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Evaluation of the three-dimensional (3D) position of cervical vertebrae in individuals with unilateral posterior crossbite

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To evaluate the three-dimensional (3D) position of the cervical vertebrae of growing subjects with unilateral posterior crossbite (UPC).

Materials and methods

In this cross-sectional study, cone beam computed tomography (CBCT) scans of 1455 patients were screened, and ultimately 58 scans (26 patients with UPC and 32 controls with normal occlusion) were included after imposing inclusion/exclusion criteria. Roll, yaw, and deviation of the geometric center of C1, C2, and C3 vertebrae were measured and compared between groups. A correlation between these parameters and different variables on mandibular positioning was also carried out.


A statistically significant difference (p < 0.05) was observed between groups for the deviation of pogonium (Pog), mandibular plane roll, and C3 roll, and patients with UPC showed higher cant or deviation. A significant correlation was reported for the roll of C2 and C3 with the deviation of Pog, a roll of the occlusal plane, and roll of the mandibular plane (p < 0.05). The greater the deviation of the Pog to one side, the greater the roll of the vertebrae with this same side up. The same tendency was observed between the roll of the occlusal plane or the mandibular plane with the roll of these cervical vertebrae.


There is a positive correlation between transverse occlusal changes and positional deviations of the cervical vertebrae, especially C2 and C3.

Clinical relevance

The study results do not allow us to infer the clinical/functional consequences of these deviations, as well as if malocclusion’s treatment would result in an improvement of intervertebral relationships.

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The work was done and supported by the University of Sao Paulo and Joana De Gusmao Children Hospital, Brazil.

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Correspondence to Nandakumar Janakiraman.

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Cardinal, L., da Silva, T.R., Andujar, A.L.F. et al. Evaluation of the three-dimensional (3D) position of cervical vertebrae in individuals with unilateral posterior crossbite. Clin Oral Invest 26, 463–469 (2022).

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