Tuesday, 17 May 2011

Re-evaluation of cervical vertebral maturation and its relation to mandibular growth, AJO-DO

The cervical vertebral maturation stages were introduced by Dr. Baccetti as 5 stages initially, and 6 stages in 2005.

This relates the mandibular growth velocity with  6 distinguished stages of cervical vertebral maturation.

These are the stages from the article of Baccetti Sept 2005, Sem Orth:

 CS1:Mandibular peak will start in 2 years
CS2:Mandibular peak will start in 1 year
CS3:Mandibular peak will happen during that year
CS4:Mandibular peak has started 1-2 years ago
CS5:Mandibular peak has finished 1 year ago
CS6:Mandibular peak has finished 2 years ago

Ball et al at the current issue of the AJO-DO made an investigation of :Relationship between cervical vertebral maturation and mandibular growth

It seems that the above model is not so accepted any more and the vertebral maturation could still serve as a tool but not alone at least for the mandibular growth velocity in boys.

The study took cephalograms every 4 years of 90 boys 9 to 18 years of age. Measuring from articulare to gnathium the sample was divided to 3 groups:

  1. Early
  2. Average
  3. Delayed growers
Those groups were then compared with the CVM stages. The results are interesting:

  • The peak of mandibular velocity occurs on average at 14.4 plus minus 1.4 years
  • It lasts 2.2 years

Concerning CVM relation:
  • Progression from 1 cervical vertebral stage to another does not occur annually. Instead, the time spent in each stage varies, on average, from 1.5 to 4.2 years depending on the stage and the group (delayed, average or advanced growers)
  • The longest duration is CS 4, regardless of maturation group.
  • Most frequently the mandibular peak happens at CS 4
  • Advanced maturers can be treated at CS3 as well as CS4
  • Average at CS4
  • And delayed at late CS4 even CS5

Summing up:

As a final conclusion, the CVM alone cannot derive safe diagnostics of the patients maturity and predict wether he is behind, at or after the peak of the mandibular growth.

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