Assessment of Cervical Vertebral Bone Mineral Density in Adolescents Undergoing Functional Appliance Treatment
Scherene Basheer, Suma Thimmaiah, Rajkumar S Alle
Citation Information :
Basheer S, Thimmaiah S, Alle RS. Assessment of Cervical Vertebral Bone Mineral Density in Adolescents Undergoing Functional Appliance Treatment. J Contemp Dent Pract 2020; 21 (7):756-759.
Aim: The cervical vertebral maturation (CVM) method has proved to be effective to assess the adolescent growth peak in both body height and mandibular size. The aim of this study was to evaluate whether cone-beam computed tomography (CBCT) images can be used to detect the changes of cervical vertebral bone mineral density (BMD) distribution and whether these changes are associated with CVM changes and mandibular length. Materials and methods: Samples were collected from the patients of age group between 9 years and 15 years of both sexes, who reported to the Department of Orthodontics and Dentofacial Orthopedics, RajaRajeswari Dental College and Hospital, Bengaluru. All the measurements were done on constructed CBCT three-dimensional images. Gray levels, which are equivalent to the BMD, were obtained for C2 and C3 vertebrae at pretreatment (T1) and six months after starting the treatment (T2). The vertebral variables [mean, standard deviation (SD)], CVM stages, and mandibular length between T1 and T2 were compared. Results: Significant changes in the examined variables were detected during the observation period. The BMD values showed a positive correlation with mandibular length increments. Conclusion: The CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics and the BMD distribution changed because of active bone remodeling during the maturation. Clinical significance: This study proves that CBCT imaging can provide additional information about the growth status of a patient above and beyond that obtained from two-dimensional cephalometric radiographs. CBCT is an effective tool to analyze the volumetric parameter of BMD in routine dentofacial orthopedics with better accuracy and minimum distortion.
Crawford B, Kim DG, Moon ES, et al. Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment. Am J Orthod Dentofacial Orthop 2014;146(2):183–189. DOI: 10.1016/j.ajodo.2014.04.019.
Baccetti T, Franchi L, McNamara Jr JA. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316–323.
Chen F, Terada K, Hanada K. A new method of predicting mandibular length increment on the basis of cervical vertebrae. Angle Orthod 2004;74(5):630–634.
da Silva Campos MJ, de Souza TS, Júnior SL, et al. Bone mineral density in cone beam computed tomography: only a few shades of gray. World J Radiol 2014;6(8):607. DOI: 10.4329/wjr.v6.i8.607.
Naitoh M, Hirukawa A, Katsumata A, et al. Evaluation of voxel values in mandibular cancellous bone: relationship between cone-beam computed tomography and multislice helical computed tomography. Clin Oral Implants Res 2009;20(5):503–506. DOI: 10.1111/j.1600-0501.2008.01672.x.
Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995;107(1):58–66. DOI: 10.1016/S0889-5406(95)70157-5.
Franchi L, Baccetti T, McNamara Jr JA. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 2000;118(3):335–340. DOI: 10.1067/mod.2000.107009.
O'Reilly MT, Yanniello GJ. Mandibular growth changes and maturation of cervical vertebrae: a longitudinal cephalometric study. Angle Orthod 1988;58(2):179–184.
Cassetta M, Stefanelli LV, Pacifici A, et al. How accurate is CBCT in measuring bone density? A comparative CBCT-CT in vitro study. Clin Implant Dent Relat Res 2014;16(4):471–478. DOI: 10.1111/cid.12027.
Gabriel DB, Southard KA, Qian F, et al. Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop 2009;136(4):478.e1–478.e7; discussion 478-80, 10.1016/j.ajodo.2007.08.028.
Santiago RC, de Miranda Costa LF, Vitral RW, et al. Cervical vertebral maturation as a biologic indicator of skeletal maturity: a systematic review. Angle Orthod 2012;82(6):1123–1131. DOI: 10.2319/103111-673.1.
Shim JJ, Heo G, Lagravère MO. Assessment of skeletal maturation based on cervical vertebrae in CBCT. Int Orthod 2012;10(4):351–362. DOI: 10.1016/j.ortho.2012.09.005.
Katsumata A, Hirukawa A, Okumura S, et al. Relationship between density variability and imaging volume size in cone-beam computerized tomographic scanning of the maxillofacial region: an in vitro study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107(3):420–425. DOI: 10.1016/j.tripleo.2008.05.049.
Guerra EN, Almeida FT, Bezerra FV, et al. Capability of CBCT to identify patients with low bone mineral density: a systematic review. Dentomaxillofac Radioly 2017;46(8):20160475. DOI: 10.1259/dmfr.20160475.
Shi H, Scarfe WC, Farman AG. Three-dimensional reconstruction of individual cervical vertebrae from cone-beam computed-tomography images. Am J Orthod Dentofacial Orthop 2007;131(3):426–432. DOI: 10.1016/j.ajodo.2005.12.031.