Relationship of Frontal Sinus Size and Maturation of Cervical Vertebrae for Assessment of Skeletal Maturity

  • Sara Alijani Orthodontics Department, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
  • Nasrin Farhadian Orthodontics Department, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
  • Behnaz Alafchi Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
  • Mahsa Najafi Mail Orthodontics Department, Dental Faculty, Hamadan University of Medical Sciences, Hamadan, Iran
Keywords:
Frontal Sinus, Cervical Vertebrae, Growth and Development, Cephalometry

Abstract

Objectives: This study aimed to assess the relationship of frontal sinus height and width with the cervical vertebral maturation (CVM) for assessment of skeletal maturity.
Materials and Methods: This retrospective study evaluated lateral cephalograms of 132 patients between 8 to 21 years, including 66 males and 66 females. For each of the six stages of the CVM, 22 patients (11 males and 11 females) were evaluated. The Ertuk’s method was used to measure the height and width of the frontal sinus. The sinus height to width ratio was calculated and considered as the sinus index. The CVM was evaluated on the same lateral cephalograms using the Baccetti’s method. The correlation of frontal sinus height and width with the CVM was analyzed, and comparisons were made using independent t-test, ANOVA, Mann-Whitney test, and Kendall's tau-b correlation coefficient.
Results: The sinus width was 10.85±2.7 mm in males and 9.47±2.6 mm in females. The sinus index was 2.43±0.37 in males and 2.66±0.32 in females (P<0.000). The frontal sinus index and width were significantly greater in males but the sinus length was not significantly different between males and females (P=0.383). Significant differences were found in stages 2 and 3, and also 4 and 5 in females and 2 and 3, 3 and 4, and 4 and 5 in males. The mean frontal sinus index had a significant correlation with the CVM stage in both groups. 
Conclusion: According to the results, the frontal sinus index cannot be used as a predictor of skeletal maturity. 

References

1. Mahmood HT, Shaikh A, Fida M. Association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity. Am J Orthod Dentofacial Orthop. 2016 Oct;150(4):637-42.
2. Tarvade S, Ramkrishna S. Skeletal maturity indicators. J Orthod Res. 2015 Sep;3(3):158-61.
3. Moore RN, Moyer BA, DuBois LM. Skeletal maturation and craniofacial growth. Am J Orthod Dentofacial Orthop. 1990 Jul;98(1):33-40.
4. Canavese F, Charles YP, Dimeglio A. Skeletal age assessment from elbow radiographs. Review of the literature. Chir Organi Mov. 2008 May;92(1):1-6.
5. Houston WJ. Relationships between skeletal maturity estimated from hand-wrist radiographs and the timing of the adolescent growth spurt. Eur J Orthod. 1980 Jan;2(2):81-93.
6. Houston WJ, Miller JC, Tanner JM. Prediction of the timing of the adolescent growth spurt from ossification events in hand-wrist films. Br J Orthod. 1979 Jul;6(3):145-52.
7. Lamparski DG, Nanda SK. Skeletal age assessment utilizing cervical vertebrae. Craniofac Growth Ser. 2002 Apr;39:171-84.
8. Gabriel DB, Southard KA, Qian F, Marshall SD, Franciscus RG, Southard TE. Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop. 2009 Oct;136(4):471-80.
9. Nestman TS, Marshall SD, Qian F, Holton N, Franciscus RG, Southard TE. Cervical vertebrae maturation method morphologic criteria: poor reproducibility. Am J Orthod Dentofacial Orthop. 2011 Aug;140(2):182-8.
10. Wong RW, Alkhal HA, Rabie AB. Use of cervical vertebral maturation to determine skeletal age. Am J Orthod Dentofacial Orthop. 2009 Oct;136(4):481-6.
11. Ruf S, Pancherz H. Development of the frontal sinus in relation to somatic and skeletal maturity. A cephalometric roentgenographic study at puberty. Eur J Orthod. 1996 Oct;18(5):491-7.
12. Ruf S, Pancherz H. Can frontal sinus development be used for the prediction of skeletal maturity at puberty? Acta Odontol Scand. 1996 Aug;54(4):229-34.
13. Valverde Y, Watanabe N, Yamaki M, Saito I. The frontal sinus enlargement as an indicator of growth maturity in class III patients-A pilot study. Int J Med Sci Public Health. 2013 Apr;2:451-5.
14. Ertürk N. Fernröntgenuntersuchungen über die Entwicklung der Stirnhöhle. Fortschritte der Kieferorthopädie. 1968;29(2):245-8.
15. Baccetti T, Franchi L, McNamara Jr JA. The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin. Orthod. 2005 Sep;11(3): 119-29.
16. Neter J, Wasserman W, Kutner MH. Applied linear statistical models. Richard D. Irwin. Inc., Homewood, IL. 1974:842.
17. Guenther WC. Desk calculation of probabilities for the distribution of the sample correlation coefficient. Am Stat. 1977;31(1):45-8.
18. Zar JH. Biostatistical analysis. edn. Singapore: Pearson Education (Singapore)(P) Ltd. New Delhi (Indian Branch). 1999;4:1-663.
19. Nathani R, Diagavane P, Shrivastav S, Kamble R, Gupta D, Korde S. Evaluation of frontal sinus as a growth predictor in horizontal, vertical, and average growth pattern in children from 8 to 11 years: A cephalometric study. J Indian Orthod Soc. 2016 Apr;50(2):101-5.
20. Hanson CL, Owsley DW. Frontal sinus size in Eskimo populations. Am J Phys Anthropol. 1980 Aug;53(2):251-5.
21. Ponde JM, Metzger P, Amaral G, Machado M, Prandini M. Anatomic variations of the frontal sinus. Minim Invasive Neurosurg. 2003 Feb;46(1):29-32.
22. Ruf S, Pancherz H. Frontal sinus development as an indicator for somatic maturity at puberty? Am J Orthod Dentofacial Orthop. 1996 Nov;110(5):476-82.
23. Patil AA, Revankar AV. Reliability of the frontal sinus index as a maturity indicator. Indian J Dent Res. 2013 Jul-Aug;24(4):523.
Published
2020-09-23
How to Cite
1.
Alijani S, Farhadian N, Alafchi B, Najafi M. Relationship of Frontal Sinus Size and Maturation of Cervical Vertebrae for Assessment of Skeletal Maturity. Front Dent. 17.
Section
Original Article