The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 20 , ISSUE 9 ( September, 2019 ) > List of Articles


Estimation and Comparison of the Duration of the Pubertal Peak in Skeletal Class II and Class I Subjects Using the Cervical Vertebrae Maturation Index Method

Hasna Ghaleb, Roula Akl, Elie Khoury, Joseph Ghoubril

Keywords : Cervical vertebrae maturation, Class I and class II subjects, Pubertal peak, Retrospective cross-sectional study, Skeletal age

Citation Information : Ghaleb H, Akl R, Khoury E, Ghoubril J. Estimation and Comparison of the Duration of the Pubertal Peak in Skeletal Class II and Class I Subjects Using the Cervical Vertebrae Maturation Index Method. J Contemp Dent Pract 2019; 20 (9):1095-1101.

DOI: 10.5005/jp-journals-10024-2637

License: CC BY-NC 4.0

Published Online: 00-09-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Aim: The purpose of this study is to estimate and compare the duration of the pubertal peak in skeletal class II and class I subjects and to detect any difference between boys and girls or between hypo-, normo-, and hyperdivergent subjects for skeletal maturation indicator (CVM) in white Caucasians. Materials and methods: 346 subjects were selected from 3,119 examined files. Pretreatment lateral cephalometric records were hand-traced and divided following the anteroposterior skeletal relationship, the gender, the vertical pattern, and the skeletal maturation. The duration of the pubertal peak was calculated based on the chronological age interval according to each group. The age of onset of the active growth and the duration of the pubertal peak were compared between the different groups studied. Results: Pubertal peak had a mean duration of 13 months in skeletal class I subjects, 19 months in skeletal class II subjects, 15 months in girls, 20 months in boys, 13 months in normodivergent and hypodivergent subjects, whereas in hyperdivergent subjects, it lasted 18 months. Conclusion: The growth interval corresponding to the pubertal growth spurt (CS3–CS4) was (1) significant between skeletal class I and class II subjects, (2) longer in boys, and (3) longer in hyperdivergent subjects. Clinical significance: Orthodontic treatments can start earlier for girls in class I or class II relationship and for hyperdivergent subjects as well. Furthermore, boys and subjects in class II skeletal relationship have a significantly longer duration of the pubertal peak and consequently a much efficient orthopedic and orthodontic treatment.

PDF Share
  1. Björk A, Helm S. Prediction of the age of maximum pubertal growth in body height. Angle Orthod 1967;37:134–143.
  2. Tarranger J, Hägg U. The timing and duration of adolescent growth. Acta Odontol Scand 1979;38:57–67. DOI: 10.3109/00016358008997719.
  3. Hunter C. The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod 1966;36: 44–54.
  4. Bowden B. Epiphyseal changes in the hand/wrist area as indicators of adolescent stage. Aust Orthod J 1976;4:87–104.
  5. Fishman L. Chronological vs skeletal age, an evaluation of craniofacial growth. Angle Orthod 1979;49:181–189.
  6. Engel TP, Renkema AM, et al. The cervical vertebral maturation (CVM) method cannot predict craniofacial growth in girls with class II malocclusion. Eur J Orthod 2016 Feb;38:1–7. DOI: 10.1093/ejo/cju085.
  7. Gray S, Bennani H, et al. Morphometric analysis of cervical vertebrae in relation to mandibular growth. Am J Orthod Dentofacial Orthop 2016;149:92–98. DOI: 10.1016/j.ajodo.2015.06.028.
  8. Nanda R-S. The rates of growth of several facial components measured from serial cephalometric roentgenograms. Am J Orthod Dentofacial Orthop 1955;41:658–673. DOI: 10.1016/0002-9416(55)90112-3.
  9. Bishara S, Jakobsen J, et al. Changes in dentofacial structures in untreated Cl II division 1 and normal subjects. Angle Orthod 1997;67:55–66.
  10. Mellion ZJ, Behrens RG, et al. The pattern of facial skeletal growth and its relationship to various common indexes of maturation. Am J Orthod Dentofacial Orthop 2013;143:845–854.
  11. Tofani M. Mandibular growth at puberty. Am J Orthod 1972;62: 176–195. DOI: 10.1016/0002-9416(72)90141-8.
  12. Hägg U, Taranger J. Menarche and voice change as indicators of the pubertal growth spurt. Acta Odontol Scand 1980;38:179–186. DOI: 10.3109/00016358009004718.
  13. Björk A, Skieller V. Facial development and tooth eruption: an implant study at the age of puberty. Am J Orthod 1972;62:339–383. DOI: 10.1016/S0002-9416(72)90277-1.
  14. Chertkow S, Fatti P. The relationship between tooth mineralization and early radiographic evidence of the ulnar sesamoid. Angle Orhod 1979;49:282–288.
  15. Mappes M, Harris E, et al. An example of regional variation in the tempos of tooth mineralization and hand-wrist ossification. Am J Orthod Dentofacial Orthop 1992;101:145–151. DOI: 10.1016/0889-5406(92)70006-V.
  16. Krailassiri S, Anuwongnukroh N, et al. Relationships between dental calcification stages and skeletal maturity indicators in Thai individuals. Angle Orthod 2002;72:155–166.
  17. Başaran G, Özer T, et al. Cervical vertebral and dental maturity in Turkish subjects. Am J Orthod Dentofacial Orthop 2007;131: 447.e13–447.e20. DOI: 10.1016/j.ajodo.2006.08.016.
  18. Smith R. Misuse of hand-wrist radiographs. Am J Orthod 1980;77: 75–78. DOI: 10.1016/0002-9416(80)90225-0.
  19. Kumar S, Singla A, et al. Skeletal maturation evaluation using mandibular second molar calcification stages. Angle Orthod 2011;81:872–877. DOI: 10.2319/110610-646.1.
  20. Lamparski DG. Skeletal Age Assessment Utilizing Cervical Vertebrae. Angle Orthod 1972;67:458–460. DOI: 10.1016/0002-9416(75)90038-X.
  21. Hassel B, Farman A, et al. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995;107:58–66. DOI: 10.1016/S0889-5406(95)70157-5.
  22. Franchi L, Baccetti T, et al. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofac Orthop 2000;118:335–340. DOI: 10.1067/mod.2000.107009.
  23. Baccetti T, Franchi L, et al. The Cervical Vertebral Maturation (CVM) Method for the Assessment of Optimal Treatment Timing in Dentofacial Orthopedics. Semin Orthod 2005;11:119–129. DOI: 10.1053/j.sodo.2005.04.005.
  24. Seedat A, Forsberg C. An evaluation of the third cervical vertebra (C3) as a growth indicator in Black subjects. SADJ 2005;60:156–160.
  25. Jaqueira L, Armond M, et al. Determining skeletal maturation stage using cervical vertebrae: evaluation of three diagnostic methods. Braz Oral Res 2010;24:433–437. DOI: 10.1590/S1806-83242010000400010.
  26. Rainey BJ, Burnside G, et al. Reliability of cervical vertebral maturation staging. Am J Orthod Dentofacial Orthop 2016;150:98–104. DOI: 10.1016/j.ajodo.2015.12.013.
  27. Dolce C, McGorray S, et al. Timing of class II treatment: Skeletal changes comparing 1-phase and 2-phase treatment. Am J Orthod Dentofacial Orthop 2007;132:481–489. DOI: 10.1016/j.ajodo.2005.08.046.
  28. Kuc-Michalska M, Baccetti T. Duration of the pubertal peak in skeletal Cl I and Cl III subjects. Angle Orthod 2010;80:54–57. DOI: 10.2319/020309-69.1.
  29. Salazar-Lazo R, Arriola-Guillén LE, et al. Duration of the peak of adolescent growth spurt in class I and II malocclusion subjects using a cervical vertebrae maturation analysis. Acta Odontol Latinoam 2014;27(2):96–101.
  30. Craig CE. The skeletal patterns characteristics of class I and class II, division I malocclusion in normalateralis. Angle Orthod 1951;21: 44–56.
  31. Reidel RA. The relation of maxillary structures to cranium in malocclusion and normal occlusion. Angle Orthod 1952;22:142–145.
  32. Class II division 1 and class II division 2 (Angle) malocclusion. Angle Orthod 1954;24:106–119.
  33. Harris J, Kowalski C, et al. Discrimination between normal and class II individuals using Steiner's analysis. Angle Orthod 1972;42:212–220.
  34. Rothstein T. Facial morphology and growth from 10 to 14 years of age in children presenting class II, division 1 malocclusion: a comparative roentgenographic cephalometric study. Am J Orthodont 1971;60:619–620. DOI: 10.1016/0002-9416(71)90202-8.
  35. Altemus L. Horizontal and vertical dentofacial relationships in normal and class II, division 1 malocclusion in girls 11–15 years. Angle Orthod 1955;25:120–137.
  36. Fisk G, Culbert M, et al. The morphology and physiology of distocclusion. Am J Orthodont 1953;39:3–12. DOI: 10.1016/0002-9416(53)90092-X.
  37. Rosenblum R. Class II malocclusion: mandibular retrusion or maxillary protrusion? Angle Orthod 1995;65:49–62.
  38. Henry RG. A classification of class II, division 1 malocclusion. Angle Orthod 1957;27:83–92.
  39. McNamara Jr JA. Components of class II malocclusion in children 8-10 years of age. Angle Orthod 1981;51:177–202.
  40. Pancherz H, Zieber K, et al. Cephalometric characteristics of class II division 1 and class II division 2 malocclusions: a comparative study in children. Angle Orthod 1997;67:111–120.
  41. Drelich RC. A cephalometric study of untreated class II, division 1 malocclusion. Angle Orthod 1948;18:70–75.
  42. Ngan P. Longitudinal evaluation of growth changes in Cl II division 1 subjects. Semin Orthod 1997;3:222–231. DOI: 10.1016/S1073-8746(97)80055-2.
  43. Karlsen AT. Association between facial height development and mandibular growth rotation in low and high MP-SN angle faces: a longitudinal study. Angle Orthod 1997;67:103–110.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.