Cervical vertebral maturation method

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Cervical vertebral maturation method is an assessment of skeletal age based on the cervical vertebrae, as seen in a cephalometric radiograph. also called as CVM. It was developed by Lamparski in 1972. Cephalometric radiographs are usually obtained for orthodontic patients, which offer the benefit of avoiding additional radiation exposure when gauging the adolescent growth spurt. Nevertheless, several studies have contested the reliability and accuracy of deriving skeletal age from cervical vertebrae, [1] with one study contending that chronologic age is just as reliable as CVM method. [2] Research into CVM has yielded notable findings in regards to intraobserver and interobserver reliability. Comparable results to that of hand–wrist radiographs have been recorded, which was further affirmed by the outcome of one specific prospective review of the literature. [3]

History

Cervical vertebral maturation method CVM method.png
Cervical vertebral maturation method

Estimating the bone age of a living child is typically performed by comparing images of their bones to images of models of the average skeleton for a given age and sex acquired from healthy children and compiled in an atlas. [4] Features of bone development assessed in determining bone age include the presence of bones (have certain bones ossified yet), the size and shape of bones, the amount of mineralization (also called ossification), and the degree of fusion between the epiphyses and metaphyses. [5] The first atlas published in 1898 by John Poland consisted of x-ray images of the left hand and wrist. [6] Since then, updated atlases of the left hand and wrist have appeared,[ citation needed ] along with atlases of the foot and ankle, [7] knee, [8] and elbow. [9] An alternative approach to the atlas method just described is the so-called "single-bone method" where maturity scales are assigned to individual bones. [4] Here, a selection of bones are given a score based on their perceived development, a sum is totaled based on the individual bone scores, and the sum is correlated to a final bone age. [4] [10]

Lamparski (1972) [11] used the cervical vertebrae and found them to be as reliable and valid as the hand-wrist area for assessing skeletal age. He developed a series of standards for the assessment of skeletal age for both males and females. This method has the advantage of eliminating the need for additional radiographic exposure in cases where the vertebrae have already been recorded on a lateral cephalometric radiographic. [12]

Hassel & Farman (1995) [13] developed an index based on the second, third, and fourth cervical vertebrae (C2, C3, C4) and proved that atlas maturation was highly correlated with skeletal maturation of the hand-wrist. Several smartphone applications have been developed to facilitate the use of vertebral methods such as Easy Age.

Related Research Articles

<span class="mw-page-title-main">Bone age</span> Degree of a persons skeletal development

Bone age is the degree of a person's skeletal development. In children, bone age serves as a measure of physiological maturity and aids in the diagnosis of growth abnormalities, endocrine disorders, and other medical conditions. As a person grows from fetal life through childhood, puberty, and finishes growth as a young adult, the bones of the skeleton change in size and shape. These changes can be seen by x-ray and other imaging techniques. A comparison between the appearance of a patient's bones to a standard set of bone images known to be representative of the average bone shape and size for a given age can be used to assign a "bone age" to the patient.

<span class="mw-page-title-main">Dental radiography</span> X-ray imaging in dentistry

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<span class="mw-page-title-main">Cephalometry</span> Study and measurement of the head

Cephalometry is the study and measurement of the head, usually the human head, especially by medical imaging such as radiography. Craniometry, the measurement of the cranium (skull), is a large subset of cephalometry. Cephalometry also has a history in phrenology, which is the study of personality and character as well as physiognomy, which is the study of facial features. Cephalometry as applied in a comparative anatomy context informs biological anthropology. In clinical contexts such as dentistry and oral and maxillofacial surgery, cephalometric analysis helps in treatment and research; cephalometric landmarks guide surgeons in planning and operating.

Cephalometric analysis is the clinical application of cephalometry. It is analysis of the dental and skeletal relationships of a human skull. It is frequently used by dentists, orthodontists, and oral and maxillofacial surgeons as a treatment planning tool. Two of the more popular methods of analysis used in orthodontology are the Steiner analysis and the Downs analysis. There are other methods as well which are listed below.

Cecil C. Steiner was a dentist and one of Edward H. Angle's first students in 1921. He developed a form of cephalometric analysis, presented in 1953, referred to as the Steiner method of analysis.

<span class="mw-page-title-main">Functional matrix hypothesis</span>

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<span class="mw-page-title-main">Ravindra Nanda</span>

Dr. Ravindra Nanda is a professor and Head of the Department of Craniofacial Sciences and Chair of the Division of Orthodontics at the University of Connecticut School of Dental Medicine. He is part of the founding faculty of School of Dental Medicine and has been at the University of Connecticut since 1972 where he also holds an Alumni Chair in the Orthodontics Division. He is an innovator of various appliances in orthodontics. His research and clinical interests include adolescent and adult orthodontics, the biology of tooth mobility, craniofacial orthopedics, biomechanics and developing efficient mechanics to deliver orthodontic care.

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Calvin Suveril Case was an American orthodontist who is known to be one of the earliest prominent figures in orthodontics. Case did extensive work with cleft lip and palate and is known for developing the Velum Obturator. Case is also known for his part in the Extraction Debate of 1911 that happened between Edward Angle and Case.

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References

  1. Gabriel, Daniel B.; Southard, Karin A.; Qian, Fang; Marshall, Steven D.; Franciscus, Robert G.; Southard, Thomas E. (October 2009). "Cervical vertebrae maturation method: Poor reproducibility". American Journal of Orthodontics and Dentofacial Orthopedics. 136 (4): 478.e1–478.e7. doi:10.1016/j.ajodo.2007.08.028. ISSN   0889-5406.
  2. Gray, Sophie; Bennani, Hamza; Kieser, Jules A.; Farella, Mauro (January 2016). "Morphometric analysis of cervical vertebrae in relation to mandibular growth". American Journal of Orthodontics and Dentofacial Orthopedics. 149 (1): 92–98. doi:10.1016/j.ajodo.2015.06.028. ISSN   0889-5406.
  3. Rainey, Billie-Jean; Burnside, Girvan; Harrison, Jayne E. (July 2016). "Reliability of cervical vertebral maturation staging". American Journal of Orthodontics and Dentofacial Orthopedics. 150 (1): 98–104. doi:10.1016/j.ajodo.2015.12.013. ISSN   0889-5406.
  4. 1 2 3 Hackman, S. Lucina M. R. (2012). Age estimation in the living: a test of 6 radiographic methods.
  5. Oestreich, A. E. (2008). Encyclopedia of diagnostic imaging. A. L. Baert. Berlin: Springer. pp. 148–150. ISBN   978-3-540-35280-8. OCLC   233973147.
  6. Poland, John (1898). Skiagraphic atlas showing the development of the bones of the wrist and hand: for the use of students and others. Smith, Elder, & Company.
  7. Hoerr, Normand L.; Pyle, Sarah Idell; Francis, Carl C. (1962). Radiographic Atlas of Skeletal Development of the Foot and Ankle. Springfield, IL: Charles C. Thomas.
  8. Pyle, Sarah Idell; Hoerr, Normand L. (1969). A Radiographic Atlas of Skeletal Development of the Knee. Springfield, IL: Charles C. Thomas.
  9. Brodeur, A.E.; Silberstein, M.J.; Gravis, E.R. (1981). Radiology of the Pediatric Elbow. Boston: G.K. Hall Medical Publishers.
  10. Assessment of skeletal maturity and prediction of adult height (TW3 method). J. M. Tanner (3rd ed.). London: W.B. Saunders. 2001. ISBN   978-0-7020-2511-2. OCLC   46393147.{{cite book}}: CS1 maint: others (link)
  11. Lamparski, DG (1972). "Skeletal Age Assessment Utilizing Cervical Vertebrae". Master Science Thesis.
  12. Caldas, Maria de Paula; Ambrosano, Gláucia Maria Bovi; Haiter, Francisco (April 2007). "Use of cervical vertebral dimensions for assessment of children growth". Journal of Applied Oral Science. 15 (2): 144–147. doi:10.1590/S1678-77572007000200014. ISSN   1678-7757. PMC   4327247 . PMID   19089119.
  13. Hassel, B.; Farman, A. G. (January 1995). "Skeletal maturation evaluation using cervical vertebrae". American Journal of Orthodontics and Dentofacial Orthopedics. 107 (1): 58–66. doi:10.1016/S0889-5406(95)70157-5. ISSN   0889-5406. PMID   7817962.