Cervical Vertebral Maturation Method Research Articles

Correlation between dental and skeletal maturity in Korean children based on dental maturity percentile: a retrospective study

BackgroundThe correlation between dental maturity and skeletal maturity has been proposed, but its clinical application remains challenging. Moreover, the varying correlations observed in different studies indicate the necessity for research tailored to specific populations.AimTo compare skeletal maturity in Korean children with advanced and delayed dental maturity using dental maturity percentile.DesignDental panoramic radiographs and cephalometric radiographs were obtained from 5133 and 395 healthy Korean children aged between 4 and 16 years old. Dental maturity was assessed with Demirjian’s method, while skeletal maturity was assessed with the cervical vertebral maturation method. Standard percentile curves were developed through quantile regression. Advanced (93 boys and 110 girls) and delayed (92 boys and 100 girls) dental maturity groups were defined by the 50th percentile.ResultsThe advanced group showed earlier skeletal maturity in multiple cervical stages (CS) in both boys (CS 1, 2, 3, 4, and 6) and girls (CS 1, 3, 4, 5, and 6). Significant differences, as determined by Mann-Whitney U tests, were observed in CS 1 for boys (p = 0.004) and in CS 4 for girls (p = 0.037). High Spearman correlation coefficients between dental maturity and cervical vertebral maturity exceeded 0.826 (p = 0.000) in all groups.ConclusionA correlation between dental and skeletal maturity, as well as advanced skeletal maturity in the advanced dental maturity group, was observed. Using percentile curves to determine dental maturity may aid in assessing skeletal maturity, with potential applications in orthodontic diagnosis and treatment planning.

Dental and skeletal maturation of Chinese male children with unilateral cleft lip and palate.

The aim of this study was to determine whether the relationship between dental age (DA), cervical stage (CS) and chronological age (CA) in Chinese male children with unilateral cleft lip and palate (UCLP) is similar to that of children without clefts. Panoramic and cephalometric radiographs of 105 male UCLP patients, aged from 8 to 16 years, were collected and compared to 210 age-matched healthy control males. The Demirjian and cervical vertebral maturation (CVM) methods were used to visually examine the radiographs and Spearman's correlation analysis was used to identify differences between the two groups with regards to CS, DA and CA. There was a significant positive correlation between DA and CA in both groups and the mean CA-DA difference was significantly higher in children with UCLP when compared to controls (0.319 vs. 0.003, p < 0.05). A significant delay in tooth development was detected in UCLP children from 10 to 12 years-of-age. Both the UCLP and control groups showed high correlations between CS and DA. Calcification stage D appeared only before CS3; however, from CS5 to 6, all teeth have almost completed their maturation phase. Chinese male UCLP patients are likely to experience delayed tooth development compared to healthy controls, especially during the fast-growing period. Evaluating the stages of tooth mineralization could represent a rapid method to assess growth potential.

The psc-CVM assessment system: A three-stage type system for CVM assessment based on deep learning

BackgroundMany scholars have proven cervical vertebral maturation (CVM) method can predict the growth and development and assist in choosing the best time for treatment. However, assessing CVM is a complex process. The experience and seniority of the clinicians have an enormous impact on judgment. This study aims to establish a fully automated, high-accuracy CVM assessment system called the psc-CVM assessment system, based on deep learning, to provide valuable reference information for the growth period determination.MethodsThis study used 10,200 lateral cephalograms as the data set (7111 in train set, 1544 in validation set and 1545 in test set) to train the system. The psc-CVM assessment system is designed as three parts with different roles, each operating in a specific order. 1) Position Network for locating the position of cervical vertebrae; 2) Shape Recognition Network for recognizing and extracting the shapes of cervical vertebrae; and 3) CVM Assessment Network for assessing CVM according to the shapes of cervical vertebrae. Statistical analysis was conducted to detect the performance of the system and the agreement of CVM assessment between the system and the expert panel. Heat maps were analyzed to understand better what the system had learned. The area of the third (C3), fourth (C4) cervical vertebrae and the lower edge of second (C2) cervical vertebrae were activated when the system was assessing the images.ResultsThe system has achieved good performance for CVM assessment with an average AUC (the area under the curve) of 0.94 and total accuracy of 70.42%, as evaluated on the test set. The Cohen's Kappa between the system and the expert panel is 0.645. The weighted Kappa between the system and the expert panel is 0.844. The overall ICC between the psc-CVM assessment system and the expert panel was 0.946. The F1 score rank for the psc-CVM assessment system was: CVS (cervical vertebral maturation stage) 6 > CVS1 > CVS4 > CVS5 > CVS3 > CVS2.ConclusionsThe results showed that the psc-CVM assessment system achieved high accuracy in CVM assessment. The system in this study was significantly consistent with expert panels in CVM assessment, indicating that the system can be used as an efficient, accurate, and stable diagnostic aid to provide a clinical aid for determining growth and developmental stages by CVM.

Skeletal, dental, and sexual maturation as an indicator of pubertal growth spurt.

The aims of this study were to determine the skeletal, dental, and sexual maturation stages of individuals at the peak of the pubertal growth spurt and to analyze the correlations between these parameters. The study included 98 patients, 49 females (mean chronological age 12.05 ± 0.96 years) and 49 males (mean chronological age: 13.18 ± 0.86 years), in the MP3cap stage. Skeletal maturation stages were determined using the cervical vertebral maturation (CVM) method on lateral cephalometric radiographs. The Demirjian index was used to determine dental maturation stages and dental ages on panoramic radiographs. The sexual maturation of the patients was evaluated in the pediatric endocrinology clinic by a pediatrician according to the Tanner stages. The frequencies of the variables were determined, and the Spearman rank correlation coefficients were used to analyze the correlations between the variables. It was determined that the cervical vertebral maturation stage was CS3 in 81.6% (n = 40) of both female and male patients, and 81.6% of the female and 89.8% of the male patients were in stage G in terms of mandibular second molar tooth development. According to the Tanner pubic hair staging, 73.5% of the male and 51.0% of the female patients were in Stage 3. A significant correlation was found between the cervical vertebra stages and mandibular second molar tooth development stages in both sexes and between the cervical vertebra and Tanner pubic hair stages only among the male patients (r = 0.357; p < .05). There was also a significant and strong correlation between the Tanner pubic hair stages and breast development stages (r = 0.715; p < .05). Cervical vertebral development in the CS3 stage and mandibular molar tooth development in the G stage can be considered the peak of the pubertal growth spurt. Tanner Stage 3 marks the peak of the pubertal growth spurt in males.

Tridimensional Changes in Mandibular Arch after Rapid Maxillary Expansion Therapy: A Clinical Study.

Aim: The upper jaw transverse deficit is certainly one of the most common clinical issues in the orthodontic field. It can be due to skeletal or dental factors, and its etiology may be both genetic and environmental. Rapid maxillary expanders (RMEs) are certainly the most effective appliance for upper transverse deficiency correction. The aim of this study was to evaluate the changes that occurred in the mandibular arch during treatment with RMEs in growing subjects by analyzing tridimensional lower digital casts. Materials and Methods: The study group (SG) consisted of 20 subjects (10 M, 10 F; mean age 9.4 ± 2.8 years old) randomly selected at the Department of Orthodontics at the University of Rome, "Tor Vergata". The inclusion criteria were negative posterior transverse interarch discrepancy ≥ 4 mm, mixed dentition phase with first permanent molars erupted, and prepubertal skeletal maturation stage (CS1-2), evaluated on a lateral radiograph through the Cervical Vertebral Maturation method. The SG was compared to an untreated control group (CG) of 20 subjects (10 M, 10 F, mean age 8.7 ± 2.3 years old) enrolled with the same inclusion criteria. The SG was treated by using RMEs. Dental casts of the lower arch were taken at two different times (T0-T1 = 6 months). All the dental casts were scanned with an OrthoXscan (Dentaurum 6mmbh E Co., Ispringen, Germany) and twenty points on the mandibular arch were digitized using Viewbox software. A Student t-test was used to compare the means of the quantitative variables associated with the effect of the device over time T0 and T1. Results: The results show a statistically significant increase (p < 0.05) in the intercanine and the intermolar diameters between the times T0 and T1 when compared to the CG. Conclusions: Rapid maxillary orthopedic expansion may achieve an increase in mandibular intercanine and intermolar diameter.

Assessment of dehydroepiandrosterone sulphate (DHEAS) and cortisol levels in saliva and their correlation to cervical vertebrae maturation method in males and females at different growth stages: a clinical study.

The aim of this in-vivo study was to assess the salivary dehydroepiandrosterone sulphate (DHEAS) and cortisol levels, and their correlation to the Cervical Vertebrae Maturation method (CVM) in males and females at pre-pubertal, pubertal and post-pubertal growth stages. 48 patients (24 males, 24 females) who were to undergo routine orthodontic treatment were screened according to the inclusion and exclusion criteria. Then subjects were grouped according to CVM stages, using lateral cephalogram, in pre-pubertal, pubertal and post-pubertal groups. Unstimulated saliva from the selected subjects was collected. DHEAS and cortisol levels in the salivary samples were estimated by Enzyme-Linked Immunosorbent assay (ELISA). Then they were compared to Cervical Vertebrae Maturation Method stages. One-way ANOVA test followed by Tukey's post-hoc test was used to compare the salivary DHEAS and cortisol levels between different CVM stages in males and females. Independent Student t-test was used to compare the mean salivary DHEAS and cortisol levels between different males and females in each CVM stage. There was a progressive increase in salivary DHEAS and cortisol concentration as skeletal maturation progressed from CVM stages 1 and 2, CVM stages 3 and 4, reaching the highest value at CVM stages 5 and 6. Their levels were higher in males than females. The salivary DHEAS and cortisol levels can be useful as a potential indicator of skeletal maturation, to aid in the assessment of pubertal status.

ICVM: An Interpretable Deep Learning Model for CVM Assessment Under Label Uncertainty.

The Cervical Vertebral Maturation (CVM) method aims to determine the craniofacial skeletal maturational stage, which is crucial for orthodontic and orthopedic treatment. In this paper, we explore the potential of deep learning for automatic CVM assessment. In particular, we propose a convolutional neural network named iCVM. Based on the residual network, it is specialized for the challenges unique to the task of CVM assessment. 1) To combat overfitting due to limited data size, multiple dropout layers are utilized. 2) To address the inevitable label ambiguity between adjacent maturational stages, we introduce the concept of label distribution learning in the loss function. Besides, we attempt to analyze the regions important for the prediction of the model by using the Grad-CAM technique. The learned strategy shows surprisingly high consistency with the clinical criteria. This indicates that the decisions made by our model are well interpretable, which is critical in evaluation of growth and development in orthodontics. Moreover, to drive future research in the field, we release a new dataset named CVM-900 along with the paper. It contains the cervical part of 900 lateral cephalograms collected from orthodontic patients of different ages and genders. Experimental results show that the proposed approach achieves superior performance on CVM-900 in terms of various evaluation metrics.

Estimating and comparing the duration of adolescent growth peak in skeletal class I and III subjects using cervical vertebral maturation method

BackgroundEstimating skeletal maturation and growth potential is essential for developing adolescents' best orthodontic treatment plan. The purpose of this study was to compare the duration of adolescent growth peak in subjects of skeletal classes I and III using the cervical vertebral maturation (CVM) method.MethodsThis retrospective cross-sectional study included 116 Iranian subjects (skeletal class I = 68, skeletal class III = 48) aged 8–16 years old and without previous orthodontic treatments. Using Steiner and Wits analyses, two independent examiners traced pre-treatment lateral cephalograms to determine the subjects' skeletal relationship. The skeletal maturation was then assessed using Baccetti's CVM method. The onset and duration of adolescent growth peak (interval of CS3–CS4) were compared between two skeletal classes and two genders using independent samples t test.ResultsIn skeletal class I and III subjects, the adolescent peak had a mean duration of 1.62 (± 1.33) and 2.00 (± 1.27) years, respectively. The average difference of 0.38 years (4.6 months) between the two groups was statistically significant (p < 0.001). Furthermore, the onset age of adolescent growth peak was 11.91 (± 1.32) and 12.08 (± 1.31) years old in class I and III subjects, respectively. This age difference was not statistically significant (p = 0.630). Males’ adolescent growth peak occurred 1.44 years later (p < 0.001) and lasted 0.20 years less (p < 0.001).ConclusionsThe adolescent growth peak started at a similar age in class I and III subjects, but the latter experienced the peak for 4.6 months longer. Moreover, females had an earlier and more extended adolescent growth peak.

Accuracy of skeletal maturation with chronological age and gender of children aged 7 – 15 Years

Background: Skeletal maturation has been used as a way to evaluate growth and development and its accuracy with the chronological age of a child. Cervical Vertebrae Maturation method (CVM), assessing changes in the concavity of the inferior border and the shape of the cervical vertebrae C2, C3, C4 which is currently a reliable method. The aim of this study is to analyze the accuracy of skeletal maturation by chronological age and gender in children Aged 7-15 Years. Material and methodology: Cross-sectional study using cephalometrics radiographs of 100 children who were recently undergoing dentoskeletal treatment at the Pediatric Dental Specialist Clinic, RSKGMP Universitas Airlangga Surabaya, 54 girls (mean age 10.91±2.09) and 46 boys (mean age 10.49±1.84) in the age group 7-15 years. Skeletal maturation was analyzed using the Cervical Vertebrae Maturation method by Baccetti. Statistical analysis to examine the differences between chronological age and skeletal maturation using Mann-Whitney. Results: There was a significant difference (p&lt;0.05) in skeletal maturation between boys and girls in the age group 12-12.9 (p=0.02) and 13-13.9 (p=0.01) years. Conclusion: Skeletal maturation differs in boys and girls with girls maturing earlier.

Assessment of Frontal Sinus Morphology and Cervical Vertebral Maturation for Evaluation of Skeletal Maturity

Background: The growth prediction using reliable growth assessment methods is an invaluable tool during orthodontic treatment planning. This study aimed to examine the relationship between frontal sinus (FS) morphology and cervical vertebral maturation (CVM) to predict the skeletal maturity of an individual. Methods: The present study consisted of 252 lateral cephalograms of orthodontic patients. CVM stages and FS parameters such as FS height, FS width, and FS index were assessed using the same lateral cephalogram. Statistical methods including t test, analysis of variance (ANOVA), and Pearson correlation (r) were used for the statistical analysis. Results: FS height and width were greater in males (24.33±4.21; 10.08±3.20) compared to females (21.43±5.34; 8.12±2.19), indicating a statistical difference (P&lt;0.05). However, FS index did not show a statistically significant difference (P=0.32) between males (2.59±0.74) and females (2.69±0.44) (P=0.32). FS height and width increased significantly in a linear fashion from CVM stage 1 to stage 6. FS index, on the other hand, did not exhibit any statistically significant differences among CVM stages in both males and females. FS height and width showed a significant weak to moderate correlation with CVM stages in both males and females. However, FS index exhibited a mild and weak negative correlation with the CVM stages in both males and females. Conclusions: FS height and width had a significant weak to moderate correlation with CVM stages in both the males and females, while FS index had a weak negative correlation with CVM stages in both males and females. Unlike the CVM method, the FS morphology cannot be reliably utilized to assess the skeletal maturity.

Investigation of salivary biomarkers as indicators of skeletal and dental maturity in children.

Estimation of patient's skeletal maturity in orthodontics is essential for the diagnosis and treatment planning. The aim of the study was to investigate the potential use of metabolic fingerprint of saliva for bone growth and tooth development estimation. Saliva samples from 54 young patients were analysed by an untargeted gas chromatography-mass spectrometry metabolomics-based method. The skeletal maturity was calculated with the cervical vertebrae maturation method, and the dental age was estimated with the Demirjian method. Multivariate analysis and univariate analysis were performed to investigate differences within skeletal, dental and chronological age groups. Metabolomic analysis identified 61 endogenous compounds. Mannose, glucose, glycerol, glyceric acid and pyroglutamic acid levels differentiated significantly with skeletal age (P=.02 to .043), while mannose, lactic acid, glycolic acid, proline, norleucine, 3-aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid levels differed within the dental age groups (P=.018 to .04); according to the chronological age, only the levels of mannose and 3-hydroxyphenylacetic acid showed variation (P=.029 and .048). The principal component analysis did not manage to highlight differences between the groups of the studied parameters. Differentiated levels of mannose, glucose, glycerol, glyceric acid and pyroglutamic acid related to skeletal maturation were identified. According to dental development, the levels of mannose, lactic acid, glycolic acid, proline, norleucine, 3-aminoisobutyric acid, threonine, cadaverine and hydrocinnamic acid differed within the groups, while regarding chronological age, only the levels of mannose and 3-hydroxyphenylacetic acid showed variations. Further studies are required to prove their relation to skeletal and dental development pathway by applying complementary analytical techniques to wider cover the metabolome.

Efficacy of the Cervical Vertebral Maturation Method: A Systematic Review.

The present systematic review was carried out to evaluate both qualitatively and quantitatively the effectiveness of the cervical vertebral maturation (CVM) method in predicting the pubertal growth spurt. PubMed, PMC, Scopus, SciELO, Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases were searched. The research included every article published from 1970 to June 2019, featuring the keywords: ("cervical vertebrae" OR ("cervical" AND "vertebrae") AND ("orthodontics" OR "growth and development" OR ("growth" AND "development") OR ("growth"). The Preferred Reporting Items for Reporting Systematic Reviews and Meta Analyses (PRISMA) protocol was adopted, and quality assessments modified from the "Strengthening the Reporting of Observational Studies in Epidemiology" (STROBE) and the "Standards for the Reporting of Diagnostic Accuracy Studies" (STARD) were performed to conduct this systematic review. Initially, 1284 articles were found. All the articles were then examined, and 43 studies met the inclusion criteria. Sixteen articles had low-quality scores, 25 had moderate scores, and 2 had high scores. The results showed a moderate to high statistically significant correlation between the CVM and other maturation methods. Overall, the CVM method can be considered an effective method and may be used with other skeletal indices for the radiographic assessment of skeletal maturity, and also to identify the growth peak in growing patients.

Chronological age range estimation of cervical vertebral maturation using Baccetti method: a systematic review and meta-analysis.

SummaryBackgroundThe timing of growth is a key factor for correct orthodontic treatment planning. Cervical vertebrae maturation (CVM) is no exception, although the reported chronological ages vary in the literature.ObjectiveWe aimed to estimate the average chronological age for each Baccetti’s CVM staging.Search methodsSearch on MEDLINE-PubMed, Scopus, LILACS, Google Scholar, Cochrane Central Register of Controlled Trials (CENTRAL) was conducted until July 2021. The review was performed according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.Selection criteriaObservational or interventional studies reporting chronological age classified through Baccetti’s CVM method were included.Data collection and analysisMethodological quality was assessed, and pooled estimates were carried out through random-effects meta-analysis of single means. The impact of sex and continent were also investigated through subgroup analyses.ResultsForty-one studies were included (9867 participants, 4151 men, and 5716 women). The average chronological age was 9.7 years old (95% confidence interval [CI]: 9.4 to 10.1) in CS1, 10.8 years old (95% CI: 10.5 to 11.1) in CS2, 12.0 years old (95% CI: 11.7 to 12.2) in CS3, 13.4 years old (95% CI: 13.2 to 13.6) in CS4, 14.7 years old (95% CI: 14.4 to 15.1) in CS5, and 15.8 years old (95% CI: 15.3 to 16.3) in CS6. A significant difference was found between the sexes in all CVM stages. We also found significant differences across continents.ConclusionsFor each CVM staging a chronological age range was successfully estimated. Girls presented an earlier skeletal maturation compared to boys. The skeletal maturation differs also according to continents, except for CMV stage 1, pointing to the need for personalized ranges according to each region.RegistrationRegistration number: PROSPERO: CRD42021225422

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

Background: Malocclusion is one of the most familiar dental problems, with a high prevalence among the population. Understanding the patient’s craniofacial growth and development is crucial in diagnosis, as are the planning and subsequent success of the treatment. Malocclusion needs to be treated early to optimise the outcome achieved by the treatment. One of the most common types of malocclusions observed in clinics is crowding. The craniofacial bone relevant to the treatment of crowding is the mandible, defined as the mandibular length from the condylion to gnathion areas. When planning treatment, clinicians may experience difficulties in determining the biological age of patient, particularly when supporting diagnostic tools are not available. The indicators of biological age can be observed by the assessment of bone maturation using the cervical vertebrae maturation (CVM) method and by the analysis of tooth maturation using Demirjian’s method. However, limited studies are available regarding the accuracy of these methods as diagnostic tools. Purpose: This study aims to analyse the accuracy of the CVM method compared with Demirjian’s method concerning mandibular length growth. Methods: An analytic research method and a cross-sectional design are employed. The research sample comprised 50 lateral cephalometric and panoramic photos of children aged 8-16 years. Data were collected by analysing the maturity level of the cervical vertebrae and the teeth, and measuring the mandible length of the children in the photos. The statistical test used was the Wilcoxon test. Results: The results of the Wilcoxon test for the asymptotic sign had a p-value of 0.116 &gt; 0.05, indicating no significant difference between the CVM and Demirjian methods. Conclusion: Both of the methods noted above yielded equally accurate results for determining mandibular length growth.

Salivary IGF-1 and Alkaline Phosphatase-Based Modeling for Skeletal Maturity Prediction in Orthodontic Patients.

Results A strong positive correlation was found between CA and cervical stages (r = 0.836, P < 0.001). Based on the regression model analysis, the model which combined IGF-1, ALP, and CA provided the best prediction at P < 0.001 with McFadden's pseudo R2 value of 0.552 for cervical stage prediction and 0.646 for growth phase prediction. In particular, its predictive ability for the prepubertal, pubertal, and postpubertal growth phases was 95%, 80%, and 90%, respectively. Conclusions A new model with the combination of salivary IGF-1 and ALP with CA can be used as a less invasive method to determine the cervical stage and also growth phase with high predictive ability in healthy subjects.

Cervical vertebrae maturation assessment as a predictive method for midpalatal suture maturation stages in 11- to 14-year-olds: retrospective study

ABSTRACT Introduction The treatment of transverse maxillary deficiency must be performed with the patient inside the growth phase, then, it is necessary to evaluate the patient’s skeletal maturation. There are two common methods: cervical vertebrae maturation (CVM) and midpalatal suture maturation (MSM). Objective to evaluate and correlate the methods in patients aged from 11 to 14 years old, to investigate if CVM method can be predictive of the midpalatal suture maturation stage. Methods Forty-two CBCT scans and lateral cephalometric radiographs of children, aged between 11 and 14 were analysed. The images were evaluated by two investigators. Kappa coefficient was calculated to estimate intra and inter-examiner agreement. Spearman correlation test was performed to evaluate the correlation between methods, age and gender. To evaluate the diagnostic performance of the CVM and MSM methods, the likelihood ratio (LHR positive) was applied. Results MSM evaluation showed a strong correlation with the CVM evaluation (rs = 0.6916). A high correlation between the methods were found for the male gender (rs = 0.7809). There was no correlation between age and the maturation methods, considering both genders. The CVM method presented a strong positive LHR with the MSM method (2.250), in the early stages; nonetheless, in the more advanced stages there was a lower ratio (1.500). Conclusions The CVM method can be used as a predictor of the maturation stages of the midpalatal suture in the early stages of maturity. In more advanced stages, the evaluation of the palatal suture by tomography is suggested.

Comparison of AdvanSync2® and Twin Block Appliances in Treatment of Class II Malocclusion With Retrognathic Mandible—An Observational Retrospective Study

Objectives: To evaluate the treatment outcomes between Twin Block and AdvanSync2® appliances by comparing the skeletal, dentoalveolar, and soft tissue changes. Materials and Methods: Radiographic data of 20 patients were retrospectively analyzed. Data were selected from patients in their skeletal growth spurt as evaluated by the cervical vertebral maturation method (CVMI 2, 3, and 4), with class II malocclusion characterized with retrognathic mandible (ANB &gt; 4°, SNB &lt; 77°, FMA = 25 ± 5°, overjet &gt; 5 mm). There were 10 patients in each group that underwent orthodontic correction for class II malocclusion: either using Twin Block or AdvanSync2®. Independent t test and Paired t test and chi-square tests were used for the data analysis. The level of statistical significance was set at P value ≤.05. Results: The chronological and skeletal age were similar in both the groups. Records were taken for the functional treatment with mean treatment span of 8 ± 1 month. Changes in SNB (group I = 1.59°, group II = 3.11°) ( P &lt; .01), Co-Gn (group I = 2.89 mm, group II = 5.34 mm), and U1-L1° (group I = −1.51°, group II = 2.97°) showed statistically different outcome between the groups, when the pre-post data were studied. Rest of the variables—cranial base, maxillary skeletal, mandibular skeletal, intermaxillary, vertical skeletal, maxillary dentoalveolar, mandibular dentoalveolar, and soft tissue—showed similar outcome ( P &gt; .05). Conclusion: Both appliances lead to desirable outcomes in the correction of class II malocclusion. AdvanSync2® resulted in inducing more of changes in SNB and effective mandibular length as compared to Twin Block. Overjet and molar relation improved significantly with both the appliances. Both the appliances resulted in similar skeletal, dentoalveolar, and soft tissue changes.

Concordances and correlations between chronological, dental and bone ages: A retrospective study in French individuals

Bone and dental maturations are subject to physiological, environmental and pathological variables and are unique to each individual. Numerous methods for age estimation appeared to answer a new demand explained by the contemporary migratory movements and the increase of the crime rates. The objective of this study was to observe the relationships between skeletal and dental maturation stages to estimate which methods can be applied to a French population. This retrospective study was based on panoramic and cephalometric radiographs belonging to 192 (101 females and 91 males) orthodontic patients aged between 9 and 19 years, inhabitants of the Provence-Alpes-Côte d′Azur region. The Demirjian method based on dental calcification was used to estimate dental age. For the assessment of skeletal maturity and bone age, the Cervical Vertebral Maturation (CVM) method (Baccetti et al.) and its computerized version (Decocq et al.) were used. Spearman’s correlation tests were performed to estimate the correlation between dental calcification stages and those of cervical vertebral maturation among the study population. The methods of Lin’s concordance correlation coefficient and Bland and Altman were used to analyze the concordance between bone, dental and chronological ages. A moderate but statistically significant correlation was obtained between dental and skeletal developmental stages (R = 0.383–0.618). The tooth showing the highest correlation with vertebral stages was the second molar for both sexes. Earlier vertebral maturation stage affiliation was observed in girls. The results confirmed that bone and dental maturations can be assessed to estimate relevant biological ages for children in orthodontic or forensic contexts.

Comparison of abnormalities in the sequence of growth stages in the skeletal maturity index vs cervical vertebral maturation.

To evaluate the frequency of abnormal progression that could ultimately affect the reliability of the skeletal maturity index (SMI) and the cervical vertebral maturation (CVM) method that are most commonly used analyses for skeletal age assessment. A retrospective design was used to compare 299 hand-wrist radiographs with 299 lateral skull radiographs regarding the number of abnormalities in the proposed sequence of maturation in the SMI and CVM methods. A significantly greater number of abnormalities occurred in the sequence of CVM progression compared with SMI (P < .001). Sex and age did not have an effect. Skeletal age assessment based on SMI is more accurate than CVM regarding the progressive sequence of stages.

Correlation between Dental and Skeletal Maturity in Korean Children

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Korean subjects. The samples were derived from hand-wrist, panoramic radiographs, and lateral cephalograms of 743 subjects (359 males and 384 females) with ages ranging from 6 to 14 years. Calcification of seven permanent mandibular teeth on the left side were rated according to the system of Demirjian. To evaluate the stage of skeletal maturation, hand-wrist radiographs were analyzed by skeletal maturity indicators (SMI) system of Fishman and lateral cephalograms by cervical vertebral maturation (CVM) method of Baccetti. Statistically significant relationships were found between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients (r = 0.40-0.84, p &lt; 0.001). The second molar showed the highest correlation and central incisor showed the lowest correlation for female and male subjects. For both sexes, canine stage G and second molar stage F were related to SMI 6 and CS 3. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period in Korean patients.