Another Look at Skeletal Maturation Using Hand Wrist and Cervical Vertebrae Evaluation

Abstract

Introduction and Aims-The Growth stage of a patient can have considerable influence on diagnosis, treatment goals, timing and planning and the eventual outcome of orthodontic/orthopedic treatment. The purpose of this study was to analyze associations between the cervical vertebrae maturation score (CVMS) and skeletal maturation index (SMI). The second objective was to determine the reproducibility of the measurements on lateral cephalograms and hand-wrist radiographs. Materials and Methods-Lateral cephalometric and left hand-wrist radiographs of 92 untreated subjects (44 females and 48 males) aged from 8 to 17 years were obtained from the files of the Columbia University, Division of Orthodontics and measured for growth stage using cervical vertebrae and hand-wrist methods. Results-A high correlation was revealed between the hand-wrist and cervical vertebrae measurements. The Spearman's rho correlation coefficient was 0.925 and significant at the 0.01 level. The correlation between hand-wrist and age (0.665, p < 0.01) was slightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability was high. When the three categorically modified methods of the Fishman's 11 skeletal maturation stages in hand and wrist analysis were used to compare with CVMS, methods 2 and 3 were both statistically significantly different according to the Wilcoxon signed ranks test and the Sign test at a significance level of less than 0.05. However, for method 1, the tests showed probability scores of 0.028 and 0.151, respectively, showing no significant difference at the 0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in the 0.01 and 0.05 level in the Signed Test. Conclusions-The Fishman's hand and wrist skeletal maturation index and Bacetti's cervical vertebrae maturation stages are both useful tools in evaluating growth stages. Fishman's handwrist method is slightly more accurate.

<p>Hubungan tingkat maturitas vertebra servikalis dengan panjang mandibula</p><p>Relationship between cervical vertebrae maturity and mandibular length</p>

“…Pemahaman mengenai pertumbuhan dan perkembangan kraniofasial pasien sangat penting dalam membantu menegakkan diagnosis, merencanakan perawatan, dan keberhasilan perawatan. 1,2 Waktu perawatan ortodonti berhubungan dengan keparahan dan tipe maloklusi yang dikaitkan dengan tingkat maturitas pasien. Rata-rata perawatan ortodonti dilakukan pada masa tumbuh kembang.…”

Cephalometric Evaluation of Cervical Vertebral Column Morphology and Cervical Vertebral Maturation in Subjects with Vertical and Horizontal Growth Pattern

“…Beginning in the 1970s, several attempts at cervical vertebrae analysis were performed, with the most popular one being modified by Bacetti et al (4) . Mandibular growth alterations in growing subjects and the stages of cervical vertebrae maturation (CVM) have both been shown to be reliable indicators of mandibular skeletal maturity (5) . According to Salagnac et al (6) , the mandible, upper face, and cervical spine all grew vertically at associated anatomical and physiological rates.…”

A comparison of the accuracy of the cervical vertebrae maturation stage method and Demirjian’s method on mandibular length growth

“…The craniofacial bone relevant to the treatment of crowding is the mandible, as measured by the mandibular length. [7][8][9][10] Recent studies showed that cervical vertebral growth is closely related to mandibular maturation and growth. In particular, mandibular growth peaks have been reported to occur concurrently in CVM stages 3 and 4.…”