Kang Sung-Tae, Choi Sung-Hwan, Kim Kyung-Ho, Hwang Chung-Ju
Department of Orthodontics, Institute of Craniofacial Deformity, Yonsei University College of Dentistry, Seoul, Korea.
BK21 PLUS Project, Yonsei University College of Dentistry, Seoul, Korea.
Korean J Orthod. 2020 May 25;50(3):181-187. doi: 10.4041/kjod.2020.50.3.181.
This study aimed to evaluate the differences in cephalometric characteristics and skeletal maturation in girls with central precocious puberty (CPP) via lateral and hand-wrist radiographs. We also aimed to identify the indicators that are most effective for determining skeletal maturity in these patients.
The study included 70 Korean girls (mean age, 8.5 ± 0.5 years) diagnosed with CPP at the Department of Pediatrics, and 48 normal healthy age-matched girls who visited the Department of Orthodontics and had no history of hormone treatment or growth problems. Skeletal maturation was evaluated using lateral cephalometric and hand-wrist radiographs using cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI).
The mean mandibular plane angle was smaller in the CPP group than in the control group (35.8° ± 4.9° vs. 39.0° ± 6.5°), resulting in greater posterior facial height ( = 0.003). SMI was significantly greater in the CPP group (3.5 ± 1.4 vs. 2.0 ± 1.0) than in the control group ( = 0.001) and was significantly associated with CPP ( = 0.492; = 0.001), whereas CVMI was not.
In comparison with the control group, the CPP group exhibited a smaller mandibular plane angle, greater posterior facial height, and greater skeletal maturation. SMI may be more suitable than CVMI for determining skeletal maturation in CPP. Hand-wrist radiography is recommended in addition to lateral cephalogram for predicting growth in girls with CPP.
本研究旨在通过头颅侧位片和手腕部X线片评估中枢性性早熟(CPP)女童的头影测量特征和骨骼成熟度差异。我们还旨在确定对这些患者骨骼成熟度判断最有效的指标。
本研究纳入了70名在儿科诊断为CPP的韩国女童(平均年龄8.5±0.5岁),以及48名年龄匹配、健康、无激素治疗史或生长问题且前往正畸科就诊的正常女童。使用颈椎成熟度指标(CVMI)和骨骼成熟度指标(SMI),通过头颅侧位片和手腕部X线片评估骨骼成熟度。
CPP组的平均下颌平面角小于对照组(35.8°±4.9° vs. 39.0°±6.5°),导致面部后份高度更大(P = 0.003)。CPP组的SMI显著高于对照组(3.5±1.4 vs. 2.0±1.0)(P = 0.001),且与CPP显著相关(r = 0.492;P = 0.001),而CVMI则不然。
与对照组相比,CPP组表现出更小的下颌平面角、更大的面部后份高度和更大的骨骼成熟度。在CPP患者中,SMI可能比CVMI更适合用于确定骨骼成熟度。除头颅侧位片外,建议加做手腕部X线片以预测CPP女童的生长情况。