The Fourth Cervical Vertebra Anterior and Posterior Body Height Projections (Vba) for the Assessment of Pubertal Growth Spurt (original) (raw)

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

Dentomaxillofacial Radiology, 2014

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.

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 Journal of Contemporary Dental Practice

Aim: 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. Materials and methods: 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. Results: 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. Conclusion: 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. Clinical significance: 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.

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

The Open Dentistry Journal, 2021

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, ...

Growth pattern of lumbar maturity stage at L1 to L5 during adolescent growth spurt

European Spine Journal

Purpose This study aimed to clarify the order of the lumbar maturity stage, each at L1 to L5, and the relationships between age at peak height velocity (APHV) and the lumbar maturity stage. Methods A total of 120 male first-grade junior high school soccer players were enrolled and followed for two years, and measurements were performed five times (T1 to T5). The lumbar maturity stage was assessed according to the degree of lesion of the epiphyseal from L1 to L5 using magnetic resonance imaging and classified into three stages: cartilaginous stage, apophyseal stage, and epiphyseal stage. The relationships between T1 and T5 temporal changes and developmental stages divided by 0.5 year increments based on APHV and the lumbar maturity stage at L1 to L5 were examined. For the apophyseal stage, developmental age calculated based on the difference between APHV and chronological age between each lumbar vertebra was compared. Results We found that part of the cartilaginous stages decreased a...

Natural sagittal spino-pelvic alignment in boys and girls before, at and after the adolescent growth spurt

European Spine Journal, 2014

Purpose Adolescent idiopathic scoliosis occurs far more often in girls than in boys, and its initiation and progression normally takes place around the adolescent growth spurt. Despite extensive research into the topic, no solid explanation for both well-known phenomena has been offered. The sagittal profile of the growing spine has been demonstrated previously to play an important role in the spine's rotational stiffness. Changes in this sagittal alignment around the growth spurt can be inferred to play an important role in the spine's propensity to develop a rotatory deformity, i.e. scoliosis. The aim of this study was to quantify sagittal spino-pelvic alignment and orientation in space of each individual vertebra in normal boys and girls in the beginning, at the peak and at the end of pubertal growth. Methods Standardized lateral radiographs of the spine of boys (n = 57) and girls (n = 99) between the age of seven and eighteen who underwent screening for scoliosis, but had a normal spine were enrolled in this study. Children with spino-pelvic pathology at initial screening or during follow-up were excluded. According to Dimeglio's data, subjects were classified into three groups: before, at and after the peak growth spurt. Seven regional sagittal spinopelvic parameters, as well as the inclination angles of each individual vertebra between C7 and L5 compared to the gravity line, were measured semi-automatically using inhouse developed software. Results In all subjects, the posteriorly tilted segment was longer, vertebrae T1-T8 were more posteriorly inclined and thoracic kyphosis, pelvic incidence and pelvic tilt were lower before as well as during the peak of the growth spurt, when compared to after the growth spurt (P B 0.023). Furthermore, in girls, thoracic kyphosis was smaller (P = 0.023), the posteriorly inclined segment was longer (P \ 0.001) and T1 as well as levels T3-T11 were more posteriorly inclined (P \ 0.05) compared to boys at all stages of development. At the peak of the growth spurt, girls had more posterior inclination of upper thoracic vertebrae and lower values for thoracic kyphosis than boys (P = 0.005). Conclusions These results imply that the spines of girls during the growth spurt are more posteriorly inclined, and thus rotationally less stable, compared to boys at the same stage of development, as well as compared to girls after the growth spurt. This may explain why initiation and progression of adolescent idiopathic scoliosis are more prevalent in girls around puberty.

Reliability of cervical vertebral maturation compared to hand-wrist for skeletal maturation assessment in growing subjects: A systematic review

Journal of Back and Musculoskeletal Rehabilitation, 2021

BACKGROUND: Radiographic methods to assess skeletal maturity (SM) have a key role in adolescent idiopathic scoliosis (AIS) management, allowing to predict risk of spinal curve progression. Cervical vertebral maturation (CVM) has been recently introduced as an alternative tool to assess skeletal maturity; however, its clinical role is still debated. OBJECTIVE: This systematic review aimed to investigate the reliability of CVM in the SM assessment of growing subjects, comparing it to hand wrist maturation (HVM). METHODS: PubMed, Scopus, and Web of Science databases were systematically searched from inception until 31 st December 2020 to identify observational studies presenting: growing subjects as participants; CVM methods as intervention; HVM methods as comparator; reliability for SM assessment as outcome. A 10-item quality tool has been used to assess study quality. RESULTS: Out of 205 papers, 12 papers were included in the data synthesis. We classified 10 studies (83.3%) as medium-quality studies and 2 studies (16.7%) as high-quality studies. Eight studies reported a significant correlation between CVM Baccetti and different HWM methods. CONCLUSION: Taken together, these findings suggested that CVM might be considered as reliable SM assessment method compared to HWM in growing subjects. However, further studies are warranted to confirm these findings.

A comparison between cervical vertebrae and modified MP3 stages for the assessment of skeletal maturity

Journal of Natural Science, Biology and Medicine, 2013

Objective: Evaluation of skeletal maturity in human individuals is an important aspect in orthodontics and dentofacial orthopedics because, growth guidance and fundamental structural changes are essential for treatment of skeletal discrepancies in all the three planes. Among various growth assessment methods, cervical vertebra maturation stages and hand wrist have been correlated with the individual growth changes during puberty. The purpose of this study is to determine correlation of the CVM index with the modified median phalanx index (MP3) as described by Rajagopal and Kansal. Materials and Methods: 200 subjects (100 males and 100 females) of Nellore, Indian origin boys aged between 10 to 19 years and girls of 8 to 16 years were selected for the study. The subjects are selected randomly from patients visiting the Departments of Orthodontics and Dentofacial Orthopedics, Pediatric dentistry and Oral medicine and Radiology at Narayana Dental College and Hospital. Nellore. Radiographs of left hand MP3 and lateral cephalogram were taken. Results: Cohen's kappa statistic was used to assess the agreement between the two measurements based on categorical variables. Conclusions: There was a good concordance between 6 stages of CVMI (Hassel and Farman) and the 6 stages of MP3 (Rajagopal and Kansal). Physiological maturity was earlier in females than in males when compared to the individuals of opposite sex of same chronological age. Chronological age was not a valid predictor of assessing the skeletal maturity because of significant variations in the distribution of CVMI and MP3 stages with respect to individual chronological age distribution.

Growth of the cervical vertebrae in girls from 8 to 17 years. A longitudinal study

The European Journal of Orthodontics, 2012

An important criterion of orthodontic diagnosis is the determination of the skeletal maturation stage. The cervical vertebral maturation (CVM) method is presented as an alternative to skeletal maturation determination. However, studies published to date concerning CVM have generally been cross-sectional. The aim of this investigation was to longitudinally evaluate growth and development with the CVM method. Lateral cephalometric radiographs of 41 girls, aged 9-16 years, collected between 1978 and 1984 were used to evaluate changes in C2, C3, and C4 dimensions. The mean values, standard deviations, maximum and minimum values of cervical vertebrae growth, and growth rate were calculated for every age and age interval. Cumulative growth increment was determined by summing annual mean values for each parameter. CVM stages were initially evaluated according to the method of Lamparski. The time differences between the following CVM stages were evaluated with a paired t-test. The total length increment was distinct for C2 but similar for C1, C3, and C4. Total length increments reached their maximum between CVM stages 2 and 3, except for C3. The total length increment of C3 reached its peak 1 year earlier. The height increments of the spinose processes of C2, C3, and C4 were similar. The results showed that height increments were greater than length increments, which was due to changes in the anatomical pattern. Vertical growth displayed a decreasing trend from the upper to the lower cervical vertebrae. Determination of skeletal maturation from dimensional measurements and anatomical changes of the cervical vertebrae will facilitate orthodontic evaluation by eliminating the need for hand-wrist films and, therefore, decrease the patient's exposure to radiation.

Quantification of cranial base growth during pubertal growth

Journal of Orthodontics, 2009

Objective: To quantify longitudinal cranial base growth from prepubertal through postpubertal stages of development, as defined by biological indicators of individual skeletal maturity (cervical vertebral maturation -CVM) method and to determine if there is sexual dimorphism resulting from cranial base growth.