• 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 Korean Neurosurgical Society
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• v.57 no.3
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• pp.185-191
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• 2015

Objective : In order to provide normal values of the pediatric sub-axial cervical spinal canal and vertebral body growth pattern using computed tomographic scans, a total of 318 patients less than 10 years old were included. Methods : The growth of the vertebral body and canal space was investigated using four different age groups. The Torg ratio (TR) was calculated and all patients were classified into a low TR group and a high TR group according to a cutoff value of 1.0. To account for spinal curvature, the C3-7 angle was measured. Results : Very little axial expansion and growth in height were observed (2.9 mm and 3.4 mm, respectively), and the spinal canal increments (1.8 mm) were much smaller than the dimensions of the vertebral body. The mean TR values were $1.03{\pm}0.14$ at the C3 vertebral level, $1.02{\pm}0.13$ at C4, $1.05{\pm}0.13$ at C5, $1.04{\pm}0.13$ at C6, and $1.02{\pm}0.12$ at C7 in all patients. The mean sub-axial angle (C3-7) was $7.9{\pm}10.6^{\circ}$ (range: $-17-47^{\circ}$). Conclusion : The upper sub-axial spinal canal continuously increased in size compared to the lower sub-axial spine after 8 years of age. Considerable decrements in the TR was found after late childhood compared to younger ages. Generally, there were no significant differences between boys and girls in vertical length of the cervical vertebrae. However, the axial dimension of the vertebral body and the spinal canal space varied according to gender.

• 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.

• Advances in pediatric surgery
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• v.17 no.2
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• pp.154-161
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• 2011

Tracheoesophageal fistula without esophageal atresia (H-type TEF) is a congenital anomaly that is characterized by a fistula between the posterior wall of the trachea and the anterior wall of the esophagus, not accompanied by esophageal atresia. The purpose of this study is to investigate the clinical characteristics, diagnostic time, the side of cervical approach and short term result after surgery by searching medical records of patients treated for H-type TEF. The search was done at University of Ulsan, Department of Pediatric Surgery of Asan Medical Center, and the total number of patients from May 1989 to December 2010 was 9 with M:F ratio of 1:2. The median gestational age was $39^{+6}$ ($32^{+6}{\sim}41^{+0}$) wks. Seven out of nine patients were born at term and the other two were born premature. The clinical presentation was aspiration pneumonia, difficulty in feeding, chronic cough, vomiting, abdominal distension and growth retardation. The symptoms presented right after birth. The diagnosis was made with esophagography and the median time of diagnosis was 52 days of life. The majority of surgical corrections were performed within two weeks of diagnosis (median; 15d, range; 1d - 6m). Six patients had associated anomalies, and cardiac anomalies were most common. The cervical approach was utilized in all cases (right 2, left 7). Transient vocal cord palsy and minor esophageal leakage complicated two cases. Although the diagnosis of H-type TEF was difficult and often delayed, we had a good short term result. The left cervical approach was preferred.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.1
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• pp.89-103
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• 2023

The purpose of this study was to measure bone age using an artificial intelligence program based on the Greulich-Pyle (GP) method to find out the bone age corresponding to each stage of cervical vertebral maturation (CVM) and the middle phalanx of the third finger (MP3). This study was conducted on 3,118 patients who visited pediatric dentistry at Kyung Hee University Dental Hospital and Pusan National University Dental Hospital from 2013 to 2021. The CVM stage was divided into 5 stages according to the classification by Baccetti, and the MP3 stage was divided into 5 stages according to the methods of Hägg and Taranger. Based on the GP method, bone age was evaluated using an artificial intelligence program. The pubertal growth spurt in the CVM stage was CVM II and III. The mean bone age in CVM II was 11.00 ± 1.81 years for males and 10.00 ± 1.49 years for females, and in CVM III, 13.00 ± 1.46 years for males and 12.00 ± 1.44 years for females (p < 0.0001). The pubertal growth spurt in the MP3 stage was MP3 - G stage. The bone age at the MP3 - G stage was 13.14 ± 1.07 years for males and 11.40 ± 1.09 years for females (p < 0.0001). Bone age evaluation using artificial intelligence is worth using in clinical practice, and it is expected that a faster and more accurate diagnosis will be possible.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.243-258
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• 2008

The purpose of this study was to investigate the relationship between the stages of calcification of various teeth and skeletal maturity stages among Korean individuals. The study subjects consisted 154 female and 179 male ranging from 7 years to 16 years of age. A total of 333 hand-wrist, cephalo-lateral and panoramic radiographs were obtained and analyzed. The tooth development of the mandibular canines, first, second premolars, and second molars were assessed according to the Dermijian's system. Skeletal maturity stages were determined from hand-wrist radiographs by using the SMI system and cephalo-lateral radiographs by using the CVMS, respectively. The results were as follows. 1. The mean ages of each stage of skeletal maturity were consistently younger in female subjects. 2. There was a high correlation between skeletal maturity of hand-wrist and cervical vertebrae in the both sexes. 3. There was a high correlation between skeletal maturity and dental calcification stage of mandibular canines, first premolar, second premolars, and second molar. 4. The mandibular second molar was tooth showing the highest correlation. 5. Percent distributions of the relationship between calcification stages of individual teeth and stages of skeletal maturity were obtained in both sexes. In summary, this suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.3
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• pp.255-268
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• 2021

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 < 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.36 no.1
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• pp.46-52
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• 2009

The purpose of this study was to compare the skeletal maturation of cervical vertebrae according to vertical skeletal patterns in the adolescents. Lateral cephalograms of 198 subjects(10 years old), 216 subjects(12 years old), and 138 subjects(14 years old) were reviewed, and subjects were classified according to vertical skeletal patterns. The 30 subjects were selected with the greatest predominance of vertical growth, and the other 30 subjects, with the greatest predominance of horizontal growth; these subjects comprised the vertical and horizontal groups, respectively. For evaluating of skeletal maturation, the concavity of inferior border and verticohorizontal ratio of cervical vertebrae were observed and measured according to age. The measurements were analyzed statistically by SPSS computerized program. The results were as follows : In general, the concavity of the inferior border of the cervical vertebrae was greater in the horizontal group than the vertical group in all of the 10, 12, 14 year olds, but was not statistically significant. The vertico-horizontal ratio of the 3rd and 4th vertebra of the horizontal groups was a significantly larger than the vertical groups in 12 year olds but did not show any statistical significance in 10 and 14 year olds. There were a weak negative correlations between SUM, FMA and the vertico-horizontal ratio for each groups at 12 ages.

• Journal of the korean academy of Pediatric Dentistry
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• v.47 no.3
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• pp.235-247
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• 2020

The purpose of this study was to evaluate the skeletal and dentoalveolar effects and optimal timing for treatment of class II malocclusion with functional appliances in children and adolescents. A group of 30 patients with class II malocclusion were divided into 3 groups according to their use of functional appliance: Twin block, Activator, Fränkel appliance. The group was also divided into 2 groups according to the cervical vertebrae maturation method. Lateral cephalometric radiographs were analyzed pretreatment (T0) and posttreatment (T1). Among the functional appliances, treatment with Twin block and Activator showed significant increase in the length of the mandible (Co-Gn) and the lower anterior facial height (ANS to Me), whereas the overjet and overbite were significantly reduced. Treatment with Fränkel appliance showed significant improvement in the relationship of maxilla and mandible. In addition, if the functional appliance was used during the period of pubertal growth peak, there was a significant increase in mandibular length, improvement in the relationship of maxilla and mandible, labial inclination of lower incisors and decrease in overjet compared to the treatment before pubertal growth peak. Therefore, this study indicates that using functional appliances for patients with class II malocclusion is effective and the optimal timing for using functional appliances is during pubertal growth peak.