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Bulut M, Hezenci Y. Is hand-wrist radiography still necessary in orthodontic treatment planning? BMC Oral Health 2024; 24:616. [PMID: 38802759 PMCID: PMC11131214 DOI: 10.1186/s12903-024-04396-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Accepted: 05/22/2024] [Indexed: 05/29/2024] Open
Abstract
OBJECTIVES The aim of our study is to compare the relationship between hand-wrist and cervical vertebra maturation stages with chronological age and to investigate the effect of malocclusion type on the relationship between these methods. MATERIALS AND METHODS Hand-wrist and cephalometric radiographs of 1000 patients (526 females, 474 males) with a mean age of 13.41 ± 1.83 were analyzed. The methods of Bacetti et al. were used for the cervical vertebra maturation stage, and Björk, Grave and Brown's methods were used for the hand-wrist maturation stage. One-way ANOVA test was applied to compare skeletal classes between them. Tukey post hoc test was used to determine the differences. The relationship between the malocclusion type, cervical vertebra and hand-wrist maturation stages was evaluated with the Spearman correlation test. RESULTS Spearman's correlation coefficient was 0.831, 0.831 and 0.760 in Class I, II and III females, respectively. In males, it was calculated as 0.844, 0.889 and 0.906, respectively. When sex and malocclusion were not differentiated, the correlation was found to be 0.887. All were statistically significant (P < 0.001). The highest correlation was observed in class III males, while the lowest was found in class III females. CONCLUSION Cervical vertebrae can be used safely to assess pubertal spurt without hand-wrist radiography. Diagnosing growth and development stages from cephalometric images is important in reducing additional workload and preventing radiation risk.
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Affiliation(s)
- Musa Bulut
- Faculty of Dentistry, Department of Orthodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey.
- Diş Hekimliği Fakültesi, Ortodonti A.D. Gölköy Kampüsü, Bolu Abant İzzet Baysal Üniversitesi, Bolu, Turkey.
| | - Yasin Hezenci
- Faculty of Dentistry, Department of Orthodontics, Bolu Abant Izzet Baysal University, Bolu, Turkey
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Gv V, Tripathi T, Rai P, Mahajan B, Kanase A. Association, diagnostic accuracy and optimal threshold of salivary IGF-1 and vitamin DBP levels for estimation of pubertal growth spurt: A cross sectional study. Int Orthod 2023; 21:100786. [PMID: 37354889 DOI: 10.1016/j.ortho.2023.100786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/16/2023] [Accepted: 05/18/2023] [Indexed: 06/26/2023]
Abstract
AIM To determine the association of salivary IGF-1 and vitamin D Binding Protein with cervical vertebral maturation index (CVMI) across the pubertal stages and to determine the diagnostic accuracy and optimal threshold of these biomarkers for estimation of pubertal growth. DESIGN Cross-sectional observational study. SETTING Material and methods. All patients in the age group of 8-23 years from the Outpatient Department of Orthodontics and Dentofacial orthopaedics, between the period of July 2020 to December 2020 meeting the eligibility criteria were included. Lateral cephalograms obtained from the patients were divided into pre pubertal, pubertal & post pubertal groups based on CVMI by Baccetti et al. Unstimulated whole saliva was collected by a swab-based method & analyzed with ELISA. RESULTS Ninety-four participants were divided in three stages: prebubertal (30), pubertal (33), post pubertal (31). A significant difference was observed in the salivary IGF-1 & DBP across the three stages. Post-hoc test revealed significantly higher mean salivary IGF-1 & DBP in pubertal group than in pre & post-pubertal group. Receiver operator characteristic curve revealed excellent diagnostic accuracy for salivary IGF-1with areas under the curve (AUC) of 0.962, satisfactory for vitamin DBP with AUC of 0.831 and poor diagnostic accuracy for age with AUC of 0.536. Youden index revealed the optimal threshold to be 3.96ng/ml and 124.13pg/ml for salivary IGF-1 and vitamin DBP respectively. CONCLUSION The levels of Salivary IGF-1 and Vitamin DBP increased during C3 and C4 stages. Compared to vitamin DBP diagnostic accuracy of salivary IGF-1 was excellent and an optimal threshold of 3.96ng/ml can be utilized to distinguish pubertal & non-pubertal participants.
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Affiliation(s)
- Veena Gv
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
| | - Tulika Tripathi
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India.
| | - Priyank Rai
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
| | - Bhawna Mahajan
- Govind Ballabh Pant Institute of Postgraduate Medical Education & Research, Department of Biochemistry, New Delhi 110002, India
| | - Anup Kanase
- Maulana Azad Institute of Dental Sciences, Department of Orthodontics and Dentofacial Orthopaedics, Bahadur Shah Zafar Marg, New Delhi 110002, India
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Mirabelli L, Bianco E, Pigato G, Ferrari M, Maddalone M. Comparison between Two Methods of Skeletal Growth Evaluation: Cervical Vertebrae Maturations and Middle Phalanx Maturation. Int J Clin Pediatr Dent 2023; 16:327-332. [PMID: 37519967 PMCID: PMC10373761 DOI: 10.5005/jp-journals-10005-2571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Aim Growth measurement has always been essential to identify the best time to employ orthopedic or orthodontic appliances. Optimal timing for orthodontic treatment is strictly linked to the identification of periods of craniofacial growth when treatment is more effective.The aim of this study was to compare two different methods, middle phalanx maturation (MPM) and cervical vertebrae maturation (CVM), used to evaluate the stage of facial growth. Materials and methods The research data was collected from July 2018 to April 2019 at the Dental Clinic of the San Gerardo Hospital in Monza. The study included a sample of 98 patients-46 males and 52 females. For each patient, a latero-lateral teleradiography of the skull and an X-ray on the middle finger of the right hand were obtained.The statistical analysis of the comparison of the stages of skeletal maturation obtained by the MPM and CVM methods was performed using the correlation coefficient for ranks of Spearman. Results A descriptive statistical analysis of the entire sample of 98 patients was performed (mean age of 12.2 years and median of 12.2 years). The average age of females in every single stage of MPM was significantly lower than the average age of males. Of the total sample, 87 patients (88.8%) showed complete agreement between the two methods. Conclusion The results obtained from the statistical analysis of this study allowed us to confirm a satisfactory agreement between the two methods.The intermediate phalanx method is a valid and alternative indicator to CVM for the identification of the puberty growth peak. We can, therefore, consider the MPM method a valid indicator of skeletal maturity. How to cite this article Mirabelli L, Bianco E, Pigato G, et al. Comparison between Two Methods of Skeletal Growth Evaluation: Cervical Vertebrae Maturations and Middle Phalanx Maturation. Int J Clin Pediatr Dent 2023;16(2):327-332.
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Affiliation(s)
- Luca Mirabelli
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Lombardy, Italy
| | - Edoardo Bianco
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Lombardy, Italy
| | - Giada Pigato
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Lombardy, Italy
| | - Maurizio Ferrari
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Lombardy, Italy
| | - Marcello Maddalone
- Department of Medicine and Surgery, University of Milano Bicocca, Milan, Lombardy, Italy
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Can IGF-1 serve as a reliable skeletal maturity indicator? A meta-analysis. J Orofac Orthop 2021; 83:124-140. [PMID: 34596696 DOI: 10.1007/s00056-021-00357-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/20/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Many clinical studies have evaluated the role of biochemical mediators like insulin-like growth factor 1 (IGF-1) in assessment of skeletal maturity. But still the reliability of IGF‑1 as an indicator of skeletal maturity remains controversial. OBJECTIVE To assess the correlation between IGF‑1 and different radiographic skeletal maturity indicators. SEARCH METHODS Seven electronic databases (PubMed, Scopus, EMBASE, Medline, Cochrane CENTRAL, Web of Science and SciELO) were searched until January 2020 without any restriction based on language or date of publication. SELECTION CRITERIA The study design included cross-sectional and longitudinal studies comparing IGF‑1 and other skeletal maturity indicators (SMIs). DATA COLLECTION AND ANALYSIS Data extraction was done by two reviewers independently; 15 studies were eligible to be included in the quantitative synthesis. RESULTS There was significant positive correlation between IGF‑1 and different SMIs until puberty which was 0.95 (confidence interval [CI] = 0.89, 1.02) for males and 0.87 (CI = 0.77, 0.97) for females. A negative correlation between IGF‑1 and different SMIs was found after puberty which was -0.86 (CI = -0.97, -0.75) for males and -0.89 (CI = -0.98, -0.81) for females. The type of SMI compared and type of IGF‑1 sample used accounted for the high heterogeneity found across the studies. Chronological age and number of months passed after puberty showed moderate negative correlation with mean IGF‑1 levels which were -0.57 (CI = -0.67, -0.47) and -0.54 (CI = -0.66, -0.42). Annual increments in mandibular length showed significant positive correlation of 0.69 (CI = 0.48, 0.90). CONCLUSIONS IGF‑1 would serve as a promising alternative to conventional radiographic skeletal maturity indicators and in predicting the amount of residual mandibular growth.
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Thierens LAM, Manalili L, De Roo N, Verdonck A, De Llano-Pérula MC, De Pauw GAM. Assessment of craniofacial maturation in preadolescents with cleft lip and/or palate using the cervical vertebral maturation method. Clin Oral Investig 2021; 25:4851-4859. [PMID: 33483870 DOI: 10.1007/s00784-021-03790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Accepted: 01/08/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Aberrant growth of the maxillomandibular complex in patients with cleft lip and/or palate (CL/P) can be managed with dentofacial orthopaedics. However, no consensus has been reached regarding timing and evolution of the maturational stages. Therefore, the aim of this study is to determine if patients with CL/P have an increased risk for delayed craniofacial maturation. MATERIALS AND METHODS A sample of 246 cleft patients and 210 non-affected individuals was retrospectively compiled. Cephalometric radiographs taken between the ages of 10 and 14 years (girls) and 12 and 16 years (boys) were collected and assessed with the cervical vertebral maturation (CVM) method. RESULTS In boys, no significant association between the presence of CL/P and a CVM score of CS3 or higher was observed in any age subsample. This was similar for a CVM score of CS5 or higher. Girls in the CL/P group had a significant lower probability of having a CVM score of at least CS3 in the subsample with age 11 to 12 (p = 0.001) and a borderline non-significant lower probability of having a CVM score of at least CS5 in the subsample with age 12 to 13 (p = 0.055). CONCLUSIONS The current study demonstrated a discrete delay in skeletal maturation before the pubertal growth spurt of (pre)adolescents with CL/P, especially girls. This delay was less apparent at the end of the pubertal growth spurt. CLINICAL RELEVANCE This research suggests that the craniofacial maturational stages relevant for dentofacial orthopaedic treatment in cleft patients, especially girls, occur at higher chronological age. Further research must quantify this delay, investigate its clinical significance, and determine its effect on the timing of dentofacial orthopaedic treatment.
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Affiliation(s)
- Laurent A M Thierens
- Oral Health Sciences, Department of Orthodontics, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,Centre for Congenital Facial Anomalies, Ghent University Hospital, Ghent, Belgium. .,Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.
| | - Laura Manalili
- Oral Health Sciences, Department of Orthodontics, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Noëmi De Roo
- Oral Health Sciences, Department of Orthodontics, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - An Verdonck
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Maria Cadenas De Llano-Pérula
- Department of Oral Health Sciences-Orthodontics, KU Leuven and Dentistry, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium.,Leuven Cleft Lip and Palate Team, University Hospitals Leuven, Kapucijnenvoer 7, 3000, Leuven, Belgium
| | - Guy A M De Pauw
- Oral Health Sciences, Department of Orthodontics, Ghent University, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Centre for Congenital Facial Anomalies, Ghent University Hospital, Ghent, Belgium
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Oyonarte R, Sánchez-Ugarte F, Montt J, Cisternas A, Morales-Huber R, Ramirez-Lobos V, Janson G. Diagnostic assessment of tooth maturation of the mandibular second molars as a skeletal maturation indicator: A retrospective longitudinal study. Am J Orthod Dentofacial Orthop 2020; 158:383-390. [PMID: 32732004 DOI: 10.1016/j.ajodo.2019.09.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Our aim was to analyze the correlation between growth status in height and chronological age, carpal maturation, cervical maturation, and dental maturation, and assess the diagnostic performance of Demirjian's dental maturation as an indicator of the pubertal growth spurt, through a retrospective longitudinal study. METHODS Records of 60 Canadian patients obtained from the Burlington Growth Centre, which included height and weight charts and a set of x-rays at 6 points in time, were analyzed. The images at each point in time included 1 hand and wrist radiograph, a lateral cephalometric x-ray, and one 45° oblique cephalometric radiograph of each side, which were analyzed using the methods of Fishman, Baccetti, and Demirjian on the mandibular left and right second molars, respectively. The onset of the pubertal growth peak in height (distance to growth peak [DGP]) was identified, and the correlation between methods with DGP was assessed. RESULTS High levels of correlation were obtained between the methods of Fishman, Baccetti, and Demirjian with DGP. The cutoff point between prepubertal and postpubertal stages was F stage for women and G stage for men, with statistically significant levels of sensitivity and specificity for the test. CONCLUSIONS The use of the method of Demirjian applied to mandibular second molars is plausible as a predictor of the occurrence of the DGP for the studied population.
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Affiliation(s)
- Rodrigo Oyonarte
- Faculty of Odontology, Universidad de los Andes, Las Condes, Santiago, Chile.
| | | | - Juan Montt
- Faculty of Odontology, Universidad de los Andes, Las Condes, Santiago, Chile
| | - Alejandra Cisternas
- Faculty of Odontology, Universidad de los Andes, Las Condes, Santiago, Chile
| | | | | | - Guilherme Janson
- Department of Orthodontics, Bauru Dental School, University of São Paulo, Bauru, São Paulo, Brazil
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Perinetti G, Braga C, Contardo L, Primozic J. Cervical vertebral maturation: Are postpubertal stages attained in all subjects? Am J Orthod Dentofacial Orthop 2020; 157:305-312. [PMID: 32115108 DOI: 10.1016/j.ajodo.2019.03.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 03/01/2019] [Accepted: 03/01/2019] [Indexed: 10/24/2022]
Abstract
INTRODUCTION The cervical vertebral maturation (CVM) method comprises 6 stages reported to be prepubertal (1 and 2), pubertal (3 and 4) and postpubertal (5 and 6), and its use has been recommended for planning treatment timing in orthodontics. Reliable use of the method implies that pubertal stages have to mature into postpubertal as soon as the growth peak is terminated. The present study was aimed at determining whether postpubertal CVM stages 5 or 6 are attained in all subjects. METHODS A total of 450 adult subjects (270 females and 180 males; mean age, 30.4 ± 27.3 years; range, 20-45 years) seeking orthodontic treatment and having a lateral head film were included in the study. Customized cephalometric analysis was used, and each recording was converted into an individual CVM code according to the concavities of the C2 to C4 and shapes of C3 and C4. The retrieved CVM codes, either falling within the reported norms (regular cases) or not (exception cases), were also converted into the CVM stages and a newly introduced CVM score (0-9) capable of defining intermediate stage. RESULTS The most frequent CVM stage was 5, while the CVM stage 6 was attained in only one third of the sample. Up to about 11% of adult subjects showed the pubertal CVM stage 4. Irrespective of the CVM stage or CVM score, no significant differences were seen between the sexes or across ages. The C4 showed a rectangular vertical shape in only 16.4% of the cases. CONCLUSIONS The percentage of adult population maintaining a pubertal CVM stage 4 is not high, but still relevant from a clinical standpoint. In light of this finding, planning treatment timing-based only on CVM appears not fully reliable.
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Affiliation(s)
| | - Camilla Braga
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Luca Contardo
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Trieste, Italy
| | - Jasmina Primozic
- Department of Dental and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Morris KM, Fields HW, Beck FM, Kim DG. Diagnostic testing of cervical vertebral maturation staging: An independent assessment. Am J Orthod Dentofacial Orthop 2019; 156:626-632. [PMID: 31677671 DOI: 10.1016/j.ajodo.2018.11.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 11/01/2018] [Accepted: 11/01/2018] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The reliability of the cervical vertebral maturation (CVM) method has been questioned. The objective of this research was to evaluate the diagnostic reliability of the CVM method to diagnose the mandibular growth spurt using longitudinal records from an alternative database (Iowa Facial Growth Study [IFGS]) using established diagnostic testing methods. METHODS Cephalometric films from 43 subjects (males = 20, females = 23) with Class I or Class II skeletal pattern from the IFGS were scanned, digitized, and adjusted for magnification. At least 5 consecutive, annual films were digitized. For each subject, mandibular length (Co-Gn) was measured for each film, and the growth increment between films was calculated. The largest growth increment was the growth spurt. For each subject, the film displaying CVM stage 3 was identified by a blinded examiner viewing the films in random order. Interrater and intrarater repeatability for Co-Gn (intraclass correlation) and CVM staging (weighted kappa) were calculated. Diagnostic tests, including sensitivity, specificity, accuracy, positive predictive value (PPV), and negative predictive value (NPV) were carried out. The present data were compared with data previously derived from samples of the University of Michigan, Oregon, and Burlington Growth studies (UMGS, OGS, and BGS, respectively). A multilevel logistic regression analysis was also run with the mandibular growth peak as the response variable. RESULTS Interrater repeatability for mandibular measurements (intraclass correlation coefficient [ICC] = 0.91) and CVM staging (k = 0.88) were excellent. Intrarater repeatability for mandibular measurements (ICC = 0.98) and CVM staging (kw = 0.55) were excellent to moderate. The UMGS data demonstrated higher sensitivity with comparable specificity. Accuracy was largely similar. Their PPV and NPV had larger ranges. The OGS and BGS data, compared with the IFGS data, showed that our sensitivity and PPVs were higher, that their specificity was higher, and that the NPV and accuracy were very similar. The regression analysis was applied to age groups 10-11 years through 13-14 years. Only chronological age was significant (P = 0.04). CONCLUSIONS Agreement between CVM stage 3 and the maximum mandibular growth spurt is inconsistent. The diagnostic capability of CVM for the mandibular growth spurt is questionable.
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Affiliation(s)
- Kara M Morris
- Formerly, Division of Orthodontics, The Ohio State University, Columbus, Ohio; currently, Private practice, Columbus, Ohio
| | - Henry W Fields
- Division of Orthodontics, The Ohio State University College of Dentistry, Columbus, Ohio.
| | - F Michael Beck
- Division of Biosciences, The Ohio State University College of Dentistry, Columbus, Ohio
| | - Do-Gyoon Kim
- Division of Orthodontics, The Ohio State University, Columbus, Ohio
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The Third Finger Middle Phalanx Maturation (MPM) Method to Assess Timing of Functional Treatment for Skeletal Class II Malocclusion: Report of Three Cases. Case Rep Dent 2019; 2019:8382612. [PMID: 31428482 PMCID: PMC6681608 DOI: 10.1155/2019/8382612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 06/27/2019] [Indexed: 11/17/2022] Open
Abstract
A deficient mandibular growth on the sagittal plane is the most frequent diagnostic finding in dentoskeletal Class II malocclusion. Evidence indicated that functional treatment for such malocclusion is efficient only if performed during the pubertal growth spurt, as identified through radiographical growth indicators. With the aim of reducing the radiation to the patients and to follow longitudinally individual growth phases, the use of the sole third finger middle phalanx maturation (MPM), as a 5-stage method, has been proposed. Herein, three clinical cases of skeletal Class II malocclusion in growing patients treated by removable functional appliances (with or without full-fixed appliance treatment) are reported. Timing of intervention was strictly planned according to the MPM method, and skeletal effects have been recorded up to 21 months of follow-up. In all the cases, noteworthy skeletal effects have been achieved in terms of mandibular elongation, with relevant occlusal and aesthetic outcomes. It has also been showed that results are stable or slightly improved after functional treatment. These results would be achieved irrespective of the appliance used and support the use of the MPM method in everyday clinical practice.
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Perinetti G, Primozic J, Sharma B, Cioffi I, Contardo L. Cervical vertebral maturation method and mandibular growth peak: a longitudinal study of diagnostic reliability. Eur J Orthod 2019; 40:666-672. [PMID: 29608692 DOI: 10.1093/ejo/cjy018] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background/objectives The capability of the cervical vertebral maturation (CVM) method in the identification of the mandibular growth peak on an individual basis remains undetermined. The diagnostic reliability of the six-stage CVM method in the identification of the mandibular growth peak was thus investigated. Subjects/Methods From the files of the Oregon and Burlington Growth Studies (data obtained between early 1950s and middle 1970s), 50 subjects (26 females, 24 males) with at least seven annual lateral cephalograms taken from 9 to 16 years were identified. Cervical vertebral maturation was assessed according to the CVM code staging system, and mandibular growth was defined as annual increments in Co-Gn distance. A diagnostic reliability analysis was carried out to establish the capability of the circumpubertal CVM stages 2, 3, and 4 in the identification of the imminent mandibular growth peak. Results Variable durations of each of the CVM stages 2, 3, and 4 were seen. The overall diagnostic accuracy values for the CVM stages 2, 3, and 4 were 0.70, 0.76, and 0.77, respectively. These low values appeared to be due to false positive cases. Limitations Secular trends in conjunction with the use of a discrete staging system. In most of the Burlington Growth Study sample, the lateral head film at age 15 was missing. Conclusions/Implications None of the CVM stages 2, 3, and 4 reached a satisfactorily diagnostic reliability in the identification of imminent mandibular growth peak.
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Affiliation(s)
| | - Jasmina Primozic
- Department of Dental and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Slovenia
| | | | | | - Luca Contardo
- Department of Medical, Surgical and Health Sciences, School of Dentistry, University of Trieste, Italy
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Perinetti G, Contardo L, Primozic J. Diagnostic accuracy of the cervical vertebral maturation method. Eur J Orthod 2018; 40:453-454. [PMID: 29924313 DOI: 10.1093/ejo/cjy043] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | - Luca Contardo
- Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Jasmina Primozic
- Department of Orthodontics and Jaw Orthopaedics, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
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Orthodontics in Growing Patients: Clinical/Biological Evidence and Technological Advancement 2018. BIOMED RESEARCH INTERNATIONAL 2018; 2018:7281846. [PMID: 30622960 PMCID: PMC6304191 DOI: 10.1155/2018/7281846] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 09/24/2018] [Indexed: 11/17/2022]
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de Frutos-Valle L, Martin C, Alarcon JA, Palma-Fernandez JC, Iglesias-Linares A. Subclustering in Skeletal Class III Phenotypes of Different Ethnic Origins: A Systematic Review. J Evid Based Dent Pract 2018; 19:34-52. [PMID: 30926101 DOI: 10.1016/j.jebdp.2018.09.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 12/21/2022]
Abstract
OBJECTIVE We aimed to systematically review articles investigating the efficiency of the clustering of skeletal class III malocclusion phenotypic subtypes of different ethnic origins as a diagnostic tool. METHODS The review protocol was structured in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and registered in Prospero (CRD42016053865). A survey of articles published up to March 2018 investigating the identification of different subgroups of skeletal class III malocclusion via cluster analysis was performed using 11 electronic databases. Any type of study design that addressed the classification of subclusters of class III malocclusion was considered. The Newcastle-Ottawa scale for cohort and cross-sectional (modified) studies was used for quality assessment. RESULTS The final selection included 7 studies that met all the criteria for eligibility (% overall agreement 0.889, free marginal kappa 0.778). All studies identified at least 3 different types of class III clusters (ranging from 3 to 14 clusters; the total variation of the prevalence of each cluster ranged from 0.2% to 36.0%). The main shared variables used to describe the more prevalent clusters in the studies included were vertical measurements (Ar-Go-Me: 117.51°-135.8°); sagittal measurements: maxilla (SNA: 75.3°-82.95°), mandible (SNB: 77.03°-85.0°). With regard to ethnicity, a mean number of 8.5 and 3.5 clusters of class III were retrieved for Asian and Caucasian population, respectively. CONCLUSIONS The total number of clusters identified varied from 3 to 14 to explain all the variability in the phenotype class III malocclusions. Although each extreme may be too simple or complex to facilitate an exhaustive but useful classification for clinical use, a classification system including 4 to 7 clusters may prove to be efficient for clinical use in conjunction with complete and meticulous subgrouping. CLINICAL SIGNIFICANCE The identification and description of a subclustering classification system may constitute an additional step toward more precise orthodontic/orthopedic diagnosis and treatment of skeletal class III malocclusion.
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Affiliation(s)
| | - Conchita Martin
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain; BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain.
| | - Jose Antonio Alarcon
- BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain; Faculty of Odontology, University of Granada, Campus Universitario de Cartuja, Granada, Spain
| | | | - Alejandro Iglesias-Linares
- Section of Orthodontics, Faculty of Odontology, Complutense University, Madrid, Spain; BIOCRAN (Craniofacial Biology) Research Group, Complutense University, Madrid, Spain
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Franchi L, Nieri M, McNamara JA. Diagnostic reliability of the objective cervical vertebral maturation method for the mandibular growth peak. Eur J Orthod 2018; 40:452-453. [PMID: 29924307 DOI: 10.1093/ejo/cjy032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- Lorenzo Franchi
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy
| | - Michele Nieri
- Department of Surgery and Translational Medicine, Orthodontics, University of Florence, Florence, Italy
| | - James A McNamara
- Department of Orthodontics and Pediatric Dentistry, School of Dentistry.,Department of Cell and Developmental Biology, School of Medicine.,Center for Human Growth and Development, University of Michigan, Ann Arbor, MI, USA
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15
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Determination of timing of functional and interceptive orthodontic treatment: A critical approach to growth indicators. J World Fed Orthod 2017. [DOI: 10.1016/j.ejwf.2017.08.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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