Cervical vertebrae maturation index estimates on cone beam CT: 3D reconstructions vs sagittal sections.
OBJECTIVE
The aim of this study was to evaluate the performance of CBCT three-dimensional (3D) reconstructions and sagittal sections for estimates of cervical vertebrae maturation index (CVMI).


METHODS
The sample consisted of 72 CBCT examinations from patients aged 8-16 years (45 females and 27 males) selected from the archives of two private clinics. Two calibrated observers (kappa scores: ≥0.901) interpreted the CBCT settings twice. Intra- and interobserver agreement for both imaging exhibition modes was analyzed by kappa statistics, which was also used to analyze the agreement between 3D reconstructions and sagittal sections. Correlations between cervical vertebrae maturation estimates and chronological age, as well as between the assessments by 3D reconstructions and sagittal sections, were analyzed using gamma Goodman-Kruskal coefficients (α = 0.05).


RESULTS
The kappa scores evidenced almost perfect agreement between the first and second assessments of the cervical vertebrae by 3D reconstructions (0.933-0.983) and sagittal sections (0.983-1.000). Similarly, the agreement between 3D reconstructions and sagittal sections was almost perfect (kappa index: 0.983). In most divergent cases, the difference between 3D reconstructions and sagittal sections was one stage of CVMI. Strongly positive correlations (>0.8, p < 0.001) were found not only between chronological age and CVMI but also between the estimates by 3D reconstructions and sagittal sections (p < 0.001).


CONCLUSIONS
Although CBCT imaging must not be used exclusively for this purpose, it may be suitable for skeletal maturity assessments.
1 Department of Orthodontics, University of São Paulo City, São Paulo, São Paulo, Brazil.
Marco A E
MA
Bonfim
1 Department of Orthodontics, University of São Paulo City, São Paulo, São Paulo, Brazil.
André L F
AL
Costa
1 Department of Orthodontics, University of São Paulo City, São Paulo, São Paulo, Brazil.
Acácio
A
Fuziy
2 INDOR Clinic, São Paulo, São Paulo, Brazil.
Michel E L
ME
Ximenez
3 Vellini Institute, São Paulo, São Paulo, Brazil.
Flávio A
FA
Cotrim-Ferreira
4 Department of Radiology, Paulista University, Campinas, São Paulo, Brazil.
Rívea I
RI
Ferreira-Santos
D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods* / Q000706:statistics & numerical data; D000367:Age Factors; D002508:Cephalometry / Q000379:methods / Q000706:statistics & numerical data; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods* / Q000706:statistics & numerical data; D021621:Imaging, Three-Dimensional / Q000379:methods* / Q000706:statistics & numerical data; D008297:Male; D015588:Observer Variation; D011627:Puberty; D015203:Reproducibility of Results; D012189:Retrospective Studies
Bone development; Orthodontics; biological indicators; cone beam computed tomography