Craniofacial growth percentile curves: A clinical tool from the Craniofacial Growth Consortium Study

Introduction: This study aimed to develop new cephalometric standards incorporating samples from across North America, focusing on creating sex-specific percentile growth curves for craniofacial cephalometric measures using the extensive longitudinal data from the Craniofacial Growth Consortium Study. Methods: This study comprised 2,100 subjects (1,056 males and 1,044 females) with 17,290 lateral cephalometric radiographs, spanning ages of 2.5-31.3 years. Twenty-four linear cephalometric measurements were calculated, including traits from the basicranium, maxilla, and mandible. For each measurement, multilevel nonlinear growth models were used to estimate growth milestones by sex, percentile growth curves were created, and a web-interface tool was developed to facilitate the practical application of these growth curves. Results: Growth milestones, including age at peak growth velocity and peak growth velocity, were estimated for each sex using double logistic growth models. The timing of peak growth velocity varies across different regions of the craniofacial complex. Craniofacial growth percentile curves were created and cross-validated. A web interface tool was created to allow users to retrieve individual-specific percentile scores. Conclusions: The developed percentile growth curves and web-based tool offer a robust framework for clinicians to assess individual growth patterns, identify deviations from normative growth, and estimate future growth potential, supporting more personalized treatment planning and timing.