Association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity.
BACKGROUND
Various methods have been proposed to evaluate a patient's developmental status. However, most of them lacked precision and failed to give a reliable estimate of skeletal maturity. The aims of this study were to evaluate the association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity and to determine its validity in assessing the different stages of the adolescent growth spurt.


METHODS
A cross-sectional study was performed on the pretreatment lateral cephalograms of 252 subjects aged 8 to 21 years. The sample was divided into 6 groups based on the cervical vertebral maturation stages. The frontal sinus index was calculated by dividing the frontal sinus height and width, and the cervical stages were evaluated on the same radiograph. The Kruskal-Wallis test was applied to compare frontal sinus index values at different cervical stages, and the post hoc Dunnett T3 test was applied to compare frontal sinus index values between adjacent cervical stages for each sex. The Kendall tau-b values were computed to assess the correlation between the cervical stages and the sinus index. A P value of ≤0.05 was considered statistically significant.


RESULTS
The height and width of the frontal sinus were significantly larger in the male subjects than in the females. A significant association was found between the frontal sinus height and width and cervical stages (P ≤0.001) in both sexes. However, the changes in the frontal sinus index across the different cervical stages were found to be significant (P ≤0.001) in male subjects only. Similarly, a weak negative correlation was found between the sinus index and the cervical stages in male subjects (tau-b = -0.271; P <0.001), whereas no correlation was found in female subjects (tau-b = -0.006; P <0.928). However, the post hoc analysis showed that the values of the sinus index were comparable between any 2 adjacent cervical stages.


CONCLUSIONS
The frontal sinus index cannot be used to identify the prepubertal, pubertal, and postpubertal stages of the adolescent growth spurt. Therefore, it cannot be used as a reliable maturity indicator.
Resident in orthodontics, Section of Dentistry, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Hafiz Taha
HT
Mahmood
Consultant orthodontist, assistant professor, and program coordinator for the orthodontics residency program, Section of Dentistry, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan. Electronic address: attiya.shaikh@aku.edu.
Attiya
A
Shaikh
Consultant orthodontist, associate professor, and program director for the orthodontics residency program, Section of Dentistry, Department of Surgery, Aga Khan University Hospital, Karachi, Pakistan.
Mubassar
M
Fida
D000293:Adolescent; D000365:Age Determination by Skeleton; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000254:growth & development*; D003430:Cross-Sectional Studies; D005260:Female; D005626:Frontal Sinus / Q000033:anatomy & histology / Q000254:growth & development*; D006801:Humans; D008297:Male; D012016:Reference Values; D013223:Statistics as Topic