I patients, 0.9 years in class II and 3.5 years in class III patients. In boys the average duration of growth spurt was 1.4 years in class I patients, 1.1 years in class II and 2.9 years in class III patients. Pubertal growth peak occurs earlier in girls with class III malocclusion than in girls with class I and class II malocclusions. Conclusion: The results of this study showed a high correlation coefficient between chronological age and the stages of cervical vertebrae maturation in all three malocclusions. Therefore, it is possible to use CVM to measure skeletal maturity in all three malocclusions. Girls experience adolescent growth spurt 1.3 years earlier than boys on average. Girls with class III malocclusion experience the adolescent growth spurt earlier in comparison to other malocclusions, while class II boys mature later than the others.