• Journal of the korean academy of Pediatric Dentistry
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• v.34 no.4
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• pp.551-559
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• 2007

This study was to investigate if cervical vertebrae maturation stages are as useful as hand-wrist maturation stages in evaluating the mandibular growth. The subject consisted of 292 girls aged from 8 to 16 years with normal occlusion. They were classified according to diagnosis by using studycast, lateral cephalogram, and handwrist X-ray film. The results were as follow: 1. Cervical vertebrae and hand-wrist maturation stages increased with age. 2. All mandibular measurements (Ar-Go, Go-Me, N-Go, S-Gn, N-Me) increased linearly with cervical vertebrae maturation stages. 3. Ar-Go, Go-Me, N-Go, S-Gn increased linearly with hand-wrist maturation stages. 4. Ar-Go, Go-Me, N-Go, S-Gn increased relatively rapidly between cervical vertebrae maturation stages 3 and 4. Go-Me and S-Gn increased relatively rapidly between hand-wrist maturation stages 6 and 7. 5. Ar-Go, Go-Me, N-Go, S-Gn, N-Me had high correlations with cervical vertebrae maturation stages as well as hand-wrist maturation stages. These results suggest that cervical vertebrae maturation stages are reliable on evaluating the mandibular growth.

• Journal of the korean academy of Pediatric Dentistry
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• v.39 no.4
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• pp.357-365
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• 2012

There are orthodontic treatment which involves tooth movements and orthopedic treatment which involves skeletal movement. In childhood and adolescence, especially for the treatment of orthopedic treatment, the evaluation of bone maturity and growth potential is very important. The purpose of this study is to assess the developmental stage and to compare the amount of mandibular growth with cephalometric radiographs and hand-wrist radiograph in 6 to 13-year-old children with normal occlusion. The results are as follows : SMI and CVM showed a significant correlation (p < 0.05). Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn increased with increasing maturity of hand-wrist and Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn increased with increasing maturity of cervical vertebrae maturation. Also Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn showed a significant correlation with each of the cervical vertebrae maturation stages and hand-wrist maturation stages (p < 0.05). These results suggested that mandibular growth had a significant correlation with cervical vertebrae maturation stages and hand-wrist maturation stages.

• Journal of the korean academy of Pediatric Dentistry
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• v.38 no.3
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• pp.237-243
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• 2011

The purpose of study is for the certified correlations of hand-wrist radiograph with cervical vertebrae for skeletal maturation in children. Normal evaluation devices of growth stage is sexual feature, biological age, tooth development stage, height and weight. Evaluation of growth potential is very important for childhood and puberty. The skeletal developmental stages were evaluated by using the hand-wrist radiograph and cephalometric radiograph that obtained from 6 to 18 years old children. 1. Chronologic age was not more suitable indicator of skeletal development compared to Skeletal Maturity Indicators(SMI) and Cervical Vertebrae Maturation(CVM) stages. 2. SMI and CVM stages for females occurred earlier than that for male. 3. SMI 1 and 2 stages were corresponded to CVM 1; SMI 3,4 = CVM 2; SMI 5,6 = CVM 3. 4. Reproducibility and reliability of observer for SMI and CVM were excellent. This results suggest CVM stage is comparable to SMI stage in terms of evaluating the skeletal development.

• The korean journal of orthodontics
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• v.27 no.3 s.62
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• pp.481-492
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• 1997

In order to investigate the possibility of using a cervical vertebral maturation indicator as a mandibular growth indicator, the relationship of cervical vertebral maturation and mandibular & body height growth changes was assessed in biennial serial lateral cephalometric radiographs of eighteen korean male and fourteen korean female while they were 8.5 to 18.5 years old. The following results were obtained. 1. It was a reliable method to evaluate skeletal maturation by using cervical vertebrae. 2. In general, cervical vertebral maturation stages of females were higher than those of males at the same age and there were significant differences in statistics at the age of 10.5, 14.5. 3. The age of a female at the same cervical vertebral maturation stage were earlier than that of a male. 4. In the case of males, significant Ar-Gn increases were found between stage 3 and 4,5; Ar-Go increases between stage 4 and 5. 5. In the case of females, significant S-Gn and Ar-Gn increases were (end between stage 3 and 4. 6. Significant body height increases were found between stage 3 and 4 in both sexes. 7. The peak velocity of body height and mandibular length was observed between cervical vertebral maturation stage 3 and 4 in both sexes. 8. The relationship between mandibular & body height changes and specific maturation stage of cervical vertebra was found, therfore using a cervical vertebral maturation indicator as mandibular growth indicator is quite within realms of possibility.

• The korean journal of orthodontics
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• v.30 no.2 s.79
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• pp.143-157
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• 2000

To investigate the developmental stages of dental and skeletal maturation by ages and the correlations among dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist, the author used the cephalograms, orthopantomograms, and hand-and-wrist radiograms of 1055 patients (male 458, female 597) aged 7 to 20 years old. In the cephalograms, the skeletal maturity stages of each bone were mainly assessed by Hassel and Farman's cervical vertebrae maturation indicators (CVMI) method. In the orthopantomograms, the dental maturity stages of each tooth were mainly assessed by Nolla's tooth calcification stages method. In the hand-and-wrist radiograms, the skeletal maturity stages of each bone were mainly assessed by Fishman's skeletal maturity indicators (SMI) method. The results were as follows. 1. There was a high correlation among dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist in the both sexes (P<0.001). 2. There was a high correlation (r=0.91-0.93) between skeletal maturity of cervical vertebrae and that of hand-and-wrist. 3. There was a high correlation (r>0.8) between skeletal maturity of hand-and-wrist and maturity of upper and lower canine, first premolar, and second premolar. 4. There was high a correlation(r=0.8) between skeletal maturity of cervical vertebrae and maturity of upper canine. 5. By the ages, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist were obtained in the both sexes. In summary, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist we of sufficient diagnostic worth as an index to predict adolescent growth.

• Imaging Science in Dentistry
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• v.52 no.1
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• pp.83-91
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• 2022

Purpose: This study assessed the associations between chronological age, dental maturation (DM), cervical vertebrae maturation (CVM), and hand-wrist maturation (HWM) in individuals aged 9-19 years. In addition, this study aimed to derive practical methods to evaluate the skeletal age using DM, CVM, or HWM for orthodontic, medical, and forensic purposes and to compare which of these 3 developmental parameters is more accurate for estimating the age of individuals in a Turkish population. Materials and Methods: Panoramic, lateral cephalometric, and hand-wrist radiographs of 284 patients aged 9-19 years were used in this study. The DM, CVM, and HWM stages were determined. The Kolmogorov-Smirnov, kappa, Wilcoxon, Kruskal-Wallis, chi-square, and Spearman correlation tests and simple linear regression analysis were used for statistical analysis. The significance level was 0.05. Results: Statistically significant differences were found between chronological age and DM, chronological age and CVM, and chronological age and HWM in both sexes (P<0.05). DM did not show statistically significant differences according to sex (P>0.05), but CVM and HWM were statistically different between males and females (P<0.05). The DM-estimated age yielded more accurate values than the other methods. Conclusion: All correlations between skeletal and dental stages were statistically significant. Our results showed that there was no statistically significant difference between chronological age and DM-estimated age. Therefore, it can be concluded that DM stages have the potential to be used for legal purposes.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.209-216
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• 2020

Purpose: In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years. Materials and Methods: Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM. Results: Real age increased as the CVM stage gradually increased. The results of 2×2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively. Conclusion: Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.

• The korean journal of orthodontics
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• v.46 no.6
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• pp.345-355
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• 2016

Objective: The purpose of this study was to determine whether predicting maturation of the midpalatal suture is possible by classifying its morphology on cone-beam computed tomography (CBCT) images and to investigate relationships with other developmental age indices. Methods: The morphology of the midpalatal suture was assessed by using CBCT images of 99 patients. Axial plane images of the midpalatal suture were classified into five stages according to the classification scheme. To make the assessment more accurate, the morphology and fusion of the midpalatal suture were additionally investigated on coronal cross-sectional planar images and volume-rendered images. Bone age was evaluated using the hand and wrist method (HWM) and cervical vertebrae method (CVM); dental age (Hellman's index), sex, and chronological age were also assessed. To evaluate relationships among variables, Spearman's rho rank test was performed along with crosstabs using contingency coefficients. Results: The HWM and CVM showed strong correlations with the maturation stage of the midpalatal suture, while other indices showed relatively weak correlations (p < 0.01). Through crosstabs, the HWM and CVM showed high association values with CBCT stage; the HWM demonstrated slightly higher values (p < 0.0001). Based on the HWM, the midpalatal suture was not fused until stage 6 in both sexes. Conclusions: Among developmental age indices, the HWM and CVM showed strong correlations and high associations, suggesting that they can be useful in assessing maturation of the midpalatal suture.

• The Journal of the Korean dental association
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• v.56 no.2
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• pp.94-102
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• 2018

The present study was conducted to assess the growth changes of human chin in childhood and adolescence at various stages of skeletal maturation using metallic implant installed in mandibular body. Lateral cephalographs including 23 subjects (9 males and 14 females) between 7-18 years old were used, which had been taken at University of California in San Francisco and kept at University of the Pacific. Three lateral cephalographs were chosen for each subject according to CVM (Cervical Vertebral Maturation) method (CVM stage 1 to 2, CVM stage 3 to 4, and CVM stage 5 to 6) which assess the extent of the skeletal maturation using the second, third, and fourth cervical vertebrae. V-ceph was used in order to mark the 8 landmarks (S, N, A, B, Pog, Me, Go, Imp) on lateral cephalographs and obtain 8 angular and linear measurements(ANB, SNPog, SN-GoMe, Imp-B, Imp-Pog, B-Pog//GoMe, $GoMe{\bot}B$, $GoMe{\bot}Pog$). Among 8 measurements, ANB, SNPog, SN-GoMe, B-Pog//GoMe, $GoMe{\bot}B$ showed statistically significant growth changes at various stages of skeletal maturation according to CVM method, while there were no significant differences on Imp-B, Imp-Pog, $GoMe{\bot}Pog$. The results suggest that the increasing prominence of human chin is greatly influenced by the vertical growth of B point area, in addition to the change and growth in chin and mandible proper.

• The korean journal of orthodontics
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• v.46 no.5
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• pp.323-330
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• 2016

Objective: The purpose of this study was to determine whether the results of fractal analysis can be used as criteria for midpalatal suture maturation evaluation. Methods: The study included 131 subjects aged over 18 years of age (range 18.1-53.4 years) who underwent cone-beam computed tomography. Skeletonized images of the midpalatal suture were obtained via image processing software and used to calculate fractal dimensions. Correlations between maturation stage and fractal dimensions were calculated using Spearman's correlation coefficient. Optimal fractal dimension cut-off values were determined using a receiver operating characteristic curve. Results: The distribution of maturation stages of the midpalatal suture according to the cervical vertebrae maturation index was highly variable, and there was a strong negative correlation between maturation stage and fractal dimension (-0.623, p < 0.001). Fractal dimension was a statistically significant indicator of dichotomous results with regard to maturation stage (area under curve = 0.794, p < 0.001). A test in which fractal dimension was used to predict the resulting variable that splits maturation stages into ABC and D or E yielded an optimal fractal dimension cut-off value of 1.0235. Conclusions: There was a strong negative correlation between fractal dimension and midpalatal suture maturation. Fractal analysis is an objective quantitative method, and therefore we suggest that it may be useful for the evaluation of midpalatal suture maturation.