BACKGROUND: The correlation between dental maturity and skeletal maturity has been proposed, but its clinical application remains challenging. Moreover, the varying correlations observed in different studies indicate the necessity for research tailored to specific populations.
OBJECTIVE: To compare skeletal maturity in Korean children with advanced and delayed dental maturity using dental maturity percentile.
METHODS: Dental panoramic radiographs and cephalometric radiographs were obtained from 5133 and 395 healthy Korean children aged between 4 and 16 years old. Dental maturity was assessed with Demirjian\'s method, while skeletal maturity was assessed with the cervical vertebral maturation method. Standard percentile curves were developed through quantile regression. Advanced (93 boys and 110 girls) and delayed (92 boys and 100 girls) dental maturity groups were defined by the 50th percentile.
RESULTS: The advanced group showed earlier skeletal maturity in multiple cervical stages (CS) in both boys (CS 1, 2, 3, 4, and 6) and girls (CS 1, 3, 4, 5, and 6). Significant differences, as determined by Mann-Whitney U tests, were observed in CS 1 for boys (p = 0.004) and in CS 4 for girls (p = 0.037). High Spearman correlation coefficients between dental maturity and cervical vertebral maturity exceeded 0.826 (p = 0.000) in all groups.
CONCLUSIONS: A correlation between dental and skeletal maturity, as well as advanced skeletal maturity in the advanced dental maturity group, was observed. Using percentile curves to determine dental maturity may aid in assessing skeletal maturity, with potential applications in orthodontic diagnosis and treatment planning.

UNASSIGNED: The purpose of the present research was to evaluate the comparison between the Skeletal Maturation phases of Fishman\'s hand-wrist skeletal maturation index (SMI) and cervical vertebral maturation angle (CVMA).
UNASSIGNED: Assessment and comparison of Skeletal Maturation utilizing the hand-wrist bone radiograph by Fishman\'s system of skeletal maturation indicator (SMI), cervical vertebra maturation stages (CVMS), and lateral cephalogram by cervical vertebral maturation angle (CVMA) conducted on 150 subjects (75 male and 75 female). Chi-square was used to reveal the significance of study parameters on a categorical scale between SMI, CVMS, CVMA, and multiple regression analysis conducted to envisage the connotation of the dependent variable.
UNASSIGNED: Multiple regression analysis models exhibited 61.9% of the variance for CVMA with autonomous variables. In multiple regression analysis, there is no substantial association (P > 0.05) between age and CVMA. The correlation of SMI and CVMA values utilizing Pearson\'s correlation coefficient for males and females presented positive association with R value of 0.801 for males and 0.834 for females and a P value of < 0.001.
UNASSIGNED: As compared to other maturity indicators like hand and wrist, cervical vertebral angular measurements were reliable enough for assessing the degree of skeletal maturation.

Aim This study aims to investigate the relationship between the frontal sinus index and different stages of cervical vertebral maturation and to determine whether these measurements can be used as accurate markers for evaluating skeletal maturity. Materials and methods The sample size was 120 subjects, with ages that ranged from 8 to 25 years. Standardized pretreatment digital lateral cephalograms were analyzed. Six groups representing different phases of cervical vertebral maturation were created from the entire sample. Each group had 20 subjects and was split into male and female groups. On the same radiograph, the cervical stages were assessed and the frontal sinus index was calculated. Correlations between the frontal sinus index and cervical vertebral maturation were assessed using statistical analysis. Results Sinus index values, which assess the ratio of frontal sinus dimensions to cervical stages, were found to be comparable between the two adjacent cervical stages. However, the patterns of sinus index values differed between males and females, suggesting potential variations in sinus development between the sexes. Conclusion Frontal sinus height and width were significantly correlated with cervical vertebral maturation stages in both sexes. The frontal sinus index, on the other hand, was not significant.

Background: The relevance of growth determination in orthodontics is driving the search for the most precise and least invasive way of tracking the pubertal growth spurt. Objectives: The aim was to explore whether minimally invasive salivary estimation of biomarkers Insulin-like growth factor (IGF-1) and Insulin-like growth factor binding protein-3 (IGFBP-3) could be used to estimate skeletal maturity with diagnostic accuracy, especially in children and adolescent age groups. Subjects and methods: The cross-sectional study was conducted on 105 participants aged 6−25 years from the out-patient Department of Preventive Dental Science at Majmaah University between the period 2 January 2021 and 12 July 2021. Each subject’s lateral cephalogram radiograph was categorized based on skeletal maturity, and saliva samples were estimated for IGF-1 and IGFBP-3 using the respective ELISA kits. Two-way ANOVA with interaction was applied to examine the main effects due to cervical vertebral maturation staging (CVS), Sex and interaction effect due to CVS, and Sex on study parameters. Karl Pearson’s Product Moment Correlation Coefficient was calculated for finding a significant association between IGF, IGFBP3, and the IGF-1/IGFBP3 molar ratio. Results: Highest mean salivary IGF-1 was observed in the pubertal peak stage, which coincides with cervical vertebral maturity stages 3 and 4 (CVS3 and CVS4) for both males (2.57 ng/mL) and females (1.57 ng/mL) and the lowest mean level of IGF-1 for females (0.85 ng/mL) and males (1.22 ng/mL) was observed during the prepubertal stage. There exists a significant variation in IGF-1 between males and females in the pubertal stage (p < 0.01), but the difference is very narrow in the prepubertal and post-pubertal groups (p > 0.05). There was no significant interaction effect of different skeletal stages and gender on the IGFBP3 and the IGF-1/IGFBP3 molar ratio (p > 0.05), but there exists a significant interaction effect on IGF-1 (p < 0.05). Conclusion: Estimation of the IGF-1 and the IGF-1/IGFBP3 molar ratio in saliva, being a non-invasive biological marker, could serve as an adjunctive tool along with radiographic assessment in estimating growth maturity in the adolescence age group. By initiating orthodontic treatment during the mandibular growth peak in adolescence, a positive outcome is ensured in managing skeletal deformities within the craniofacial complex.

OBJECTIVE: To compare and correlate the status of maturation in growing individuals using orthopantomograph (OPG) and lateral cephalogram to establish a reliable relationship between chronological age (CA) and dental maturation (DM) with cervical vertebrae maturation index (CVMI).
METHODS: Lateral cephalometric radiographs and OPGs of 50 children within the circumpubertal period were collected (male n = 25, age 12-17 years, female n = 25, age 10-15 years) and evaluated for the status of maturation using CA, DM (of mandibular left canine and second molar using Demirjian Index-DI), and CVMI stages.
RESULTS: Chronological age shows a positive correlation with CVMI stages in both groups. Gender-based association and distribution between DI stages of canine and CVMI stages shows that in both male and female sample groups DI G correlates with CVMI stage 1 and 2, DI H correlates with CVMI stage 3. Gender-based association and distribution between DI stages of 2nd molar and CVMI stages show that in the male sample group DI E shows a higher correlation with CVMI stage 1, DI F shows a higher correlation with CVMI stage 1 and 2. DI G shows a higher correlation with CVMI stages 2 and 3. DI H shows a higher correlation with CVMI stage 3. In the female sample group, DI F shows a higher correlation between CVMI stage 1 and 2, DI G and F show a higher correlation with CVMI stage 3.
CONCLUSIONS: Mandibular canine, second molar calcification stages, and CA show a positive correlation with CVMI stages in the present study, hence, this can be considered as a reliable indicator in skeletal maturity assessment.
UNASSIGNED: Pooja U, Lokesh NK, Alle RS, et al. A Study to Compare and Correlate the Status of Maturation in Growing Individuals Using Chronological Age Dental Maturation and Cervical Vertebrae Maturation. Int J Clin Pediatr Dent 2021;14(S-1):S50-S53.

The assessment of an individual\'s development by investigating the skeletal maturity is of much use in various medical fields. Skeletal maturity can be estimated by evaluating the morphology of the cervical vertebrae. The aim of this study was to conduct comparisons of the chronological age in different bone development stages. The retrospective study was conducted based on lateral cephalometric radiographs belonging to patients with ages between 6 and 15.9 years, from Romania. For the assessment of skeletal maturity, the Cervical Vertebral Maturation (CVM) method was used. In total, 356 radiographs were selected, but after applying the exclusion criteria, 252 radiographs remained in the study (178 girls and 74 boys). Different mean chronological age values were obtained for the general sample, as well as for the two genders. The chronological age started to be significantly different at the CS4 stage. Patients with CS4, CS5, and CS6 stages had a significantly higher chronological age compared to patients with CS1, CS2, and CS3 stages. It was noted that patients with CS1 and CS2 stages were more frequently boys, while patients with the CS5 stage were more frequently girls.

UNASSIGNED: The EOS-imaging system is increasingly adopted for clinical follow-up in scoliosis with the advantages of simultaneous biplanar imaging of the spine in an erect position. Skeletal maturity assessment using a hand radiograph is an essential adjunct to spinal radiography in scoliosis follow-up. This study aims at testing the feasibility and validity of a newly proposed EOS workflow with sequential spine-hand radiography for skeletal maturity assessment and bracing recommendation.
UNASSIGNED: EOS spine-hand radiographs from patients with diagnosis of idiopathic scoliosis, including both sexes and an age range of ten to 14 years, were scored using the Thumb Ossification Composite Index (TOCI), Sanders and Risser methods. Intraclass correlation coefficients (ICCs) were calculated for inter/intraobserver agreement and were tested with Cronbach\'s alpha values.
UNASSIGNED: In all, 60 EOS-spine hand radiographs selected from subjects with diagnosis of adolescent idiopathic scoliosis (AIS), including 32 male patients (mean age 11.53 years; 10 to 14) and 28 female patients (mean age 11.50 years; 10 to 13) who underwent sequential spine-hand low dose EOS imaging were generated for analysis. The overall interobserver (ICC = 0.997) and intraobserver agreement (α > 0.9) demonstrated excellent agreement for TOCI staging; ICC > 0.994 for both TOCI and Sanders staging comparing traditional digital versus EOS hand radiography; ICC ≥ 0.841 for agreement on bracing recommendation among TOCI versus the Risser and Sanders system.
UNASSIGNED: With the proposed new EOS workflow it was feasible to produce high image quality for skeletal maturity assessment with excellent reliability and validity to inform consistent bracing recommendation in AIS. The workflow is applicable for busy daily clinic settings in tertiary scoliosis centres with reduced time cost, improved efficiency and throughput of the radiology department.
UNASSIGNED: III.

The lesion of the lumbar endplate is sometimes identified in the vertebrae of children and adolescents. The purpose of this study is to compare between skeletal maturity and chronological age. The second purpose of this study is to clarify the lesions of the lumbar endplate based on the maturation of the lumbar vertebral body. Six hundred and thirty-two (485 men and 147 women) consecutive patients were included. The mean age at the first medical examination was 13.8 years. Their skeletal maturity was evaluated based on the appearances of the secondary ossification center of L3. The area of the endplate lesions was classified into five types. The apophyseal stage was observed from 10 years old to 18 years old, and the apophyseal stage was shown the peak at 14 years old. The appearance of the apophyseal ring was observed earlier in female patients than in male patients. For the concave type, the lesion at upper level vertebra was more prevalent. The anterior and middle type of the lesion at upper level vertebra was more prevalent. For the posterior type, the lesion of the inferior rim of L4 and the lesion of the rim of L5 were more prevalent. This study emerged after comparing skeletal maturity based on the maturation of the lumbar vertebral body with the chronological age of a large number of patients and examining the lesions of the lumbar endplate based on the stage of maturation of the lumbar vertebral body.

OBJECTIVE: In the present study, we developed new software for quantitative analysis of cervical vertebrae maturation, and we evaluated its applicability through a multinomial logistic regression model (MLRM).
METHODS: Digitized images of the bodies of the second (C2), third (C3) and fourth (C4) cervical vertebrae were analysed in cephalometric radiographs of 236 subjects (116 boys and 120 girls) by using a software developed for digitized vertebrae analysis. The sample was initially distributed into 11 categories according to the Fishman\'s skeletal maturity indicators and were then grouped into four stages for quantitative cervical maturational changes (QCMC) analysis (QCMC I, II, III and IV). Seven variables of interest were measured and analysed to identify morphologic alterations of the vertebral bodies in each QCMC category.
RESULTS: Statistically significant differences (p < 0.05) were observed among all QCMC categories for the variables analysed. The MLRM used to calculate the probability that an individual belonged to each of the four cervical vertebrae maturation categories was constructed by taking into account gender, chronological age and four variables determined by digitized vertebrae analysis (Ang_C3, MP_C3, MP_C4 and SP_C4). The MLRM presented a predictability of 81.4%. The weighted κ test showed almost perfect agreement (κ = 0.832) between the categories defined initially by the method of Fishman and those allocated by the MLRM.
CONCLUSIONS: Significant alterations in the morphologies of the C2, C3 and C4 vertebral bodies that were analysed through the digitized vertebrae analysis software occur during the different stages of skeletal maturation. The model that combines the four parameters measured on the vertebral bodies, the age and the gender showed an excellent prediction.