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The assessment of cervical vertebral anomalies on lateral cephalograms and cone-beam computed tomographs

Year 2015, Volume: 18 Issue: 4, 327 - 334, 25.02.2015

Abstract

Aim: The aims of this study were (1) to determine the occurrence of cervical vertebral anomaly in the selected population, (2) to evaluate the reliability of the findings obtained from lateral cephalograms. For this purpose, the lateral cephalogram findings were compared with those obtained from cone beam computed tomography (CBCT). Subjects and Methods: A sample of 123 subjects who had both lateral cephalogram and CBCT were comprised from the archive. Only the subjects with images presenting the first four cervical vertebrae were included; thus 25 subjects (14 female, 11 male) formed the study group. Normal appearance was determined when the first four vertebrae could be traced as separate entities, with all anatomical components present. Characteristics of the cervical column were classified according to Sandham as posterior arch deficiencies (PAD) and fusions. Results: The lateral cephalogram findings of the 25 subjects revealed an occurrence of 16% for fusion and an occurence of 20% for PAD. However, none of these findings were confirmed by the evaluation of CBCT images. Conclusions: The occurrence of cervical vertebral anomalies was zero in the evaluated orthodontic population. Our findings suggest that the evaluation of two-dimensional radiographs for the diagnosis of cervical vertebral anomalies was not a reliable method.

References

  • Baccetti T, Franchi L, McNamara JA, Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316-323.
  • Kylämarkula S, Huggare J. Head posture and the morphology of the first cervical vertebra. Eur J Orthod 1985;7(3):151-156.
  • Huggare JA, Laine-Alava MT. Nasorespiratory function and head posture. Am J Orthod Dentofacial Orthop 1997;112(5):507-511.
  • Vastardis H, Evans CA. Evaluation of cervical spine abnormalities on cephalometric radiographs. Am J Orthod Dentofacial Orthop 1996;109(6):581-588.
  • Sandham A. Cervical vertebral anomalies in cleft lip and palate. Cleft Palate J 1986;23:206-214.
  • Rajion ZA, Townsend GC, Netherway DJ, Anderson PJ, Yusof A, Hughes T, et al. A three-dimensional computed tomographic analysis of the cervical spine in unoperated infants with cleft lip and palate. Cleft Palate Craniofac J 2006;43:513-518.
  • Shen FH, Samartzis D, Herman J, Lubicky JP. Radiographic assessment of segmental motion at the atlanto-axial junction in the Klippel-Feil patient. Spine (Phila Pa 1976) 2006;31:171-177.
  • Anderson PJ, Hall CM, Evans RD, Hayward RD, Harkness WJ, Jones BM. The cervical spine in Saethre-Chotzen syndrome. Cleft Palate Craniofac J 1997;34:79-82.
  • Thompson DN, Slaney SF, Hall CM, Shaw D, Jones BM, Hayward RD. Congenital cervical spinal fusion: A study in Apert syndrome. Pediatr Neurosurg 1996;25:20-27.
  • Frost M, Huffer WE, Sze CI, Badesch D, Cajade-Law AG, Kleinschmidt-DeMasters BK. Cervical spine abnormalities in Down Syndrome. Clin Neuropathol 1999;18:250-259.
  • Sonnesen L, Kjaer I. Cervical column morphology in patients with skeletal open bite. Orthod Craniofac Res 2008;11:17-23.
  • Sonnesen L, Kjaer I. Cervical vertebral body fusions in patients with skeletal deep bite. Eur J Orthod 2007;29:464-470.
  • Sonnesen L, Kjaer I. Anomalies of the cervical vertebrae in patients with skeletal Class II malocclusion and horizontal maxillary overjet. Am J Orthod Dentofacial Orthop 2008;133:188.e15-20.
  • Sonnesen L, Kjaer I. Cervical column morphology in patients with skeletal Class III malocclusion and mandibular overjet. Am J Orthod Dentofacial Orthop 2007;132:427.e7-12.
  • Di Vece L, Faleri G, Picciotti M, Guido L, Giorgetti R. Does a transverse maxillary deficit affect the cervical vertebrae? A pilot study. Am J Orthod Dentofacial Orthop 2010;137(4):515-519.
  • Sonnesen L, Pedersen CE, Kjaer I. Cervical column morphology related to head posture, cranial base angle, and condylar malformation. Eur J Orthod 2007;29:398-403.
  • Patcas R, Tausch D, Pandis N, Manestar M, Ullrich O, Karlo CA, Peltomäki T, Kellenberger CJ. Illusions of fusions: assessing cervical vertebral fusion on lateral cephalograms, multidetector computed tomographs, and cone-beam computed tomographs. Am J Orthod Dentofacial Orthop 2013;143(2):213-220.
  • Klimo P Jr, Rao G, Brockmeyer D. Congenital anomalies of the cervical spine. Neurosurg Clin N Am 2007;18(3):463-478.
  • Mcrae DL. The significance of abnormalities the cervical spine. Am J Roentgenol Radium Ther Nucl Med 1960;84:3-25.
  • Bebnowski D, Hänggi MP, Markic G, Roos M, Peltomäki T. Cervical vertebrae anomalies in subjects with Class II malocclusion assessed by lateral cephalogram and cone beam computed tomography. Eur J Orthod 2012;34(2):226-231.
  • McAfee PC, Bohlman HH, Han JS, Salvagno RT. Comparison of nuclear magnetic resonance imaging and computerized tomography in the diagnosis of upper cervical spinal cord compression. Spine (Phila Pa 1976) 1986;11:295-304.
  • Guille JT, Sherk HH. Congenital osseous anomalies of the upper and lower cervical spine in children. J Bone Joint Surg Am 2002;84-A:277-288.
  • Massengill AD, Huynh SL, Harris JH Jr. C2-3 facet joint "pseudo-fusion": anatomic basis of a normal variant. Skeletal Radiol 1997;26(1):27-30.
  • Koletsis DD, Halazonetis DJ. Cervical vertebrae anomalies in orthodontic patients: a growth-based superimpositional approach. Eur J Orthod 2010;32(1):36-42.
  • Panjabi MM, Oxland T, Takata K, Goel V, Duranceau J, Krag M. Articular facets of the human spine. Quantitative three-dimensional anatomy. Spine (Phila Pa 1976) 1993;18(10):1298-1310.
  • Brown MW, Templeton AW, Hodges FJ 3rd. The incidence of acquired and congenital fusions in the cervical spine. Am J Roentgenol Radium Ther Nucl Med 1964;92:1255-1259.
  • Templeton AW, Brown MW. The transverse processes of the cervical vertebral segment. A correlation of oblique roentgenograms with skeletonized material. Radiology 1964;82:912-915.
  • Sonnesen L, Jensen KE, Petersson AR, Petri N, Berg S, Svanholt P. Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study. Dentomaxillofac Radiol 2013;42(6):20130060.

The assessment of cervical vertebral anomalies on lateral cephalograms and cone-beam computed tomographs

Year 2015, Volume: 18 Issue: 4, 327 - 334, 25.02.2015

Abstract

Objectives: The aims of this study were (1) to determine the occurrence of cervical vertebral anomaly in the selected population, (2) to evaluate the reliability of the findings obtained from lateral cephalograms. For this purpose, the lateral cephalogram findings were compared with those obtained from cone beam computed tomography (CBCT).Subjects and Methods: A sample of 123 subjects who had both lateral cephalogram and CBCT were comprised from the archive. Only the subjects with images presenting the first four cervical vertebrae were included; thus 25 subjects (14 female, 11 male) formed the study group. Normal appearance was determined when the first four vertebrae could be traced as separate entities, with all anatomical components present. Characteristics of the cervical column were classified according to Sandham as posterior arch deficiencies (PAD) and fusions.Results: The lateral cephalogram findings of the 25 subjects revealed an occurrence of 16% for fusion and an occurrence of 20% for PAD. However, none of these findings were confirmed by the evaluation of CBCT images.Conclusions: The occurrence of cervical vertebral anomalies was zero in the evaluated orthodontic population. Our findings suggest that the evaluation of two-dimensional radiographs for the diagnosis of cervical vertebral anomalies was not a reliable method

References

  • Baccetti T, Franchi L, McNamara JA, Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316-323.
  • Kylämarkula S, Huggare J. Head posture and the morphology of the first cervical vertebra. Eur J Orthod 1985;7(3):151-156.
  • Huggare JA, Laine-Alava MT. Nasorespiratory function and head posture. Am J Orthod Dentofacial Orthop 1997;112(5):507-511.
  • Vastardis H, Evans CA. Evaluation of cervical spine abnormalities on cephalometric radiographs. Am J Orthod Dentofacial Orthop 1996;109(6):581-588.
  • Sandham A. Cervical vertebral anomalies in cleft lip and palate. Cleft Palate J 1986;23:206-214.
  • Rajion ZA, Townsend GC, Netherway DJ, Anderson PJ, Yusof A, Hughes T, et al. A three-dimensional computed tomographic analysis of the cervical spine in unoperated infants with cleft lip and palate. Cleft Palate Craniofac J 2006;43:513-518.
  • Shen FH, Samartzis D, Herman J, Lubicky JP. Radiographic assessment of segmental motion at the atlanto-axial junction in the Klippel-Feil patient. Spine (Phila Pa 1976) 2006;31:171-177.
  • Anderson PJ, Hall CM, Evans RD, Hayward RD, Harkness WJ, Jones BM. The cervical spine in Saethre-Chotzen syndrome. Cleft Palate Craniofac J 1997;34:79-82.
  • Thompson DN, Slaney SF, Hall CM, Shaw D, Jones BM, Hayward RD. Congenital cervical spinal fusion: A study in Apert syndrome. Pediatr Neurosurg 1996;25:20-27.
  • Frost M, Huffer WE, Sze CI, Badesch D, Cajade-Law AG, Kleinschmidt-DeMasters BK. Cervical spine abnormalities in Down Syndrome. Clin Neuropathol 1999;18:250-259.
  • Sonnesen L, Kjaer I. Cervical column morphology in patients with skeletal open bite. Orthod Craniofac Res 2008;11:17-23.
  • Sonnesen L, Kjaer I. Cervical vertebral body fusions in patients with skeletal deep bite. Eur J Orthod 2007;29:464-470.
  • Sonnesen L, Kjaer I. Anomalies of the cervical vertebrae in patients with skeletal Class II malocclusion and horizontal maxillary overjet. Am J Orthod Dentofacial Orthop 2008;133:188.e15-20.
  • Sonnesen L, Kjaer I. Cervical column morphology in patients with skeletal Class III malocclusion and mandibular overjet. Am J Orthod Dentofacial Orthop 2007;132:427.e7-12.
  • Di Vece L, Faleri G, Picciotti M, Guido L, Giorgetti R. Does a transverse maxillary deficit affect the cervical vertebrae? A pilot study. Am J Orthod Dentofacial Orthop 2010;137(4):515-519.
  • Sonnesen L, Pedersen CE, Kjaer I. Cervical column morphology related to head posture, cranial base angle, and condylar malformation. Eur J Orthod 2007;29:398-403.
  • Patcas R, Tausch D, Pandis N, Manestar M, Ullrich O, Karlo CA, Peltomäki T, Kellenberger CJ. Illusions of fusions: assessing cervical vertebral fusion on lateral cephalograms, multidetector computed tomographs, and cone-beam computed tomographs. Am J Orthod Dentofacial Orthop 2013;143(2):213-220.
  • Klimo P Jr, Rao G, Brockmeyer D. Congenital anomalies of the cervical spine. Neurosurg Clin N Am 2007;18(3):463-478.
  • Mcrae DL. The significance of abnormalities the cervical spine. Am J Roentgenol Radium Ther Nucl Med 1960;84:3-25.
  • Bebnowski D, Hänggi MP, Markic G, Roos M, Peltomäki T. Cervical vertebrae anomalies in subjects with Class II malocclusion assessed by lateral cephalogram and cone beam computed tomography. Eur J Orthod 2012;34(2):226-231.
  • McAfee PC, Bohlman HH, Han JS, Salvagno RT. Comparison of nuclear magnetic resonance imaging and computerized tomography in the diagnosis of upper cervical spinal cord compression. Spine (Phila Pa 1976) 1986;11:295-304.
  • Guille JT, Sherk HH. Congenital osseous anomalies of the upper and lower cervical spine in children. J Bone Joint Surg Am 2002;84-A:277-288.
  • Massengill AD, Huynh SL, Harris JH Jr. C2-3 facet joint "pseudo-fusion": anatomic basis of a normal variant. Skeletal Radiol 1997;26(1):27-30.
  • Koletsis DD, Halazonetis DJ. Cervical vertebrae anomalies in orthodontic patients: a growth-based superimpositional approach. Eur J Orthod 2010;32(1):36-42.
  • Panjabi MM, Oxland T, Takata K, Goel V, Duranceau J, Krag M. Articular facets of the human spine. Quantitative three-dimensional anatomy. Spine (Phila Pa 1976) 1993;18(10):1298-1310.
  • Brown MW, Templeton AW, Hodges FJ 3rd. The incidence of acquired and congenital fusions in the cervical spine. Am J Roentgenol Radium Ther Nucl Med 1964;92:1255-1259.
  • Templeton AW, Brown MW. The transverse processes of the cervical vertebral segment. A correlation of oblique roentgenograms with skeletonized material. Radiology 1964;82:912-915.
  • Sonnesen L, Jensen KE, Petersson AR, Petri N, Berg S, Svanholt P. Cervical vertebral column morphology in patients with obstructive sleep apnoea assessed using lateral cephalograms and cone beam CT. A comparative study. Dentomaxillofac Radiol 2013;42(6):20130060.
There are 28 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Research Articles
Authors

Burcu Altan

Alper Sinanoğlu

Hüsniye Demirtürk Kocasaraç

Publication Date February 25, 2015
Submission Date February 25, 2015
Published in Issue Year 2015Volume: 18 Issue: 4

Cite

EndNote Altan B, Sinanoğlu A, Demirtürk Kocasaraç H (November 1, 2015) The assessment of cervical vertebral anomalies on lateral cephalograms and cone-beam computed tomographs. Cumhuriyet Dental Journal 18 4 327–334.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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