Cervical Vertebrae Maturation Index Research Articles

Effect of maxillary distraction osteogenesis and LeFort-1 advancement orthognathic surgery on soft-tissue thickness and anterior soft-tissue to hard-tissue movement ratios among patients with complete unilateral cleft lip and palate

Objectives: The objective of this study was to compare the soft-tissue thickness and anterior soft-tissue to hard-tissue movement ratios in patients with unilateral cleft lip and/or palate (UCLP) following maxillary distraction osteogenesis using rigid external distractor device and maxillary advancement at LeFort I level using lateral cephalograms. Material and Methods: This retrospective study was conducted on 20 patients with UCLP who underwent either LeFort I maxillary advancement or maxillary distraction osteogenesis. Non-syndromic patients with complete UCLP anomalies and skeletal class III patterns due to maxillary hypoplasia were included in the study. The patients with a pre-surgical negative overjet of ≥5 mm were treated by maxillary distraction osteogenesis, while a negative overjet of <5 mm was managed with maxillary advancement orthognathic surgery. The growth completion in all the patients was assessed using the cervical vertebrae maturation index (CS 6) on a lateral cephalogram. The lateral cephalograms taken before surgery at (T0) and after a minimum interval of six months (T1) of surgery were assessed for changes in soft-tissue thickness and hard-tissue to soft-tissue movement ratios among the two groups. Paired t-test was used to compare the mean values obtained within the same group at two different time intervals. Unpaired t-test was used to compare mean values between the Groups 1 and 2. Pearson’s correlation coefficient (r) test was used to assess the associations between the mean changes in hard- and soft-tissue variables. Results: Group 1 showed significantly greater maxillary advancement compared to Group 2 with a mean difference of 5.80 mm at Point A and 7.65 mm at the upper incisal edge. Soft-tissue thickness decreased significantly after advancement in Group 1 at subnasale (P < 0.05), labrale superius, stomion, and labrale inferius (P < 0.01) and at subnasale (P < 0.05), stomion and labrale inferius (P < 0.01) in Group 2. There was a significantly strong correlation between the hard- and soft-tissue movement in sagittal plane in both Group 1 and Group 2. In Groups 1 and 2, a statistical highly significant strong positive correlation was found between vertical change in dU1 to soft-tissue dLs and dStms. In Group 2, a statistical highly significant strong positive correlation was found between vertical change in dA to soft-tissue dC and dStms. Conclusion: The soft-tissue thickness reduced in patients with UCLP after maxillary advancement in both groups. The soft tissue followed the hard tissue in both groups. There was a greater downward movement of the maxillary base and soft-tissue lengthening in Group 1 compared to Group 2.

Dentoskeletal and soft-tissue changes concurrent to use of PowerScope appliance in treatment of Class II malocclusion – A retrospective study

Objectives: The most frequently encountered malocclusion in our daily clinical practice is Class II malocclusion with mandibular retrognathism. Treatment modalities for Class II malocclusion correction depend on numerous factors such as the severity of the malocclusion and the age at which the patient reports for the treatment. One of the innovations in Class II treatment is the PowerScope appliance. The objectives of this study were: (1) To evaluate dentoskeletal changes with the use of PowerScope appliance in the treatment of Class II division I malocclusion using lateral cephalograms in late adolescents. (2) To evaluate the soft-tissue changes with the use of PowerScope appliance in the treatment of Class II division I malocclusion using lateral cephalograms in late adolescents. Materials and Methods: This retrospective and cross-sectional study was done using pre- and post-treatment lateral cephalograms of 15 patients treated with PowerScope appliance who were under decelerated growth phase as assessed by cervical vertebrae maturation index (Stages 4, 5, and 6). All the lateral cephalograms were hand traced and measured by same investigator. Results: A highly statistically significant difference was observed between the pre-and post-angle formed by sella nasion plane and nasion to point B line (SNB), angle formed by nasion to point A line and nasion to point B line (ANB), condylion to point gnathion (Co–Gn), and distance between point A to nasion perpendicular (N perpendicular to Point A) to Pog skeletal parameters. It was found that a highly significant difference was noted for parameters upper molar to palatal plane (U6-PP), lower incisor to nasion to point B line (L1-NB), lower incisor to nasion to point B line (L1-NB*), lower incisor to mandibular plane angle (IMPA), and upper molar to pterygoid vertical line (U6-PTV). A significant difference was present for parameters upper incisor to nasion to point A line (U1-NA), while no difference was observed for upper incisor to sella nasion plane (U1-SN) and upper molar to pterygoid vertical line (U6-PTV). A significant statistical difference was observed between the pre-and post-lower lip to E line parameter. Conclusion: PowerScope caused significant skeletal changes by forward repositioning of the mandible as well as by an increase in the length of the mandible. There was significant retrusion of upper incisors and a highly significant increase in lower incisor protrusion, lower molar mesialization, and upper molar intrusion. Soft-tissue lower lip protrusion was significant.

Characterization of Spheno-occipital Synchondrosis Fusion From Preadolescents to Young Adults Using Age and Cervical Vertebrae Maturation Index.

The purpose of this study was to characterize the spheno-occipital synchondrosis fusion (SOSF) from preadolescents to young adults. A total of 630 Korean subjects (308 men, 322 women; age range, 6-18y) were divided into 26 groups according to sex and age. After 3-dimensional computed tomography (CT) images were reoriented using the Frankfort horizontal (FH) plane, mid-sagittal plane, and frontal plane via ON3D software (3DONS), the cervical vertebrae maturation index (CVMI) and SOSF stages were identified using 6-stage and 5-stage scoring systems, respectively. The distributions of stage in each group were statistically investigated. Women showed early appearance and a short range of onset (CVMI stage 2, SOSF stage 2), middle (CVMI stage 4, SOSF stage 3 and stage 4), and completion (CVMI stage 6, SOSF stage 5), indicating rapid skeletal maturation compared with men. In both males and females, there were strong positive correlations between age and CVMI stage (rs=0.902, rs=0.890), between age and SOSF stage (rs=0.887, rs=0.885), and between CVMI and SOSF stages (rs=0.955, rs=0.964) (all P<0.001). The mean ages at SOSF stage 3 and stage 4 (12.7~13.9y in males and 11.0~12.5y in females) could be used as indicators of the pubertal growth peak. Regression equations for SOSF stage (y), age (a), and CVMI stage (b) were as follows: y=1.355-(0.133×a)+(0.29007×b)+(0.041×a×b) for males (r2=0.9496); y=1.305-(0.158×a)+(0.455×b)+(0.036×a×b) for females (r2=0.9606). Ordinal logistic regression analyses with the proportional odds model showed that females had more advanced SOSF stages than males (odds ratio: 1.972; 95% CI: 1.063-3.658, P<0.05). Our findings may provide basic references for CVMI and SOSF from preadolescents to young adults.

Correlation of demirjian dental maturation stages with mandibular growth with help of cervical vertebrae maturation index in north Indian population

In the field of orthodontics, loss of precious time during rapid growth of an individual may lead to failure of addressing the laid-back growth issues which may lead to persistent dentofacial deformity in the individual. Hence, accurate and timely diagnosis aids the clinician to treat the individual appropriately for the said deformity.: To investigate the correlation of chronological age, Demirjian Dental Maturation stage with mandibular growth using CVMI method in North Indian population. The study was performed on pre-treatment lateral cephalograms and OPGs of 270 subjects aged between 8-17 years. To establish the relationship, chronological age was established from the date of birth to the date on which radiographs were taken, Dental age was calculated via Demirjian’s method and Cervical Vertebrae maturation was established on the basis of Bacetti’s method. Mean tables and Spearman Rank Correlation Coefficient was used to establish the relationship among these variables. : The results showed that the dental age was accelerated as compared to chronological age. Females have a higher grade of cervical vertebrae maturation as compared to males for the same chronological age. The dental calcification of 2 molar showed the greatest correlation with CVMI with R value of 0.734 in females and 0. 768 in males.: The chronological age in females were lesser as compared to males in all the groups except in CVMI V. Central &amp; Lateral incisor showed least, whereas 2 molar was found to correlate the highest with the cervical vertebrae maturation.

Evaluation of skeletal maturation based on permanent mandibular second molar calcification

Objective: To investigate the relationship between permanent mandibular second molar calcification stages and cervical vertebrae skeletal maturity and to evaluate whether second molar calcification stages can be used as a reliable diagnostic tool to determine skeletal maturity.Materials and Methods: The Panoramic and intraoral periapical radiographs and lateral cephalogram of 240 subjects (120 males and 120 females) with age group between 8 to 17 years were examined. The Calcification stages of mandibular second molar were rated according to Demirjian index (DI) and skeletal maturity were determined using Cervical vertebrae maturation index (CVMI) given by Hassel and Farman.Results: A highly significant association was found between CVMI and DI. DI stage E corresponded to stage 2 of CVMI (pre-pubertal growth spurt). DI stages F and G corresponded to stage 3 and 4 of CVMI (pubertal growth spurt). DI Stage H corresponded to CVMI stage 5 and 6 (end of pubertal growth spurt).Conclusion: A highly significant association exists between DI and CVMI. Mandibular second molar DI stages can be used as a reliable indicator for growth evaluation in clinical practice.

Accuracy of age estimation using cervical vertebral maturation index and demirjian's method: A comparative study

Dental age estimation is considered to be vital, as tooth development shows less variability than other developmental features. But in case of missing tooth it is not possible to estimate chronological age using dental age estimation methods. So there should be an alternate method for age estimation. The cervical vertebrae maturation index (CVMI) is one of the easiest and most commonly used skeletal maturity indices. Aim of this study is to check the accuracy of age estimation using CVMI and Demirjian's method with chronological age. It is a comparative study to check the accuracy of age estimation using Demirjians method and CVMI method with chronological age among Kannur population, of age range between 10-16 years. 100 panoramic radiographs and 100 lateral cephalograms of same patient were assessed using Demirjians and CVMI method respectively. The results were compared with chronological age and the data were analyzed. p value was less than 0.0001. The mean age difference for total sample using Demirjians method is -0.20+/-0.048 and using CVMI method is 0.63+/-0.08. In the age group of 15-16 years using CVMI method the mean difference is 1.34 +/- 0.09 and the p value is <0.934 which is not statistically significant. Pearson correlation coefficient shows good correlation value for total samples. The correlation between Demirjians and Chronologic age is 0.972 and CVMI with Chronologic age is 0.919. Demirjians method is better & preferred method for estimation of chronological age. But if need arises CVMI can efficiently replace the Demirjians method till the age of 14 years.

A Study to Compare and Correlate the Status of Maturation in Growing Individuals Using Chronological Age Dental Maturation and Cervical Vertebrae Maturation.

Aim and objectiveTo compare and correlate the status of maturation in growing individuals using orthopantomograph (OPG) and lateral cephalogram to establish a reliable relationship between chronological age (CA) and dental maturation (DM) with cervical vertebrae maturation index (CVMI).Materials and methodsLateral cephalometric radiographs and OPGs of 50 children within the circumpubertal period were collected (male n = 25, age 12–17 years, female n = 25, age 10–15 years) and evaluated for the status of maturation using CA, DM (of mandibular left canine and second molar using Demirjian Index-DI), and CVMI stages.ResultsChronological age shows a positive correlation with CVMI stages in both groups. Gender-based association and distribution between DI stages of canine and CVMI stages shows that in both male and female sample groups DI G correlates with CVMI stage 1 and 2, DI H correlates with CVMI stage 3. Gender-based association and distribution between DI stages of 2nd molar and CVMI stages show that in the male sample group DI E shows a higher correlation with CVMI stage 1, DI F shows a higher correlation with CVMI stage 1 and 2. DI G shows a higher correlation with CVMI stages 2 and 3. DI H shows a higher correlation with CVMI stage 3. In the female sample group, DI F shows a higher correlation between CVMI stage 1 and 2, DI G and F show a higher correlation with CVMI stage 3.ConclusionMandibular canine, second molar calcification stages, and CA show a positive correlation with CVMI stages in the present study, hence, this can be considered as a reliable indicator in skeletal maturity assessment.How to cite this articlePooja U, Lokesh NK, Alle RS, et al. A Study to Compare and Correlate the Status of Maturation in Growing Individuals Using Chronological Age Dental Maturation and Cervical Vertebrae Maturation. Int J Clin Pediatr Dent 2021;14(S-1):S50–S53.

Differences of anteroposterior facial dimensions in male and female children on intermediate mixed and early permanent dentition using Cervical Vertebrae Maturation Index

Introduction: Cervical vertebrae are one of the indicators for craniofacial bones maturation. Timing of craniofacial bone maturation determined achievement of orthodontic early treatment. Some previous researchers recommended cervical vertebral maturation to assess craniofacial growth. This study was aimed to analyse the differences of anteroposterior facial dimensions in male and female children on intermediate mixed and early permanent dentition using Cervical Vertebrae Maturation Index (CVMI). Methods: An analytic observational study with a cross-sectional design was conducted on the students of Islamic Elementary School (Madrasah Ibtidaiyah) in Depok district, Sleman, Yogyakarta, from July 2019 to January 2020. Subjects consisted of 22 males and 22 females aged 8-11 years, obtained by a consecutive sampling technique. The anteroposterior facial analysis was performed on the lateral cephalometry for measuring the distance of Sella turcica to Nasion (S-N) representing the anterior cranial base, Posterior Nasal Spine to Anterior Nasal Spine (PNS-ANS) representing the maxilla and Gonion-Menton (Go-Me) and Condylion-Gnathion (Co-Gn) represents the mandible. Assessment of CVMI was decided by the Hassel and Farman methods. Data were analysed by One Way ANOVA. Results: The mean value of S-N, PNS-ANS, Go-Me, and Co-Gn dimensions, generally were higher in males than females; however, only dimensions of maxillary and mandibular were showed significant difference (p&lt;0.05), while the S-N dimension was not significantly different (p&gt;0.05). At the interval of CVMI 3 and 4, the Go-Me and Co-Gn dimensions showed a significant difference (p&lt;0.05) both in males and females. Conclusion: There was a difference in anteroposterior dimensions of the maxillary and mandibular in cervical vertebral maturation in children with intermediate mixed and early permanent dentition, however, no difference was found in the anterior cranial base.

SKELETAL MATURATION EVALUATION USING MANDIBULAR SECOND MOLAR CALCIFICATION STAGES

Objective: To examine the relationship between skeletal maturity and mandibular second molar calcification stages and assessing mandibular second molar as a diagnostic tool for skeletal maturity evaluation.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Orthodontic department, Sandeman Provincial Hospital, Quetta, from Jan to Jun 2019.&#x0D; Methodology: The sample size of the study 240 comprised of equal number of males and females. Inclusion criteria was defined to include the patients (male and female) with the age from 9-16 years; on the same time, patients without facial asymmetry and without prior history of facial or neck trauma/injury or surgery were considered for the present study. Exclusion criteria was defined to exclude those patients from the study hoe had the history of bone disease and major illness in past; known cases of muscular dystrophy; any congenital malformation of cervical vertebrae and tooth caries; Low quality x-ray with poor contrast.&#x0D; Results: The study revealed association between Demirjian Index and Cervical Vertebrae Maturation Index stages (0.875) with the statistical significance. Demirjian Index Stage H indicated the greater percentage distribution at stage 4 and 6 of Cervical Vertebrae Maturation for males. Similarly, in females, demirjian index stages G and H showed the greater percentage at stage 4 and 6 of cervical vertebrae maturation index respectively.&#x0D; Conclusion: Analysis indicated that cervical vertebrae maturation index and Demirjian Index (DI) occurred earlier in femalesthan males.

Determination of Pubertal Growth Plot Using Hand-wrist and Cervical Vertebrae Maturation Indices, Dental Calcification, Peak Height Velocity, and Menarche

Introduction: Pubertal growth stages are important periods in orthodontic treatment with functional appliances and orthognathic surgery. Pubertal growth prediction, which determines the amount of growth that has taken place and estimates the remaining growth, can influence diagnosis, treatment goals, treatment plans, and orthodontic treatment outcomes, especially in cases requiring growth intensity or growth completion. Determination of pubertal growth stages is more accurate when performed using physiological maturation indicators than chronological age. There are several maturation indices that can be used to predict the pubertal growth stage, such as hand-wrist maturation, cervical vertebrae maturation index (CVMS), dental calcification, peak height velocity of body height (PHV), and menarche in females. The aim of this study was to identify the differences and correlation between hand-wrist, CVMS maturation stages, peak height velocity (PHV), canine and M2 calcification stages, and menarche age (of female subjects). The study also aimed to describe the pubertal growth curve plot of female and male subjects. Materials and Methods: This is a retrospective study with a cross-sectional approach, which included 279 females and 144 males aged 8-17 years. Subjects had digital lateral cephalograms, hand-wrist, and panoramic radiographs. The hand-wrist maturation stage was analyzed using the Fishman method, CVMS using Baccetti et al.’s method, and the stages of dental maturation were assessed using Demirjian and Goldstein method. PHV was measured from standing height using a wall-mounted plastic stadiometer, while menarche was analyzed through interviews. Statistical analysis by ANOVA, post hoc analysis, and Spearman’s rank correlation coefficient were determined with Excel Mega Stat. Results: There were significant differences between females and males in CVMS and hand-wrist (P&lt; 0.05) except for radius union (Ru). No significant differences in canine and M2 calcification between females and males were observed. PHV females increased by 7.89 cm at 11-12 years, while males increased by 9.9 cm at 13-14 years. Menarche occurred at the age of 12.2 years on average, with the oldest being 14.7 years and the youngest being 9.6 years. The correlation between females’ and males’ hand-wrist and CVMS was very high. The lowest correlation in females was between menarche and CVMS and in males, it was between PHV and canine. Conclusion: Maturation stages of hand-wrist, CVMS, and PHV females were earlier than males. Pubertal growth curves plot of females tended to skew to the left, demonstrating that the time from the beginning to the peak of pubertal growth is shorter than that from the peak to the end of pubertal growth, while pubertal growth curves plot of males tended to skew to the right, demonstrating that the time from the beginning to the peak of pubertal growth is longer than that from the peak to the end of pubertal growth.

Correlation of Infrazygomatic Bone Thickness With Cervical Vertebrae Maturation Stages

Anchorage is one of the most important consideration in the field of orthodontics to achieve a desired tooth movement. In order to eliminate the undesirable side effects such as anchorage loss, skeletal anchorage systems such as mini-implants have been introduced in orthodontics.Aim:To evaluate the bone thickness of the infrazygomatic crest in different cervical vertebrae maturation index (CVMI) and to compare it between male and female subjects, by using cone beam computerized tomography (CBCT) imaging.Materials and Methods:A retrospective study was conducted using CBCT images of 60 patients in the age group of 8–25 years. Cervical vertebra maturation was analyzed using Hassel–Farmann index and divided into 6 groups (n = 10/group). The infrazygomatic crest was divided into horizontal and vertical planes. The horizontal plane passed through the most inferior border of the zygomatic process of maxilla and the vertical plane passed through the most anterior point of the infratemporal fossa parallel to midsagittal plane. Five parallel lines were drawn at 2 mm interval in both horizontal and vertical planes (HB+2, HB+4, HB+6, HB+8, and HB+10) (V-2, V-4, V-6, V-8, and V-10). The bone thickness was measured at the point of intersection of these lines.Results:According to Kruskal–Wallis analysis, statistically significant difference in infrazygomatic crest (IZC) bone thickness was seen in various CVMI stages ( P = .001). Maximum bone thickness was 11 mm and minimum bone thickness was 1 mm. No significant difference was observed between male and female populations.Conclusion:Thus, the superolateral area in infrazygomatic crest is the most appropriate site for miniscrew insertion in all age groups.

Comparative evaluation of cervical vertebrae maturation index and stages of mandibular second molar calcification: A cross-sectional study

Aim: This study aims to evaluate the relationship between stages of mandibular second molar calcification and cervical vertebrae maturity (CVM) staging for the assessment of pubertal growth spurts in patients.Materials and Methods: Pretreatment panoramic and lateral cephalometric radiographs of 400 patients (200 males and 200 females) were evaluated to ascertain the association of Demirjian index (DI) and CVM method.Results: A highly significant correlation between Cervical vertebrae maturation Index (CVMI) and DI was calculated using Sakoda adjusted Pearson contingency coefficient (r) and a positive correlation was found between CVM and DI in male samples as r = 0.785 and female sample as r = 0.803.Conclusion: A highly significant correlation (r = 0.785 for male subjects and 0.803 for female subjects) was found between DI and CVMI and female subjects showed a higher correlation between skeletal and dental maturity compared to male subjects.

Evaluation of relationship between chronological age cervical vertebrae maturation index method and canine calcification stages for the assessment of optimal treatment timing in orthodontic patients

Introduction: The study was undertaken to evaluate the reliability of cervical vertebrae as skeletal age maturation in response to chronological age and evaluate the relationship between DEMIRIJAN system of mandibular canine calcification and cervical vertebral maturation as a clinical method for skeletal maturation indicator. Materials and Methods: 120 children (60 females and 60 males) were randomly selected in the age range of 8-14 years. Results: 23.3% of males showed E stage of (canine calcification stage) CCS and stage II of cervical vertebral maturation (CVM), 16.6% showed F stage of CCS and stage III of CVM, 13.3% showed stage G of CCS and Stage III of CVM 8.3% showed stage G of CCS and stage IV of CVM. 13.3% of females showed E stage of CCS and stage II of CVM, 13.3% showed F stage of CCS and stage III of CVM, 16.67% showed stage G of CCS and Stage III of CVM, 15% shows stage G of CCS and stage IV of CVM,. Conclusions: The correlation values between the Chronological age, dental calcification stages and cervical vertebrae maturation method were high. Attaining of maturity in canine calcification and cervical vertebrae maturational stages was ahead in females when compared to males. Keywords: Cervical vertebrae, Cephalometrics, Canine calcification.

Reliability of Mandibular Canine Maturation Stages in Predicting Pubertal Growth Spurt in a Sample of Egyptian Orthodontic Patients

Objective: to investigate the reliability of mandibular canine maturation stages in predicting pubertal growth spurt in a sample of Egyptian orthodontic patients. Materials and Methods: A retrospective, cross-sectional study was carried out on the radiographic records (left lateral cephalometric, panoramic and left hand and wrist x-rays) obtained from 250 patients who were attending private clinics on Delta area, Egypt. The age was selected between 7 and 18 years. Mandibular canine calcification stages (MCC) were assessed according to Demirjian’s method for dental maturity assessment. Skeletal maturity was assessed by the ossification stages of the middle phalanx of the third finger (MP3) using Hagg and Taranger method and the cervical vertebrae maturation index (CVMI) was evaluated using Hassel and Farman method. MCC stages were statistically correlated to both MP3 stages and CVMI stages. The significance level was set at P ≤ 0.05. Statistical analysis was performed with IBM® SPSS® Statistics Version 20 for Windows. Results: Chi-square tests have shown highly significant associations between the mandibular canine calcification stages (MCC) and both CVMI and MP3 maturation stages (p < 0.001). MCC stage F had shown a moderate correlation with MP3 FG and CVMI 2 that corresponded to the onset of pubertal growth. Conclusions: MCC stage F can be used for prediction of the onset of pubertal growth, while prediction of the peak or the post peak periods using MCC method may be unreliable. Key words: Pubertal growth, MP3 stages, CVMI stages, MCC stages.

Physiological maturation stage of cervical vertebrate index in cleft lip/palate and non-cleft lip/palate patients

Cleft lip and palate is one of the most common congenital anomalies. Cleft lip and palate patients encounter growth problems in lip and palate area, although their overall growth and development remains unknown. Cervical vertebral maturation are indicators of physiological maturation used in interceptive treatment and orthognathic surgery. The present study aims to determine physiological maturation stage of cervical vertebrae maturation index in cleft andnon-cleft patients. Lateral cephalogram of 26 cleft patients and 27 non-cleft patients with a range of chronological age from 8-16 years old were involved. The cervical vertebrae maturation were analyzed in six stages of cervical vertebrae maturation method of Hassel and Farman. Data were analyzed using t-test (p≤ 0.05). The result shows that physiologicalmaturation stage of cervical vertebrae maturation index in cleft and non-cleft patients has no significant difference in stage acceleration (p= 0.38), stage transition (p= 0.41) and deceleration (p= 0.39). Likewise, there is no significant difference in physiological maturation stage of cervical vertebrae maturation index between cleft and non-cleft patients.

Estimation and Comparison of the Duration of the Pubertal Peak in Skeletal Class II and Class I Subjects Using the Cervical Vertebrae Maturation Index Method

The purpose of this study is to estimate and compare the duration of the pubertal peak in skeletal class II and class I subjects and to detect any difference between boys and girls or between hypo-, normo-, and hyperdivergent subjects for skeletal maturation indicator (CVM) in white Caucasians. 346 subjects were selected from 3,119 examined files. Pretreatment lateral cephalometric records were hand-traced and divided following the anteroposterior skeletal relationship, the gender, the vertical pattern, and the skeletal maturation. The duration of the pubertal peak was calculated based on the chronological age interval according to each group. The age of onset of the active growth and the duration of the pubertal peak were compared between the different groups studied. Pubertal peak had a mean duration of 13 months in skeletal class I subjects, 19 months in skeletal class II subjects, 15 months in girls, 20 months in boys, 13 months in normodivergent and hypodivergent subjects, whereas in hyperdivergent subjects, it lasted 18 months. The growth interval corresponding to the pubertal growth spurt (CS3-CS4) was (1) significant between skeletal class I and class II subjects, (2) longer in boys, and (3) longer in hyperdivergent subjects. Orthodontic treatments can start earlier for girls in class I or class II relationship and for hyperdivergent subjects as well. Furthermore, boys and subjects in class II skeletal relationship have a significantly longer duration of the pubertal peak and consequently a much efficient orthopedic and orthodontic treatment.

Comparison of middle phalanx of the middle finger and cervical vertebrae as skeletal maturity indicators

Objectives: To investigate the relationship between chronological age and the stages of maturation of cervical vertebrae maturation index (CVMI) and the middle phalanx of the middle finger (MP3) and to determine the correlation between CVMI and MP3. Materials and Methods: A cross-sectional study included 100 children (boys - 50, girls - 50) aged 8–14 years based on nonprobability quota sampling. The study included digital radiographs of the MP3 of the right hand and conventional lateral cephalograms. Chronological age was assessed by the date of birth, MP3 maturation by Rajagopal and Kansal's criteria, and CVMI development by Hassel and Farman's method. Statistical Analysis: Spearman's rank-order correlation coefficient was applied to measure the association between stages of MP3 and CVMI. Results: Progressive stages of MP3 and CVMI were seen as chronological age advanced. Girls showed an advanced trend than boys in both MP3 and CVMI stages. MP3 and CVMI stages showed a strong positive correlation (r + 0.836, P < 0.01). Conclusions: MP3 and CVMI both are equally good indicators of skeletal maturity. Assessment of skeletal maturity on lateral cephalogram (CVMI) is advantageous as it avoids the need for an additional radiograph.

Assessment of skeletal and dental maturity indicators and comparison of maturity indicators in vertical and horizontal growth pattern individuals with normal growth pattern individuals

Objective: The purpose of the present study was carried out to establish whether the vertical and horizontal growth patterns influence the rate of dental and skeletal maturation as compared to normal growth patterns. Materials and Methods: This study comprised sixty samples divided into three groups. Group I normal grower (control), Group II-vertical growers, and Group III-horizontal growers. Each sample was assessed for skeletal and dental age using cervical vertebrae maturation index (CVMI), skeletal maturity indicator stages and canine calcification stages, respectively. All data in the groups were analyzed by analysis of variance test. Subgroup data and comparisons were analyzed by Dunnett D-test and -test. Results: Results showed that dental maturation was delayed in horizontal growers as compared to vertical growers with = 0.00 and 0.044. There was nonsignificant difference in dental maturation of male and females with >0.05. The comparison of skeletal maturation by hand-wrist radiograph showed significant variation in Group III with delayed skeletal maturation of horizontal growers than control group with P Conclusion: Individuals with horizontal growth pattern showed delayed dental maturation when compared to vertical growers.

Assessment of Skeletal Maturation in Concordance to Statural Height and Body Weight in 12-Year-Old Children - A Cross-Sectional Study.

To analyse the importance of bodily characteristics of growing children and its correlation towards skeletal maturity. This further aids orthodontists in proper treatment planning. The purpose of this study was to assess the correlation between cervical vertebrae maturation, statural height and body weight as measured in 12 -year-old children. Lateral cephalograms were taken as a part of treatment records in 94 children along with their statural height and body weight. The Cervical Vertebrae Maturation Index (CVMI) was used to trace the C2, C3 and C4 vertebrae respectively and the data were then correlated to the chart provided by the Indian Council for Medical Research (ICMR). The overall sample showed a statistically significant correlation between CVMI and height (p=0.047). Girls showed significant correlation in their mean heights to the CVMI staging (p=0.012) while the boys exhibited a maximal mean height value in Cervical Stage (CS) 5 followed by CS3. There was no significant correlation between weight and CVMI. The mean CVMI stage seen in boys and girls were CS2 and CS3 respectively. There exists a definitive correlation between height and CVMI stages in growing children. Girls showed an advanced level of skeletal maturity in comparison to boys. CVMI staging should be used along with statural height and body weight when considering growth modification procedures.

Radiographic Comparisons between Middle Phalanx of the Third Finger and Cervical Vertebrae Maturation for the Assessment of Skeletal Maturity

Sexual maturation characteristics, chronologic age, dental, and skeletal development are some of the more commonly used means to identify stages of growth. Hand wrist radiograph and cervical vertebrae maturation index (CVMI) are more reliable for skeletal development assessment. This study was conducted to compare the skeletal maturity using the maturational stages of middle phalanx of the third finger (MP3) with cervical vertebrae and then to evaluate the reliability of MP3 as a sole skeletal maturity assessment method. Chronological age group of the 112 subjects was 8-16 years for females and 10-18 years for males were selected for the study. Lateral cephalometry and intra oral peri-apical radiograph of MP3 of the left hand of each patient were taken. Then, statistically it was correlated which was highly significant. Skeletal maturation of MP3 and cervical vertebrae stages progress with advancing chronological age. Female subjects were advanced on an average of 2 years earlier than male subjects at every stages of growth spurt. These results suggest that MP3 can substitute CVMI for skeletal maturity evaluation to determine optimal treatment time for various orthodontic procedures. The developmental stages of the MP3 could be used as a sole indicator in assessing the skeletal maturity.