Longitudinal Assessment of Cervical Vertebral Morphometric Changes and Their Relationship with Mandibular Growth in Pakistani Orthodontic Patients: Implications for Orthodontic and Implant Treatment Planning

Abstract

Background: Cervical vertebral morphology changes during skeletal maturation and may provide clinically useful information for assessing craniofacial growth.

Objective: To evaluate longitudinal changes in the anterior height, posterior height, and anteroposterior length of C3 and C4 cervical vertebrae and to determine their relationship with mandibular length increment in Pakistani orthodontic patients, with consideration of their potential implications for orthodontic and implant treatment planning.

Materials and Methods: This longitudinal observational study included 60 Pakistani orthodontic patients. Baseline and approximately 24-month follow-up lateral cephalograms were evaluated. Mandibular length was assessed using Ar–Pog, and mandibular length increment (MLI) was calculated as follow-up Ar–Pog minus baseline Ar–Pog. Paired t-tests assessed longitudinal changes, while Pearson correlation coefficients evaluated relationships between changes in cervical vertebral dimensions and MLI.

Results: The mean baseline age was 12.4 ± 2.6 years. Mandibular length increased from 75.80 ± 9.10 mm at baseline to 83.00 ± 10.02 mm at follow-up, corresponding to a mean MLI of 7.20 mm (p < 0.001). All six cervical vertebral dimensions increased significantly over the observation period (all p < 0.001). The strongest association was observed between ΔAP4 and MLI (r = 0.39, p = 0.002).

Conclusion: C3 and C4 cervical vertebral dimensions increased concurrently with mandibular length over approximately two years. The modest positive associations between cervical vertebral dimensional changes and mandibular length increment suggest that quantitative cervical vertebral morphometry may provide supplementary information when evaluating skeletal development.