Engel Thomas P, Renkema Anne-Marie, Katsaros Christos, Pazera Pawel, Pandis Nikolaos, Fudalej Piotr S
*Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.
Department of Orthodontics and Craniofacial Biology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Eur J Orthod. 2016 Feb;38(1):1-7. doi: 10.1093/ejo/cju085. Epub 2015 Feb 8.
The cervical vertebrae maturation (CVM) method is used to determine the timing of treatment of Class II malocclusion. Because its performance has not been tested in patients with Class II, the objective of this study was to evaluate the effectiveness of the CVM method in predicting craniofacial growth in Class II malocclusion.
Twenty-nine untreated girls with Class II malocclusion were identified among participants of the Nijmegen Growth Study. Each girl had a series of cephalograms taken semi-annually from 9 to 14 years of age. The CVM status was established by five observers on a cephalogram taken at 9 years; mandibular and maxillary length and anterior face height were assessed on all available cephalograms. Method error was evaluated with kappa statistics and Bland-Altman (BA) plots. Regression analysis was used to determine if CVM grade can predict the amount of facial growth.
The mean kappa for intra-rater agreement during grading with CVM was 0.36 (fair agreement). BA plots demonstrated acceptable agreement for cephalometric measurements. The regression analysis demonstrated that the only chronologic age was associated with the facial growth. The largest effect of age was for condylion-gnathion (Cd-Gn) and articulare-gnathion (Ar-Gn)-for every additional 6 months the Cd-Gn increases by 1.8mm [95 per cent confidence interval (CI): 1.7, 1.9, P < 0.001] and Ar-Gn increases by 1.59mm (95 per cent CI: 1.52, 1.67, P < 0.001). The CVM grade could not predict the change of cephalometric variables.
There is no evidence to support the hypothesis that the CVM method can predict the amount of craniofacial growth in girls with Class II malocclusion.
颈椎成熟度(CVM)方法用于确定安氏II类错牙合畸形的治疗时机。由于其在安氏II类患者中的性能尚未经过测试,本研究的目的是评估CVM方法在预测安氏II类错牙合畸形患者颅面生长方面的有效性。
在奈梅亨生长研究的参与者中确定了29名未经治疗的安氏II类错牙合畸形女孩。每个女孩从9岁到14岁每半年拍摄一系列头颅侧位片。由五名观察者根据9岁时拍摄的头颅侧位片确定CVM状态;在所有可用的头颅侧位片上评估下颌骨和上颌骨长度以及前牙面高度。用kappa统计和布兰德-奥特曼(BA)图评估方法误差。采用回归分析确定CVM分级是否能预测面部生长量。
使用CVM分级时,评分者内一致性的平均kappa值为0.36(一致性尚可)。BA图显示头颅测量值的一致性可接受。回归分析表明,唯一与面部生长相关的是年龄。年龄对髁突-下颌角(Cd-Gn)和关节点-下颌角(Ar-Gn)的影响最大——每增加6个月,Cd-Gn增加1.8mm[95%置信区间(CI):1.7,1.9,P<0.001],Ar-Gn增加1.59mm(95%CI:1.52,1.67,P<0.001)。CVM分级不能预测头颅测量变量的变化。
没有证据支持CVM方法可以预测安氏II类错牙合畸形女孩颅面生长量这一假设。