Hand-wrist and cervical vertebral maturation indicators: how can these events be used to time Class II treatments?

Background: Ossification events in the hand and wrist and in the cervical vertebrae have been shown to occur at specific times before, during and after the adolescent growth spurt, but there is still debate about the applicability of these findings to the clinical management of Class II cases. The aim of this study was to relate, on an individual basis, cervical vertebral maturation stages and hand-wrist ossification events to the timing of peak statural and mandibular growth in a group of indigenous Australians.

Methods: Velocity curves for stature and mandibular growth were constructed for 47 boys and 27 girls, and maturation events were then plotted on the curves. Results: For the majority of children, peak velocity in mandibular growth coincided with peak velocity in stature. Particular combinations of hand-wrist and cervical maturation events occurred consistently before, during or after the adolescent growth spurt.

Conclusion: Our findings are consistent with those for North American children and we believe that assessment by orthodontists of a combination of hand-wrist and cervical vertebral maturation stages will enhance prediction of the adolescent growth spurt, thereby contributing to a positive, purposeful and more confident approach to the management of Class II cases.