Elimination of hand–wrist radiographs for maturity assessment in children needing orthodontic therapy

Our aim was to evaluate the validity of the cervical vertebra maturation (CVM) method as an indicator of skeletal age during the circumpubertal period by correlating the CVM method with the hand–wrist maturation (HWM) method in an attempt to eliminate the need for hand–wrist radiographs for maturity assessment. Hand–wrist and lateral cephalometric radiographs of 400 Chinese were randomly selected. The age for girls was between 10 years and 15 years and for boys it was between 12 years and 17 years, so that they were within the circumpubertal period. The CVM was assessed by a method developed by Baccetti and co-workers, whereas hand–wrist maturation was assessed by Fishman’s method. The CVM was significantly correlated with HWM skeletal age. (Spearman’s r boys = 0.9206, girls = 0.9363). All the patients in cervical vertebra stage 3 (CVS3) of CVM corresponded to skeletal maturation indicator 2 (SMI2) or SMI3 stages of HWM (around the peak of the growth spurt). The method error was insignificant. CVM is a valid indicator of skeletal growth during the circumpubertal period. This work will provide dental practitioners with information on jaw growth modification therapy.