• 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.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.3
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• pp.247-254
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• 2019

This study aimed to investigate the correlation between maxillary canine's dental maturity and skeletal maturity of growing children. Cephalometric radiographs, hand-wrist radiographs and panoramic radiographs of 299 children aged 6 - 17 years were analyzed to measure the cervical vertebral maturation stages (CVMS), skeletal maturity indicators (SMI) and Demirjian index (DI). Spearman correlation test was used to analyze the correlation between dental maturity and skeletal maturity. There was significant positive correlation between the DI and CVMS in both boys and girls (p = 0.000). Similarly positive correlation was found between the DI and SMI (p = 0.000). The results of this study suggest that the dental maturity of maxillary canine can be used as auxiliary maturity indicator in growing children.

• The korean journal of orthodontics
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• v.53 no.4
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• pp.232-240
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• 2023

Objective: This study aimed to evaluate the zygomaticotemporal suture (ZTS) maturation, analyze the age distribution patterns of ZTS maturation stages, and investigate the relationship between ZTS and cervical vertebral maturation (CVM). Methods: A total of 261 patients who underwent cone-beam computed tomography (112 males, mean age, 13.1 ± 3.3 years; 149 females, mean age, 13.7 ± 3.1 years) were examined to evaluate the ZTS stages. The ZTS stages were defined based on a modified method from previous studies on zygomaticomaxillary sutures. Differences between groups and correlations between indicators were analyzed using the Spearman correlation test, intraclass coefficient of correlation (ICC), one-way analysis of variance and rank sum test. Statistical significance was set at p < 0.05. The diagnostic value of CVM stages in identifying ZTS maturation stages was evaluated using positive likelihood ratios (LRs). Results: A positive relationship was found between the ZTS and CVM stage (r = 0.747, ICC = 0.621, p < 0.01) and between the ZTS stage and chronological age (r = 0.727, ICC = 0.330, p < 0.01). Positive LRs > 10 were found for several cervical stages (CSs), including CS1 and CS2 for the diagnosis of stage B, CS1 to CS3 for the diagnosis of stages B and C, and CS6 for the diagnosis of stages D and E. Conclusions: The ZTS maturation stage may be more relevant to the CVM stage than to the chronological age. The CVM stages can be good indicators for clinical decisions regarding maxillary protraction, except for CS4 and CS5.

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.2
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• pp.139-146
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• 2019

This study aimed to analyze the association of midpalatal suture (MPS) maturation stages with skeletal maturation and age and to obtain references for establishing a treatment plan for rapid maxillary expansion (RME). Cone-Beam Computed Tomography (CBCT) images from 480 children (240 boys, 240 girls) aged 7 - 15 years were obtained. MPS maturation stages and cervical vertebral maturation indicator (CVMI) were evaluated, and the correlations between MPS maturation stages, CVMI, and age were determined using the Spearman's correlation test. The positive likelihood ratio (LHR) of CVMI for MPS maturation stages was calculated. MPS maturation stages and CVMI showed a strong correlation. Especially, CVMI 1 - 3 showed positive LHR greater than 10 for the diagnosis of stages A - C. MPS maturation stages and age were correlated strongly in girls and moderately in boys. Conventional RME produces the most favorable skeletal effect at CVMI 1 - 3 or those up to 12 years of age and fewer skeletal effects at CVMI 4 or at 13 years of age in girls and 13 - 15 years in boys. It is recommended to evaluate MPS maturation stages using CBCT before RME application at CVMI 5, 6 or at 14, 15 years of age in girls.

• 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.

• 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.52 no.5
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• pp.345-353
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• 2022

Objective: To investigate airway volumes using cone-beam computed tomography (CBCT) by skeletal patterns, sex, and cervical vertebral maturation (CVM) stages in Korean adolescents. Methods: The sample consisted of pretreatment CBCT and cephalograms of 95 adolescents (aged 12-19) obtained out of 1,611 patients examined for orthodontic treatment from 2018 to 2020 in Kyungpook National University Dental Hospital. The samples were classified into two sex groups; three skeletal pattern groups, four chronological age groups and four CVM stages. Nasopharyngeal volumes (NPV), oropharyngeal volumes (OPV), total pharyngeal airway volume (TAV) and minimum cross-sectional area (MCA) measurements were taken from the CBCT. Multiple linear regression analyses to find out which one of the independent variables are good predictors for airway variables. Significant factors were analyzed by two-way multivariate analysis of variance (MANOVA) then multiple comparisons were analyzed using a t-test, and Fisher least significant difference. Results: Age, sex, CVM, and Sella-Nasion-B point have significant influence on airway variable. Males and females showed similar patterns of change in chronological age groups 1-3; however, males had larger NPV, OPV, and MCA at CVM in group 4. According to CVM stages, males had larger OPV, TAV, and MCA at CVM stage 6 (p-value: 0.019, 0.021, 0.015, respectively) and no sex differences at CVM stages 3, 4, and 5. Conclusions: Skeletal patterns have an effect on airway volume. Sex differences were found in CVM 6.

• 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.

• 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.46 no.1
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• pp.48-56
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• 2019

The objective of this study was to examine measuring agreement between middle phalanx of the third finger and cervical vertebrae analysis for assessing skeletal maturity according to body mass index percentile. A retrospective chart view was used to select patients with body mass index data, hand - wrist radiographs and lateral cephalograms of same day. The patients were divided into 4 groups by body mass index percentile. The hand - wrist radiographs were analyzed using modified middle phalanx of the third finger method and the lateral cephalograms were categorized according to cervical vertebral maturation stage. The degree of agreement between the 2 methods of analyzing skeletal maturation was measured by calculating weighted kappa statistic according to body mass index percentile group. There was a good agreement between the 2 methods in the entire body mass index percentile group. According to the body mass index percentile group, the agreement was found to be different, and the pattern was different between boys and girls. Pediatric dentist should consider sex and weight status when evaluating growing children and adolescents because it can affect the agreement of 2 method of analyzing skeletal maturation.