To assess growth of the middle/posterior cranial base during adolescence based on landmarks located on serial three-dimensional cone-beam computerized tomography (CBCT) images.

CBCT scans from 62 adolescents (11 to 17years) at baseline and 12months were used. Eleven landmarks in the cranial base were identified. Linear landmark distances were compared over the two time points using basic descriptive statistics. Shape analysis was carried out using R (R Foundation for Statistical Computing, Austria). Discrete curves were obtained and aligned via a Procrustes transformation and examined for group dimorphism and longitudinal change.

Mean differences between linear distances in the cranial base were within 1mm, apart from the difference between the right and left auditory external meatuses, which was 2.25mm. No statistically significant longitudinal differences in shape were found in relation to the peak growth period.

Cranial base growth was minimal over the observation period. There were no differences in terms of the amount and pattern of growth. The cranial base is said to complete most of its growth by age 12, but this has only been verified through two-dimensional studies. Our findings using CBCT confirm this, and support the use of the cranial base as a stable anatomical reference structure for superimpositioning.