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aResearch
spurt) has been described in many previous cephalometric studies.2-7 The intensity, onset, and duration of the
pubertal peak in mandibular growth are characterized by
great individual variations. Clinical research has demonstrated that the greatest effects of functional appliances
take place when the peak in mandibular growth is
included in the treatment period.1,8-10 In particular, Hgg
and Pancherz9 found that sagittal growth at the condyle
in patients treated with the Herbst appliance at the peak
in pubertal growth was twice that observed in patients
treated 3 years before or 3 years after the peak.
Mandibular skeletal maturity can be assessed by
means of a series of biologic indicators: increase in
body height2,4; skeletal maturation of the hand and
wrist11-13; dental development and eruption6,12,14;
menarche, breast, and voice changes15; and cervical
vertebral maturation.16-17 In the majority of subjects,
the peak in the adolescent increments in maxillary and
mandibular size occurs at the same time as does the
growth peak in height,12,18 or slightly after that.2,19
According to Nanda,20 the changes in body height
show the least variability for the assessment of skeletal age throughout the progression of growth (the predictive efficiency of height age at 9 years of age for SGn length at 13 years of age is 94%).
With respect to the cervical vertebral method, 6
stages corresponding to 6 different maturational phases
in the cervical vertebrae can be identified during the
pubertal period.16 This procedure has proved to be
335
Table I. Descriptive
statistics for computed measurements at the 6 stages in cervical vertebral maturation (n = 24)
Cvs1
Age (months)
Body height (cm)
Co-Gn (mm)
Co-Goi (mm)
Goi-Gn (mm)
S-Gn (mm)
N-Me (mm)
ANS-Me (mm)
S-Goi (mm)
Cvs2
Cvs3
Cvs4
Mean
SD
SE
Mean
SD
SE
Mean
SD
SE
Mean
SD
SE
103.7
132.2
106.9
50.9
70.7
116.2
111.4
63.4
71
14.4
9.3
6.1
4.5
5.2
7
6.3
4.6
6.3
2.9
1.9
1.2
0.9
1.1
1.4
1.3
0.9
1.3
115.2
137.6
109.2
52
72.9
119
113.9
64.3
72.9
14.1
9.3
6.3
4.9
4.8
7.3
6.3
4.6
6.7
2.9
1.9
1.3
1
0.9
1.5
1.3
0.9
1.4
128
143.6
111.3
52.9
74.4
121.7
116.2
65.3
75
14.4
9.8
6.5
4.9
5.1
7.3
6.4
4.8
7.1
2.9
2
1.3
1
1
1.5
1.3
0.9
1.4
140.2
152.3
116.6
56.6
77.4
126
119.6
66.9
78.2
13.6
9.9
6.5
5.2
5.3
7.6
6.4
4.9
7.1
2.8
2
1.3
1.1
1.1
1.5
1.3
1
1.4
Cvs5
Cvs6
Mean
SD
SE
Mean
SD
SE
152.7
157.2
118.4
57.9
78.7
128.6
122.8
68.4
80.7
13.7
9.7
6.8
5.8
5.2
7.8
6.7
5.0
7.4
2.8
2
1.4
1.2
1.1
1.6
1.4
1.0
1.5
165.1
160.6
120.7
59.8
80.3
131.5
125.5
69.8
83.4
13.1
9.4
7.3
6.2
5.4
7.7
6.9
5.2
7.8
2.7
1.9
1.5
1.3
1.1
1.6
1.4
1.1
1.6
C
Fig 3. Individual changes in body height at intervals
between stages in cervical vertebral maturation (A) in
24 subjects examined, (B) in subgroup of 15 females,
and (C) in subgroup of 9 males.
at the 5 intervals between consecutive stages in cervical vertebral maturation and statistical com-
parison (n = 24)
Cvs1-Cvs2
Age (months)
Body Height (cm)
Co-Gn (mm)
Co-Goi (mm)
Goi-Gn (mm)
S-Gn (mm)
N-Me (mm)
ANS-Me (mm)
S-Goi (mm)
Cvs2-Cvs3
Cvs3-Cvs4
Mean
SD
Mean
SD
Mean
SD
11.46
5.42
2.39
1.1
2.25
2.73
2.46
0.85
1.95
1.32
1.33
1.04
1.58
1.38
1.33
1.46
0.83
1.28
12.83
5.95
2.81
1.91
1.47*
2.76
2.24
0.96
2.12
2.51
1.35
1.51
1.14
1.47
1.41
1.45
1.01
1.62
12.21
8.70*
4.19*
2.93
3.08*
4.23
3.5
1.71
3.2
2.78
1.7
0.9
0.91
1.68
1.96
1.59
1.21
2.09
Cvs4-Cvs5
Cvs5-Cvs6
Mean
SD
Mean
SD
12.42
4.96*
2.92*
1.76*
1.27
2.68*
3.16
1.48
2.52
2.26
2.1
1.56
1.64
1.56
1.58
1.59
1.34
1.39
12.42
3.35*
2.46
1.77
1.61
2.84
2.68
1.36
2.68
3.13
1.78
1.66
1.01
1.78
1.86
1.97
1.32
2.03
gular in shape) in both boys and girls. The peak in statural height during the interval from stage 3 to stage 4
corresponds to the greatest increments in all dimensional and positional mandibular measurements.
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