Baccetti Tiziano, Franchi Lorenzo, McNamara James A
Department of Orthodontics, The University of Florence, Italy.
Angle Orthod. 2002 Aug;72(4):316-23. doi: 10.1043/0003-3219(2002)072<0316:AIVOTC>2.0.CO;2.
The present study aimed to provide a version of the Cervical Vertebral Maturation (CVM) method for the detection of the peak in mandibular growth based on the analysis of the second through fourth cervical vertebrae in a single cephalogram. The morphology of the bodies of the second (odontoid process, C2), third (C3), and fourth (C4) cervical vertebrae were analyzed in six consecutive cephalometric observations (T1 through T6) of 30 orthodontically untreated subjects. Observations for each subject consisted of two consecutive cephalograms comprising the interval of maximum mandibular growth (as assessed by means of the maximum increment in total mandibular length, Co-Gn), together with two earlier consecutive cephalograms and two later consecutive cephalograms. The analysis consisted of both visual and cephalometric appraisals of morphological characteristics of the three cervical vertebrae. The construction of the new version of the CVM method was based on the results of both ANOVA for repeated measures with post-hoc Scheffé's test (P < .05) and discriminant analysis. The new CVM method presents with five maturational stages (Cervical Vertebral Maturation Stage [CVMS] I through CVMS V, instead of Cvs 1 through Cvs 6 in the former CVM method). The peak in mandibular growth occurs between CVMS II and CVMS III, and it has not been reached without the attainment of both CVMS I and CVMS II. CVMS V is recorded at least two years after the peak. The advantages of the new version of the CVM method are that mandibular skeletal maturity can be appraised on a single cephalogram and through the analysis of only the second, third, and fourth cervical vertebrae, which usually are visible even when a protective radiation collar is worn.
本研究旨在基于对单张头颅侧位片中第二至第四颈椎的分析，提供一种用于检测下颌生长高峰的颈椎成熟度（CVM）方法。对30名未经正畸治疗的受试者进行了六次连续的头影测量观察（T1至T6），分析了第二颈椎（齿突，C2）、第三颈椎（C3）和第四颈椎（C4）椎体的形态。对每个受试者的观察包括两张连续的头颅侧位片，其中一张处于下颌生长最大值区间（通过下颌总长度Co-Gn的最大增量评估），另外还有两张较早的连续头颅侧位片和两张较晚的连续头颅侧位片。分析包括对三个颈椎形态特征的视觉评估和头影测量评估。新版CVM方法的构建基于重复测量方差分析及事后Scheffé检验（P <.05）的结果和判别分析。新版CVM方法呈现五个成熟阶段（颈椎成熟阶段[CVMS]I至CVMS V，而非旧版CVM方法中的Cvs 1至Cvs 6）。下颌生长高峰出现在CVMS II和CVMS III之间，且在未达到CVMS I和CVMS II时不会出现。CVMS V记录于生长高峰至少两年后。新版CVM方法的优点是可以在单张头颅侧位片上，仅通过分析第二、第三和第四颈椎来评估下颌骨骼成熟度，即使佩戴防护辐射颈圈时这几个颈椎通常也能看到。
