Inventi Impact: Orthopaedics

Inventi:hop/25144/18

Another Look at Skeletal Maturation Using Hand Wrist and Cervical Vertebrae Evaluation

Introduction and Aims�The Growth stage of a patient can have considerable\ninfluence on diagnosis, treatment goals, timing and planning and the\neventual outcome of orthodontic/orthopedic treatment. The purpose of this\nstudy was to analyze associations between the cervical vertebrae maturation\nscore (CVMS) and skeletal maturation index (SMI). The second objective was\nto determine the reproducibility of the measurements on lateral cephalograms\nand hand-wrist radiographs. Materials and Methods�Lateral cephalometric\nand left hand-wrist radiographs of 92 untreated subjects (44 females and 48\nmales) aged from 8 to 17 years were obtained from the files of the Columbia\nUniversity, Division of Orthodontics and measured for growth stage using\ncervical vertebrae and hand-wrist methods. Results�A high correlation was\nrevealed between the hand-wrist and cervical vertebrae measurements. The\nSpearman�s rho correlation coefficient was 0.925 and significant at the 0.01\nlevel. The correlation between hand-wrist and age (0.665, p < 0.01) was\nslightly greater than that of the CVMS (0.611, p < 0.01). Intra rater reliability\nwas high. When the three categorically modified methods of the Fishman�s 11\nskeletal maturation stages in hand and wrist analysis were used to compare\nwith CVMS, methods 2 and 3 were both statistically significantly different according\nto the Wilcoxon signed ranks test and the Sign test at a significance\nlevel of less than 0.05. However, for method 1, the tests showed probability\nscores of 0.028 and 0.151, respectively, showing no significant difference at the\n0.01 level in the Wilcoxon Signed Ranks Test, and no significant difference in\nthe 0.01 and 0.05 level in the Signed Test. Conclusions�The Fishman�s hand\nand wrist skeletal maturation index and Bacetti�s cervical vertebrae maturation\nstages are both useful tools in evaluating growth stages. Fishman�s handwrist\nmethod is slightly more accurate.