Cervical vertebrae anomalies in subjects with Class II malocclusion assessed by lateral cephalogram and cone beam computed tomography

Abstract

A high prevalence of cervical vertebrae anomalies (CVA) has been recently associated with various malocclusions. Our aim was to study the prevalence of CVA on lateral cephalograms in Class II subjects and to compare the findings with those obtained from cone beam computed tomography (CBCT). Standardized cephalograms of 238 Class II patients were analysed for CVA. Cephalogram and CBCT were available for an additional 21 subjects. Cephalometric values were correlated with vertebrae morphology; logistic regressions and intraobserver agreement were evaluated. Inspection of lateral cephalograms could exclude CVA in 90.3 per cent of the subjects, while 9.7 per cent showed potential fusions. No correlations were found between the cephalometric values and potential vertebrae anomalies. In the 21 patients with a CBCT and a lateral cephalogram, the visual assessment of the cephalogram yielded a potential fusion in nine cases. None could be confirmed by CBCT. A low number of potentially fused cervical vertebrae could be detected on lateral cephalograms. The possible fusions did not correlate to any cephalometric values nor could they be confirmed by CBCT, the gold standard for assessing CVA. Visual examination of a cephalogram may result in a false-positive finding and does not allow reliable diagnosis of CVA.

Ethnic differences in craniofacial and upper spine morphology in children with skeletal Class II malocclusion

“…21,22 In the present study, in order to avoid 'pseudofusion,' fusion was only registered if fusion was found consistently on all consecutive lateral cephalograms of the same patient and if fusion was confirmed independently by two of the authors. In a recent study 22 it was found that the agreement between lateral cephalograms and cone-beam computed tomographic images in detecting upper spine deviations was good and that lateral cephalograms were sufficient for evaluating the upper spine morphology.…”

Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study

“…Studies have found that some fusions observed on 2D radiographs were more likely to be pseudofusions. [25][26][27] Oblique These studies have recommended a more valid method such as 3D radiographs (CT or CBCT) for assessing fusions. In the present study, no statistically significant differences in the occurrence of morphological deviations of the cervical column were found between lateral cephalograms and CBCT images, and the agreement was k 5 0.64.…”

“…24 The difficulty of reliably determining morphological deviations in the cervical vertebral column on a single lateral cephalogram has been discussed in the literature. [25][26][27] Studies have found that some fusions observed on 2D radiographs were more likely to be "pseudofusions", and that a more valid method such as three-dimensional (3D) radiographs [CT or cone beam CT (CBCT)] is recommended.…”

Evaluation of the Correlation Between Vertical Facial Discrepancies and Cervical Vertebral Fusion

“…(2) However, according to previous studies, the facial morphology affects the morphology of cervical vertebrae. (1,(3)(4)(5) Of other factors that can affect both facial and cervical postures is the res-piratory needs. (4,(6)(7)(8) Solow et al, (6) Wenzel et al, (7) and Chen et al (8) reported a correlation between the respiratory needs and the head position.…”

“…(1) Previous studies have confirmed the impact of vertical and sagittal parameters of the craniofacial system on the morphology of cervical vertebrae. (1,3,5,9,10) Unfortunately, although some studies have been conducted to evaluate the relation-ship between the facial morphology and the cervical vertebral morphology, the possibility of any correlation between pathological problems associated with cervical vertebral fusion and long facial pattern has been limitedly assessed. The aim of the present study was to determine the correlation between cervical vertebral fusion and long facial pattern in adults.…”