A comparison of accuracy of skeletal maturity indicators using cone beam computed tomography, lateral cephalogram, and handwrist radiograph in circumpubertal dravidian population

Abstract

Aims: The study aims to evaluate and compare cervical maturation stage using lateral cephalogram, cone beam computed tomography (CBCT), and skeletal maturation using handwrist radiograph. Materials and methods: Forty-eight patients of circumpubertal Dravidian population were chosen. Subjects were advised to take CBCT of cervical region, lateral cephalogram, and handwrist radiograph with adequate protective measures. The CBCT and lateral cephalogram were evaluated using the Lamparski index modified by Hassel and Farman as a reference to determine skeletal maturity using cervical vertebra. Handwrist radiograph was evaluated for different stages of maturation according to Fishman’s index. Stages of maturity between handwrist radiograph, lateral cephalogram and CBCT were evaluated in circumpubertal male and female subjects for reliability and accuracy. Results: When evaluating skeletal maturity indicator using these three diagnostic aids, it was found that all three were reliable with p value <0.05 in all groups. The accuracy between CBCT, lateral cephalogram, and handwrist shows skeletal maturity indicator using CBCT was highly accurate than lateral cephalogram and handwrist radiographs. Conclusion: Cervical vertebrae maturation index (CVMI) using lateral cephalogram and CBCT shows high reliability in prepubertal, pubertal, and post-pubertal male and female subjects. The skeletal maturity indicator using handwrist shows reliable tool for skeletal maturity. When the accuracy between the aids was compared, it revealed that CBCT is the most accurate diagnostic aid in assessing skeletal maturity indicator. Clinical significance: The results of this study suggest that CBCT can be used to assess skeletal maturity and, therefore, we can avoid an additional radiogram (handwrist radiography) whenever CBCT is considered as an investigating tool for orthodontic patients.