Assessment of skeletal age using the cervical vertebrae in Ghanaian orthodontics patients

Background: Skeletal age refers to the general degree of maturation of a part of the skeleton that subjects of a population manifest with growth. Assessing skeletal age involves visually inspecting bones on a radiograph. The hand-wrist and cervical vertebral maturation methods have been used widely to determine skeletal age. Using vertebral development to evaluate skeletal maturity is advantageous because it requires only one radiograph, the lateral cephalogram, which orthodontists routinely use for diagnosis and treatment planning. Objective: This study aimed to determine the skeletal age according to cervical vertebral maturation (CVM) and its correlation with chronological age. Methods: Lateral cephalometric radiographs of 70 Ghanaian orthodontic patients aged 9 - 18 years, involving 41 females and 29 males, were taken. Skeletal age was assessed according to Hassel and Farman’s CVM method. The correlation between the chronological and skeletal ages was determined using the Spearman rank-order correlation coefficients. Results: The mean chronological age of the sample was 12.97 ± 2.74 years; 59% (n = 41) were females and 41% (n = 29) were males. The most prevalent CVM stage was stage 4 (31%, n = 22), and stage 6 (3%, n = 2) was the least prevalent. CVM stages significantly correlated with chronological age (r = 0.759). CVM stages consistently occurred earlier in females than males, indicating that skeletal maturation was more advanced in females than males. The mean pubertal growth spurt (CVM stage 3) occurred for the total sample at 11.98 ± 3.06, 10.46 ± 0.6 years in the females and 16.51 ± 0.00 years for the only male recorded at this stage. Consequently, every child must be treated as an individual based on their level of skeletal maturation. Conclusion: The lateral cephalograms can be used as initial diagnostic tools for determining the skeletal maturity stage and estimating patients’ age. However, further studies on this topic with a more representative sample to corroborate the findings of this study are required.