International orthodontics · 2025
Retention of pubertal cervical vertebral maturation stages in adults (20-45 years). Limitations of cervical vertebral maturation in growth status assessment: A cross-sectional study.
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Amin Erum, Ali Sajid, Faiza Rana, Jamil Marium, Khalid Qasim, Hussain Umar, Pandis Nikolaos
Аннотация
OBJECTIVE: To evaluate the retention of pubertal cervical vertebral maturation (CVM) stages in adults and assess the association of vertical and sagittal skeletal patterns on this retention.
METHODS: This cross-sectional study was conducted on pre-treatment records of 489 adult participants (286 females and 203 males) aged 20 to 45. Inclusion criteria were clear lateral cephalometric radiographs and the absence of systemic conditions or previous orthodontic treatment affecting skeletal maturation. Skeletal sagittal and vertical patterns were recorded. Associations between CVM stages and sex, skeletal sagittal, and vertical pattern were analysed using inverse probability weighting (IPW)-adjusted ordinal logistic regression for age.
RESULTS: The mean age was 26.09 (4.84) years. CS4 was retained in 8.59% and CS5 in 19.63%. Age varied significantly across stages (P=0.01) with participants in CS5 being older. A significant sex difference was observed (P=0.01) with more males in CS6 and more females in CS5. Skeletal class was significantly associated with CVM stages (P=0.001) with Class III subjects more likely to exhibit less mature CVM stages. However, the vertical pattern was not significantly associated with CVM stages (P=0.63). Ordinal logistic regression showed that Class III participants had a significantly lower likelihood of attaining CS6 (OR=0.30, 95% CI: 0.16-0.54, P<0.001) while vertical pattern and sex were not significant predictors after age adjustment.
CONCLUSION: A higher proportion of adults did not attain the post-pubertal CVM stage, especially in Class III malocclusion, raising concerns about CVM's reliability. Multiple growth indicators in combination with physical appearance should be used for skeletal maturation assessment.
METHODS: This cross-sectional study was conducted on pre-treatment records of 489 adult participants (286 females and 203 males) aged 20 to 45. Inclusion criteria were clear lateral cephalometric radiographs and the absence of systemic conditions or previous orthodontic treatment affecting skeletal maturation. Skeletal sagittal and vertical patterns were recorded. Associations between CVM stages and sex, skeletal sagittal, and vertical pattern were analysed using inverse probability weighting (IPW)-adjusted ordinal logistic regression for age.
RESULTS: The mean age was 26.09 (4.84) years. CS4 was retained in 8.59% and CS5 in 19.63%. Age varied significantly across stages (P=0.01) with participants in CS5 being older. A significant sex difference was observed (P=0.01) with more males in CS6 and more females in CS5. Skeletal class was significantly associated with CVM stages (P=0.001) with Class III subjects more likely to exhibit less mature CVM stages. However, the vertical pattern was not significantly associated with CVM stages (P=0.63). Ordinal logistic regression showed that Class III participants had a significantly lower likelihood of attaining CS6 (OR=0.30, 95% CI: 0.16-0.54, P<0.001) while vertical pattern and sex were not significant predictors after age adjustment.
CONCLUSION: A higher proportion of adults did not attain the post-pubertal CVM stage, especially in Class III malocclusion, raising concerns about CVM's reliability. Multiple growth indicators in combination with physical appearance should be used for skeletal maturation assessment.