Cervical Vertebral Maturation Stage as a Growth Predictor

The purposes of this study were to establish the reproducibility of skeletal age assessment as determined by the stage of cervical vertebral maturation (CVM) and to assess the ability of the CVM method to predict timing of peak mandibular growth velocity (PMdGV). The longitudinal records of 104 females (age 8 to 14 inclusive) were used to determine skeletal age (as assessed by the CVM) and mandibular length. Reproducibility of skeletal age estimates was tested by comparing five sets of first and second determinations done 2 months apart for 20 subjects chosen from the total sample before and after the principal operator calibration. The reproducibility of skeletal age assessments done prior to calibration was unacceptable. The reproducibility improved to acceptable limits following calibration. Improved definitions, the addition of an extra stage and the development of a Sequential Conditional Flow Chart rendered the modified CVM method, introduced in this study, even more reproducible. The kappa for 20 double assessments of the timing of PMdGV was 59% (not acceptable) but of the 55 subjects for whom two determinations of timing of PMdGV coincided, only 61% were at cervical vertebral stage 3 thus lending some measure of uncertainty to the use of the cervical vertebral maturation method for predicting timing of PMdGV

Cervical Vertebral Maturation Stage as a Growth Predictor

I would like to express my sincere appreciation to the members of my thesis committee: Dr Stuart Hunter, Dr Antonios Mamandras, Dr Lesley Short, Dr David Banting, Dr John Murray and Dr Brian Tompson. In particular, thank you to my thesis supervisor, Dr Stuart Hunter, for your help and support during my thesis project. You are an inspiration and a role model to me. A special thank to Dr Antonios Mamandras and to Dr Lesley Short for their help and support through the whole program. You made my experience at Western unforgettable. For all the support provided to me in completing this thesis and this program, thank you Barb Merner, Joanne Pfaff, Leesa Couper, Evelyn Larios, PJ Blake, Justina Hovarth, Jackie Geneau and Cynthia Mugimba. You made my experience at Western memorable. I want to say thanks to all of my co-residents: Nadia, Mitch, Dolly, Ali, Mark, Mike, Mariela, Manisha, Neville, Dana, Phil and Julia. Thank you for your comradery, support and humour. To my classmates Ziad and Julia, the past three years have been a true learning experience. Thank you for being such good classmates. I will never forget all the special moments we shared together. Most importantly, I dedicate this thesis to my entire family. To my husband Jalal, thank you for your love, patience and support. Thank you for believing in me and for supporting me in every step of the way. I couldn’t have done it without you. To Mom and Dad, thank you for believing in me every day of my life. Your love and support over the last three years allowed me to follow my dream. I am eternally grateful. To my adorable daughter Mayali, I know we will be able to make up for lost time together but know you are my raison d’être and the sunshine in my life