Optimized Analysis of Cervical Vertebrae Maturation in Cone-Beam Computed Tomography: A Cross-Sectional Study.

Introduction: Cone-beam computed tomography (CBCT) scans are widely used in dentistry as a valuable and accurate research tool for assessing skeletal age. This study aimed to conduct an optimized analysis of cervical vertebrae maturation using pre-existing CBCT images and compare the findings with mandibular growth stages. Methods: Seventy-five participants evaluated 24 CBCT images, from which 12 lateral cephalometric projections (Cef2D) and 12 sagittal tomographic reconstructions (Rec2D) were extracted. The inferior borders of the C2, C3, and C4 vertebrae, as well as the shapes of C3 and C4, were analyzed according to the cervical vertebral maturation (CVM) method proposed by Baccetti et al. (2005). The degree of reproducibility was assessed using Cohen's kappa coefficient. Results: The analysis of intra- and inter-examiner reproducibility for the inferior borders of the cervical vertebrae and the classification of maturation stages showed almost perfect and substantial levels of agreement, respectively. These results were consistent for both Cef2D and Rec2D images. When mandibular growth stages were grouped, the reproducibility of the CVM method also reached an almost perfect level of agreement for both image types. Conclusion: The analysis of CVM, adapted from the method by Baccetti et al. (2005) for CBCT, demonstrated a high level of reproducibility, particularly when evaluating the inferior borders of the C2, C3, and C4 vertebrae and when grouping post-peak stages of mandibular growth.