Citation Information :
Luca M, 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 (2):327-332.
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.
Baccetti T, Franchi L, McNamara JA. The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 2005;11(3):119–129. DOI: 10.1053/j.sodo.2005.04.005
Bianco E, Calvelli C, Citterio CL, et al. Evaluation with micro-CT of the canal seal made with two different bioceramic cements: GuttaFlow bioseal and BioRoot RCS. J Contemp Dent Pract 2020;21(4):359–366. DOI: 10.5005/jp-journals-10024-2816
Bianco E, Nanussi A, Bellotti D, et al. Clinical and functional analyses of the musculoskeletal balance with oral electromyography and stabilometric platform in athletes of different disciplines. World J Dent 2020;11(3):166–171. DOI: 10.5005/jp-journals-10015-1722
Cortese M, Pigato G, Casiraghi G, et al. Evaluation of the oropharyngeal airway space in class II malocclusion treated with mandibular activator: a retrospective study. J Contemp Dent Pract 2020;21(6):666–672. DOI: 10.5005/jp-journals-10024-2856
Maddalone M, Bianco E, Nanussi A, et al. Treatment of temporomandibular disorders of muscular origin with a silicon oral device (Alifix®): electromyographic analysis. J Contemp Dent Pract 2019;20(12)1367–1374. DOI: 10.5005/jp-journals-10024-2704
Maddalone M, Mirabelli L, Breschigliaro S, et al. Radiographic evaluation of the bone remodeling on tilted osseointegrated implants: follow-up at 1 year. J Contemp Dent Pract 2020;21(4):463–470. DOI: 10.5005/jp-journals-10024-2799
Maddalone M, Nanussi A, Varisco M, et al. Electromyographic evaluation of masticatory muscles in a young patient with crossbite treated with rapid palatal expander: a case report. J Contemp Dent Pract 2020;21(11):1279–1283. DOI: 10.5005/jp-journals-10024-2782
Porcaro G, Amosso E, Mirabelli L, et al. Osteoradionecrosis of the posterior maxilla: a new approach combining erbium: yttrium aluminium garnet laser and bichat bulla flap. J Craniofac Surg 2015;26(7):e627–e629. DOI: 10.1097/SCS.0000000000002136
Melsen B. Palatal growth studied on human autopsy material. A histologic microradiographic study. Am J Orthod 1975;68(1):42–54. DOI: 10.1016/0002-9416(75)90158-x
Persson M, Thilander B. Palatal suture closure in man from 15 to 35 years of age. Am J Orthod 1977;72(1):42–52. DOI: 10.1016/0002-9416(77)90123-3
Baccetti T, Franchi L, McNamara JA Jr. An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002;72(4):316–323. DOI: 10.1043/0003-3219(2002)072<0316:AIVOTC>2.0.CO;2
Gu Y, McNamara JA. Mandibular growth changes and cervical vertebral maturation. a cephalometric implant study. Angle Orthod 2007;77(6):947–953. DOI: 10.2319/071006-284.1
Franchi L, Pavoni C, Faltin K Jr, et al. Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion. Angle Orthod 2013;83(2):334–340. DOI: 10.2319/052912-450.1
Baccetti T, Franchi L, Toth LR, et al. Treatment timing for twin-block therapy. Am J Orthod Dentofacial Orthop 2000;118(2):159–170. DOI: 10.1067/mod.2000.105571
Hägg U, Taranger J. Maturation indicators and the pubertal growth spurt. Am J Orthod 1982;82(4):299–309. DOI: 10.1016/0002-9416(82)90464-x
Baccetti T, Franchi L, De Toffol L, et al. The diagnostic performance of chronologic age in the assessment of skeletal maturity. Prog Orthod 2006;7(2):176–188.
Perinetti G, Contardo L, Gabrieli P, et al. Diagnostic performance of dental maturity for identification of skeletal maturation phase. Eur J Orthod 2012;34(4):487–492. DOI: 10.1093/ejo/cjr027
Hunter CJ. The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod 1966;36(1):44–54. DOI: 10.1043/0003-3219(1966)036<0044:TCOFGW>2.0.CO;2
Perinetti G, Caprioglio A, Contardo L. Visual assessment of the cervical vertebral maturation stages: a study of diagnostic accuracy and repeatability. Angle Orthod 2014;84(6):951–956. DOI: 10.2319/120913-906.1
Fishman LS. Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod 1982;52(2):88–112. DOI: 10.1043/0003-3219(1982)052<0088:REOSM>2.0.CO;2
Perinetti G, Perillo L, Franchi L, et al. Maturation of the middle phalanx of the third finger and cervical vertebrae: a comparative and diagnostic agreement study. Orthod Craniofac Res 2014;17(4):270–279. DOI: 10.1111/ocr.12052
Patcas R, Signorelli L, Peltomäki T, et al. Is the use of the cervical vertebrae maturation method justified to determine skeletal age? A comparison of radiation dose of two strategies for skeletal age estimation. Eur J Orthod 2013;35(5):604–609. DOI: 10.1093/ejo/cjs043
Gander DL. Guidelines for the use of radiographs in clinical orthodontics. Dentomaxillofacial Radiol 2002.
De Stefani A, Bruno G, Siviero L, et al. Middle phalanx maturation of the third finger (MPM) method in the evaluation of skeletal age in a growing orthodontic patient. Int Orthod 2018;16(3):499–513. DOI: 10.1016/j.ortho.2018.06.025
Perinetti G, Sbardella V, Contardo L. Diagnostic reliability of the third finger middle phalanx maturation (MPM) method in the identification of the mandibular growth peak. Eur J Orthod 2017;39(2):194–201. DOI: 10.1093/ejo/cjw059
Abdel-Kader HM. The reliability of dental x-ray film in assessment of MP3 stages of the pubertal growth spurt. Am J Orthod Dentofacial Orthop 1998;114(4):427–429. DOI: 10.1016/s0889-5406(98)70188-x
Buschang PH, Tanguay R, Demirjian A, et al. Mathematical models of longitudinal mandibular growth for children with normal and untreated class II, division 1 malocclusion. Eur J Orthod 1988;10(3):227–234. DOI: 10.1093/ejo/10.3.227
Soegiharto BM, Cunningham SJ, Moles DR. Skeletal maturation in Indonesian and white children assessed with hand-wrist and cervical vertebrae methods. Am J Orthod Dentofacial Orthop 2008;134(2):217–226. DOI: 10.1016/j.ajodo.2006.07.037
Houston WJ. Relationships between skeletal maturity estimated from hand-wrist radiographs and the timing of the adolescent growth spurt. Eur J Orthod 1980;2(2):81–93. DOI: 10.1093/ejo/2.2.81
Franchi L, Baccetti T, McNamara JA Jr. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 2000;118(3):335–340. DOI: 10.1067/mod.2000.107009
Soegiharto BM, Moles DR, Cunningham SJ. Discriminatory ability of the skeletal maturation index and the cervical vertebrae maturation index in detecting peak pubertal growth in Indonesian and white subjects with receiver operating characteristics analysis. Am J Orthod Dentofacial Orthop 2008;134(2):227–237. DOI: 10.1016/j.ajodo.2006.09.062
Martina R, Cioffi I, Galeotti A, et al. Efficacy of the Sander bite-jumping appliance in growing patients with mandibular retrusion: a randomized controlled trial. Orthod Craniofac Res 2013;16(2):116–126. DOI: 10.1111/ocr.12013
Gabriel DB, Southard KA, Qian F, et al. Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop 2009;136(4):478.e1–478.e7. DOI: 10.1016/j.ajodo.2007.08.028
Hegde DY, Baliga S, Yeluri R, et al. Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment. Indian J Dent Res 2012;23(4):447–453. DOI: 10.4103/0970-9290.104947
Perinetti G, Bianchet A, Franchi L, et al. Cervical vertebral maturation: an objective and transparent code staging system applied to a 6-year longitudinal investigation. Am J Orthod Dentofacial Orthop 2017;151(5):898–906. DOI: 10.1016/j.ajodo.2016.09.026
Gracco A, Bruno G, De Stefani A, et al. Maturation of the middle phalanx of the third finger: a comparative study between right and left hand. J Clin Pediatr Dent 2018;42(2):161–165. DOI: 10.17796/1053-4628-42.2.14
