• 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.

• 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.28 no.2 s.67
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• pp.285-295
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• 1998

In clinical orthodontics, it is significant to understand the stage of growth in a growing patient. In order to assess the skeletal maturity of the patients, the hand-wrist radiograph and the cervical vertebrae (Cervical Vertebrae Maturation Indicators : CVMI) was evaluated from the lateral cephalograph and the skeletal maturity determined from the hand-wrist X-ray (Skeletal Maurity Indicators : SMI) taken on the same day in the same patients, and its interrelationship examined to come up with the following results: 1. The skeletal maturity evaluated from the hand-wrist radiograph and the maturation of the cervical vertebrae from the lateral cephalograph showed a significant interrelationship with each other. 2. In the evaluation of the skeletal maturity using the SMI and CVMI, the CVMI 1 showed a siginificant correlation with SMI 1, 2, the CVMI 2 with SMI 3, 4, CVMI 3 with SMI 6, 7, CVMI 4 with SMI 7, 8, CVMI 5 with 9, 10 and CVMI 6 with SMI 11. 3. When the morphological changes in the 2nd and 3rd cervical vertebrae were separately observed, it was seldom that the concavity appeared in the lower border of the 2nd cervical vertebra and at the same time not appear in the 3rd cervical vertebra (CVMI 2 : 10.38%, CVMI 3 : 6.56%) 4. In each of the skeletal maturation stage evaluated from the hand-wrist and the cervical vertebra, the average age and its standard deviation in male and female patients appeared to have large differences among individuals. Skeletal maturation seemed to appear earlier for the girls than for the boys, and its termination 24 months faster for girls.

• 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.

• The korean journal of orthodontics
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• v.38 no.1
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• pp.52-59
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• 2008

Objective: This study analyzed the morphologic changes of the fourth cervical vertebra body to determine the skeletal age of orthodontic patients during growth. Methods: Eighty-one female patients aged from 11 to 14 who had cephalograms taken on the same day were examined. The subjects were divided into three groups depending on the depth of the concavity of the lower border of the fourth cervical vertebra (Group A: less than 1.05 mm, Group B: 1.05 - 2.07 mm, Group C: greater than 2.07 mm). Menarcheal timing, SMI stage, length, width and ratio of length and width of the fourth cervical vertebra body were analyzed and the following results were obtained. Results: The average SMI stage of group A, B and C were $5.67{\pm}2.57,\;8.73{\pm}2.41,\;and\;10.00{\pm}1.47$, respectively. Length, width, ratio of length and width, and SMI stage were greater in group B than group A and in group C than group B. Mean menarcheal timing was $11.64{\pm}0.92$ years. Concavity depth, length, width, ratio of length and width showed a significant positive correlation with SMI stage, especially with the concavity depth. Conclusion: The results of this study propose a simple method for determining the timing of orthopedic treatment by measuring the concavity depth of the fourth cervical vertebra on the cephalogram.

• 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.

• 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.39 no.2
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• pp.120-129
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• 2009

Objective: To estimate dental maturity using the Demirjian Index for the mandibular third molar and investigate the relationships between dental maturity and skeletal maturity among growing children. Methods: The samples were derived from panoramic, lateral cephalometric and hand-wrist radiographs of 270 female subjects registered as patients at the orthodontic department, dental hospital, Yonsei University. Dental maturity [Demirjian Index (DI)] and skeletal maturity [skeletal maturation indicators (SMIs)] and cervical vertebrae maturation indicators (CVMIs)] were estimated from these radiographs. Results: There was a significant correlation (r = 0.64) between SMIs and DI, and a similar correlation (r = 0.59) was observed between CVMIs and DI (p < 0.001). If DI was above Stage E, then the SMI was above Stage 10 and the CVMI was above Stage 5. There was a weak correlation (r = 0.26) between age at menarche and DI (p < 0.001). There was no significant difference in DI among Class I, II or III malocclusions. Conclusions: Dental maturity evaluation using the mandibular third molar will be an adjunctive tool in combination with cervical vertebrae and hand-wrist maturity evaluations.

• 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.