Assessment of Cervical Vertebral Bone Mineral Density in Adolescents Undergoing Functional Appliance Treatment

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.

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.

Significant changes in the examined variables were detected during the observation period. The BMD values showed a positive correlation with mandibular length increments.

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.

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.