CVMS Analysis as Indicator for Osteoplasty at Patients with CLP

Objectives: Purpose of this study is to determine the relevance of skeletal maturity analysis carried out on a single lateral cephalogram to assign correct timing of the bone grafting procedure to prevent children with cleft lip and palate (CLP) from excess radiation. Our study compares skeletal maturity and analyses skeletal maturity-age correlation of CLP patients (cleft group) with patients are not suffering from this disease (control group) at upper canines same root developmental stage (2/3). Patients with CLP are undertaken a bone grafting procedure which is taken place in the above root developmental stage of upper canines.

Methods: Cleft group (n=27, mean age: 10Y06M, SD: 01Y00M) and control group (n=24, mean age: 10Y03M, SD: 01Y00M) were set up of children presented for orthodontic treatment at our department. Patients were included whose upper canine root developmental stage was corresponding to the bone grafting indication. For skeletal maturity determination morphological signs C2, C3 and C4 vertebrae were investigated on lateral cephalogram with inspection. Skeletal maturity was determined according to scientifically referred classification method called cervical vertebral maturation (CVM) analysis on a scale of 5.

Results: Average of CVM stages in cleft group is 1.59 which shows contrast to control group 1.71. Statistical test (F-test, p<0.05) shows no significant difference between examined groups, p=0.671. Age and CVM stage correlation is non-significant according to rank correlation test (Spearman's, p<0.05), r=0.099, p=0.491.

Conclusion: On the basis of statistical methods relevant deviation can be found between the CVM stage average of examined groups however the difference is not significant. This deviation justify that children with CLP have lower rate of skeletal development. In accordance with the results skeletal maturity investigation on lateral cephalogram is not confirmed to determine correct timing of the bone grafting procedure in order to prevent this patient group from further radiation exposure.