Assessment of mandibular and maxillary transverse growth using vertebral changes

Introduction: Many studies have shown that the cervical vertebrae(CV) is a reliable indicator for skeletal maturation and can be used to predict mandibular and maxillary growth potential. Objective: The purpose of this retrospective study was to assess the maxillary and mandibular transverse growth potential based on morphological changes of CV3/CV4. Methods: 100 untreated Class I occlusion Caucasian males & females were selected from the growth study at Burlington Growth Center. Following data were collected for each subject at age 9-20: (1) the maxillary width between jugale left-jugale right (JL-JR); mandibular width between left, right antegonial notch (AG-AG); (2) statural height; (3) Fishman's Skeletal Maturity Indicators (SMI) from handwrist radiographs; and (4) inferior width(W), anterior height(H) for CV3/CV4. Descriptive statistics, general linear mixed models and multivariate models were derived for JL-JR and AG-GA. Results: Both peak growth velocity (PGV) of CV3H and CV4W for female occurred around the same time as that of maxillary and mandibular transverse peak growth potential (TPGV), SMI 6-8, 12-13 years. PGV of CV3W occurred at a much earlier time than statural PGV as well as maxillary and mandibular TPGV in female. As for the male, the PGV of both CV3W and CV4W occurred at a comparable time to the maxillary and mandibular TPGV, SMI 5-7, 14-15 years. PGV of CV3H and CV4H occurred at a later time in development when compared to both maxillary and mandibular TPGV. Conclusions: In female, CV3H and CV4W can be used as an indicator of maxillary and mandibular transverse growth. On the other hand, CV3W and CV4W are promising indicators of maxillary and mandibular transverse growth in male. Predicting equations for the remaining transverse growth potential for maxilla and mandible based on a quantitative assessment of CV3 and CV4 was established.