Department of Orthodontic Sciences, Tokyo Medical and Dental University (TMDU) Graduate School, Tokyo, Japan.
Medical Science, Kawasaki Medical School, Okayama, Japan.
PLoS One. 2022 Apr 6;17(4):e0265272. doi: 10.1371/journal.pone.0265272. eCollection 2022.
Appropriate maxillofacial growth and development evaluation is important for effective orthodontic treatment. Growth evaluation is based on physiological age determined by individual development, but not chronological age. One strategy for determining physiological age is using the cervical vertebral bone age.
This study aimed to clarify the standard size of the upper and lower jawbones in Japanese patients using the cervical vertebral maturation stages (CVMS) as an index and clarify the growth pattern. And to use the cervical spine age as a diagnostic aid in orthodontic treatment.
Random sampling was performed from the outpatients who visited the Orthodontics department, Tokyo Medical and Dental University Dental Hospital, and 400 patients were enrolled before treatment. Lateral cephalometric radiographs were obtained to measure the height and length of the mandible and the maxilla length with cephalometric analysis. Standard values were calculated for each cervical-spine-age group to analyze changes during mandibular and maxillary growth. Furthermore, we compared the differences between males and females. The Kruskal-Wallis test was used to compare cervical-spine-age groups, and the Steel-Dwass test was used for multiple comparisons. The reliability of CVMS was confirmed by calculating the weighted kappa coefficient (κ).
κ for the degree of intra-evaluator agreement and the degree of the inter-evaluator agreement were calculated, and both indicated almost perfect agreement. We found that the distance between the anterior nasal spine (ANS) and posterior nasal spine (PNS) (i.e., ANS-PNS) increased significantly between CVMS II and CVMS III in males. The distance between Articulare (Ar) and Gonion (Go) (i.e., Ar-Go) and the distance between Go and Pogonion (Pog) (i.e., Go-Pog) increased significantly between CVMS III and CVMS IV in males.
The findings suggested that CVMS is a reliable indicator of the growth stage of the maxilla and mandible.
适当的颌面部生长发育评估对于有效的正畸治疗至关重要。生长评估基于个体发育所确定的生理年龄，而不是实际年龄。确定生理年龄的一种策略是使用颈椎骨龄。
本研究旨在使用颈椎成熟度阶段 (CVMS) 作为指标，明确日本患者上下颌骨的标准大小，并阐明生长模式。并将颈椎年龄用作正畸治疗的辅助诊断手段。
从东京医科齿科大学医院正畸科的门诊患者中进行随机抽样，共纳入 400 名治疗前患者。获得侧位头颅侧位片，通过头影测量分析测量下颌骨高度和长度以及上颌骨长度。为每个颈椎年龄组计算标准值，以分析下颌和上颌生长过程中的变化。此外，我们比较了男女之间的差异。使用 Kruskal-Wallis 检验比较颈椎年龄组，使用 Steel-Dwass 检验进行多重比较。通过计算加权 Kappa 系数 (κ) 来确认 CVMS 的可靠性。
计算了评估者内和评估者间的κ值，均显示出几乎完美的一致性。我们发现，男性在 CVMS II 与 CVMS III 之间，前鼻棘 (ANS) 与后鼻棘 (PNS) 之间的距离 (即 ANS-PNS) 显著增加。男性在 CVMS III 与 CVMS IV 之间，髁突 (Ar) 与下颌角 (Go) 之间的距离 (即 Ar-Go) 和 Go 与颏顶点 (Pog) 之间的距离 (即 Go-Pog) 显著增加。
这些发现表明，CVMS 是评估上颌和下颌生长阶段的可靠指标。
