Radiomorphometeric Evaluation of Clivus in Indian Paediatric Population Visiting a Tertiary Dental Hospital- A Cone Beam Computed Tomography Study

摘要

The clivus is the part of the skull base situated between the foramen magnum and the dorsum sellae. It results from the fusion of the synchondrosis between the basioccipital and exoccipital bones which grows and ossify from three to 25 years of age to form the basisphenoid and the basiocciput. The clivus is a dense part of skull, so mostly it is recovered intact from a damaged or incinerated skull. So, clivus can be used for morphometeric evaluation of humans.Aim: To determine the age and sex related changes in clivus length and clivus width. The clivus width and clivus length was also evaluated for age prediction of individuals.Material and Methods: The CBCT images of 150 study subjects obtained from Carestream 9000cc (USA) CBCT machine at 90 Kvp, 4 mA for 11.3 seconds at FOV (17?×13.5?), voxel size of 300 in the age group of six to 17 years (76 male, 74 female) were chosen prospectively. The clivus length and clivus width were measured using Trophy Dicom Ink software programme on axial and saggital images (DICOM images). Categorical variables was presented in number and percentage (%) and continuous variables was presented as mean and SD. Unpaired t-test and ANOVA test was used for comparison between groups. Pearson correlation coefficients were used to evaluate the correlations. The data analysis was done using SPSS version 21.0.Results: Irrespective of age and sex, the mean clivus width was 28.8±3.98 and mean clivus length was 42.7±3.98. Statistically no significant difference was observed between male and female (p-value>0.05) with clivus width. However, the clivus length was statistically significant (p<0.001) in both male and female population. The clivus width and clivus length was directly associated with age. The mathematical equations derived from linear regression analysis can be used in prediction of age of an individual if the clivus width/clivus length is known.Conclusion: The clivus measurements on CBCT can be used to predict the age of an individuals in medicolegal disputes. As pearson correlation coefficient showed strong association between the clivus measurements, age and gender, clivus measurements can be used to differentiate between sex of humans and helps in age determination. Clivus dimensions can be used as an additional parameter in age and sex determination in inconclusive medicolegal cases.