title: Relationship between cervical vertebral maturation and mandibular growth.
abstract: BACKGROUND
  The cervical vertebrae have been proposed as a method of determining biologic maturity. The purposes of this study were to establish a pattern of mandibular growth and to relate this pattern to the stages of cervical vertebral maturation.
  
  
  METHODS
  Cephalometric radiographs, taken annually from ages 9 to 18 years, were evaluated for 90 boys from the Burlington Growth Center, Toronto, Ontario, Canada. Mandibular lengths were measured from articulare to gnathion, and incremental growth was determined. Cervical vertebral maturation stages were assessed by using a 6-stage method. Advanced, average, and delayed maturation groups were established.
  
  
  RESULTS
  The prepubertal mandibular growth minimum velocity occurred during cervical stages 1 through 4 (P = 0.7327). Peak mandibular growth velocity occurred most frequently during stage 4 in all 3 maturation groups, with a statistical difference in the average and delayed groups (P <0.0001) and the advanced group (P = 0.0143). The average number of years spent in stage 4 was 3.79 (P <0.0001). The average amount of mandibular growth occurring during stage 4 was 9.40 mm (P <0.0001). The average amount of growth in stages 5 and 6 combined was 7.09 mm.
  
  
  CONCLUSIONS
  Progression from cervical stages 1 through 6 does not occur annually; time spent in each stage varies depending on the stage and the maturation group. Cervical vertebral maturation stages cannot accurately identify the mandibular prepubertal growth minimum and therefore cannot predict the onset of the peak in mandibular growth. The cervical vertebral maturation stages should be used with other methods of biologic maturity assessment when considering both dentofacial orthopedic treatment and orthognathic surgery.
authors.affiliation: Discipline of Orthodontics, Faculty of Dentistry, University of Toronto, Ontario, Canada.
authors.forename: Gina
authors.initials: G
authors.lastname: Ball
authors.forename: Donald
authors.initials: D
authors.lastname: Woodside
authors.forename: Bryan
authors.initials: B
authors.lastname: Tompson
authors.forename: W Stuart
authors.initials: WS
authors.lastname: Hunter
authors.forename: James
authors.initials: J
authors.lastname: Posluns
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods / Q000706:statistics & numerical data*; D002508:Cephalometry / Q000379:methods / Q000706:statistics & numerical data; D002574:Cervical Vertebrae / Q000033:anatomy & histology / Q000254:growth & development*; D002648:Child; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008334:Mandible / Q000033:anatomy & histology / Q000254:growth & development*; D011627:Puberty / Q000502:physiology; D012189:Retrospective Studies