Effect of positional errors on the accuracy of cervical vertebrae maturation assessment using CBCT and lateral cephalograms.

BACKGROUND: The objective of this study was to evaluate the effects of single plane and multiplane rotational errors in yaw, pitch, and roll of the head while recording the lateral cephalogram on CVM (cervical vertebrae maturity) assessment. METHODS: A total of 40 cone-beam computed tomography (CBCT) scans and 360 lateral cephalograms were analyzed for patients with different rotations: Controls (no rotation), Y5 (yaw 5° rotation), Y10 (yaw 10° rotation), R5 (roll 5° rotation), R10 (Roll 10° rotation), P5 (pitch 5° rotation), P10 (pitch 10° rotation), YRP5 (yaw, roll, and pitch 5° rotation), and YRP10 (yaw, roll, and pitch 10° rotation). The C2, C3, and C4 concavity and their base-anterior ratio and posterior-anterior ratio were measured. In addition, maxillomandibular linear parameters, such as effective mandibular length and height, mandibular body length, effective midface length, and maxillomandibular differential, were also evaluated. RESULTS: Y5, Y10, R5, and R10 led to overestimation of CVM in comparison with controls. Multiplane rotations (YRP5 and YRP10) led to more inaccuracies in CVM measurements than single plane rotations; 10° of rotation led to more inaccuracies than 5° of rotation while recording the lateral cephalogram, irrespective of the plane. Yaw rotational errors led to an underestimation of maxillomandibular linear measurements, whereas roll rotational errors led to an overestimation of the measurements; however, there were wide individual variations in the measurements between the different rotations and controls. CONCLUSIONS: Rotational errors lead to overestimation of CVM assessment. Multiplane rotations cause higher inaccuracies than single plane rotations. Increased degree of rotations while capturing the lateral cephalograms lead to more inaccuracies in CVM assessment.