Quantitative analysis of cervical vertebral maturation in Chinese adolescents based on three-dimensional morphology of cervical vertebrae

Objective To investigate associations between three-dimensional(3D) morphology of cervical vertebrae and skeletal maturation by cone-beam computed tomography(CBCT) and establish corresponding regression models for quantitatively evaluating cervical vertebral maturation(CVM). Methods The analyzed sample consisted of 358 CBCT images (175 male, 183 female), of which 277 images were randomly selected as the model development group and 81 as the performance test group. Twenty-one 3D morphological parameters were defined and measured, incorporating all parts of the cervical vertebrae, including the cervical vertebral bodies, transverse processes, spinous processes, pedicles, lamina, and articular processes. The cervical vertebral maturation index (CVMI) was determined by experienced orthodontists as reference standard. Spearman’s rank correlation coefficient and multivariable stepwise regression analysis were used to identify the associations and build regression models. The performance test group was employed to examine each model’s reliability. Paired-samples Wilcoxon signed-rank test compared the CVMI of the model prediction with the reference standard. Results Three-dimensional morphological changes in various parts of the cervical vertebrae correlated with CVMI (P0.05). Conclusion New associations were found between 3D morphology of cervical vertebrae and skeletal maturation. The 3D-driven morphometric CVM assessment method and corresponding regression models exhibited good credibility and high consistency with experts.