Abstract
Assessing skeletal maturation is an important determinant of successful orthodontic treatment planning for children and adolescents. While several methods are used skeletal maturation assessment, the hand-wrist radiograph is one of the most widely used. However, it does require additional exposing growing patients to additional radiation. Information on skeletal maturation can also be retrieved after evaluation of vertebrae, which are commonly portrayed on the lateral cephalometric radiographs included in standard orthodontic documentation. By means of a systematic review of the available literature, this work aimed to verify the reliability, efficacy, and reproducibility of skeletal age determination based on the evaluation of vertebrae. The LILACS, SciELO and PubMed databases were searched using the keywords cervical vertebrae and cervical maturation”. Only texts in Portuguese, Spanish, and English published in the last 10 years were selected. Twenty-nine full articles were retrieved and critically appraised. According to these references, the Cervical Vertebrae Maturation Index appears to be a valid, reliable, and reproducible method for skeletal maturation assessment and may substitute the analysis of hand-wrist radiograph in orthodontic treatment planning.
Highlights
Assessing skeletal maturation is essential for proper orthodontic treatment planning of children and adolescents since critical decisions concerning diagnosis, treatment mechanics and prognosis are affected by the patient’s skeletal age
Researchers were prompted to develop a method of assessing skeletal maturity based on evaluation of the cervical vertebrae commonly portrayed in lateral cephalometric films
After an initial screening based on the titles and abstracts, six works were excluded from the LILACS results: two were full theses, two were not directly related to Cervical Vertebrae Maturation Index (CVMI) assessment, one was a literature review, and another one was a duplicate
Summary
Assessing skeletal maturation is essential for proper orthodontic treatment planning of children and adolescents since critical decisions concerning diagnosis, treatment mechanics and prognosis are affected by the patient’s skeletal age. Lamparski (1972) pioneered the field after studying changes occurred in the vertebrae of young women and describing six stages of vertebral maturation He concluded that changes in vertebral size and shape are determined by the progressive development of concavities in the lower margins of the vertebral body, which grows in height and changes progressively from a trapezoid to a vertical shape. This method of skeletal age assessment was proven statistically valid and reliable, with clinical value similar to that of the assessments based on hand-wrist radiographs
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