Use of the cervical vertebrae maturation method in growth spurt determination

Abstract

AIM: To establish the validity of the cervical vertebra maturation (CVM) method as an indicator of skeletal age within the circumpubertal period by correlating the CVM method with the hand-wrist maturation (HWM) method. MATERIALS AND METHOD: Four hundred hand-wrist and lateral cephalometric radiographs of southern Chinese subjects randomly selected and immediately analysed. The age range for females was between 10 and 15 years, and for males between 12 and 17 years, so that they were during the circumpubertal period. CVM was assessed using the method developed by Baccetti et al. (2005) and HWM using two methods, one developed by Hägg and Taranger (1980), and the other by Fishman (1982). They were correlated using Spearman rank correlation analysis. RESULT: CVM was signifi cantly correlated with hand-wrist skeletal age (Spearman r: male = 0.9521, female = 0.9408) with Hägg and Taranger’s method and with Fishman’s method (Spearman r: male = 0.9206, female = 0.9363). The method error was insignifi cant. For the Hägg and Taranger method, all the patients in CVM stage 3 were found to be in the MP3-FG or MP-3G stages of HWM, but with Fishman’s method, all patients in CVM stage 3 were in the SMI2 or SMI3 stages of HWM, which were, for both, near the peak of the growth spurt. CONCLUSION: As the CVM method has a high correlation with HWM in both methods for the southern Chinese population, lateral radiographs can be used to replace hand-wrist radiographs for determination of skeletal maturity to avoid extra radiation. CVS stage 3 can be used as the maturation indicator to start functional appliance therapy for maximal growth response