Validity of the assessment method of skeletal maturation by cervical vertebrae: a systematic review and meta-analysis

Abstract

Objectives: To perform a systematic review with meta-analysis to answer the question: is the cervical vertebrae maturation index (CVMI) effective to replace hand-wrist radiograph (gold standard) in determining the pubertal growth spurt in patients undergoing bone growth? Methods: A search in three databases was performed, in which studies were selected that compared one of the two main assessment methods for cervical vertebrae (Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995; 107: 58-66, or Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002; 72: 316-23) to a carpal assessment method. The main methodological data from each of the texts were collected and tabulated after. Later, the meta-analysis of the correlation coefficients obtained was performed. Results: 19 articles were selected from an initial 206 articles collected. Regardless of the method used, the results of the meta-analysis showed that every article selected presented a positive correlation between skeletal maturation assessment performed by cervical vertebrae and carpal methods, with discrepancy of values between genders indicating higher correlation for the female gender (0.925; 0.878) than for the male (0.879; 0.842). When the assessment was performed without gender separation, correlation was significant (0.592; 0.688) but lower in the cases when genders were separated. Conclusions: With the results of this meta-analysis, it is safe to affirm that both CVMIs used in the present study are reliable to replace the hand-wrist radiograph in predicting the pubertal growth spurt, considering that the highest values were found in female samples, especially in the method by Hassel and Farman.

A practical formula for determining growth

“…We used a single formula with different gender coefficients, as gender-dependent differences with regard to the timing of morphologic changes in cervical vertebral bodies were reported to be significant (17). Moreover, a recent meta-analysis reported that skeletal maturation evaluation performed by cervical vertebrae is positively correlated with carpal calculation methods, showing higher correlation for female gender than for the male (28). The formula in the present study is simpler and more practical than the formulas proposed in previous studies, because it is derived from only three dependent variables.…”

Effectiveness of probiotics in the prevention of carious lesions during treatment with fixed orthodontic appliances.

“…The articles included in this review were evaluated based on their methodological quality using the Cochrane 21 clinical trial tool for risk assessment of bias. In Figure 2, studies are classified according to five types of bias if they present low, unclear or high risk; this allows for the interpretation of the reliability of the results delivered by each study.…”

The influence of non-steroidal anti-inflammatory drugs and paracetamol used for pain control of orthodontic tooth movement: a systematic review

“…The authors assessed all the articles selected according to the score system proposed by Cericato et al (2015) in order to judge the risk of bias individually for each article. Two authors classified the quality of the articles as "high" (score: 10 to 12 points), "moderate" (score: 6 to 9 points), "low" (score: 3 to 6 points), or "very low" (score: 0 to 3 points).…”