Cervical vertebrae maturation assessment as a predictive method for midpalatal suture maturation stages in 11- to 14-year-olds: retrospective study

Abstract

Introduction: The treatment of transverse maxillary deficiency must be performed with the patient inside the growth phase, then, it is necessary to evaluate the patient’s skeletal maturation. There are two common methods: cervical vertebrae maturation (CVM) and midpalatal suture maturation (MSM). Objective: to evaluate and correlate the methods in patients aged from 11 to 14 years old, to investigate if CVM method can be predictive of the midpalatal suture maturation stage. Methods: Forty-two CBCT scans and lateral cephalometric radiographs of children, aged between 11 and 14 were analysed. The images were evaluated by two investigators. Kappa coefficient was calculated to estimate intra and inter-examiner agreement. Spearman correlation test was performed to evaluate the correlation between methods, age and gender. To evaluate the diagnostic performance of the CVM and MSM methods, the likelihood ratio (LHR positive) was applied. Results: MSM evaluation showed a strong correlation with the CVM evaluation (rs = 0.6916). A high correlation between the methods were found for the male gender (rs = 0.7809). There was no correlation between age and the maturation methods, considering both genders. The CVM method presented a strong positive LHR with the MSM method (2.250), in the early stages; nonetheless, in the more advanced stages there was a lower ratio (1.500). Conclusions: The CVM method can be used as a predictor of the maturation stages of the midpalatal suture in the early stages of maturity. In more advanced stages, the evaluation of the palatal suture by tomography is suggested.