http://dx.doi.org/10.5933/jkapd.2012.39.4.357 대한소아치과학회지 39(4) 2012 소아청소년기정상교합아동에서경추골및수완부골성숙도에대한하악골성장의연관성 김수영 양규호 최남기 김선미 전남대학교치의학전문대학원소아치과학교실 국문초록교정치료에는치아를움직이는치열교정치료와골격적인이동을도모하는악정형치료가있다. 소아청소년기아동에서특히악정형치료를위해서는골성숙도와성장잠재력의평가가매우중요하다. 본연구의목적은 6 13세정상교합아동을대상으로측모두부규격방사선사진과수완부골방사선사진을촬영하여발달단계를평가하고하악골성장량을비교한것으로다음과같은연구결과를얻었다. SMI와 CVM은유의한상관관계를나타냈다 (p < 0.05). 수완부골성숙도가증가할수록 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn이증가하였고, 경추골성숙도가증가할수록 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co- Gn, Go-Me, Go-Gn이증가하였다. 또한 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn은경추및수완부골성숙도와각각유의한상관성을보였다 (p < 0.05). 이상의결과로하악골성장은경추및수완부골성숙도와유의한상관성이있음을알게되었다. 주요어 : 경추골성숙도, 수완부골성숙도, 하악골성장 Ⅰ. 서론소아청소년기에성장을이용한교정치료를악정형치료라한다. 골격성부정교합은성장정도에따라치료법이달라질수있으므로충분한효과를얻기위해서는환자의성장이얼마나진행되었는지평가해야한다 1-4). 특히 Class II 악골열성장교정을위한악기능교정장치의사용시하악골성장을평가하는것은대단히중요하다. 악정형치료의주목적은하악두연골의성장을촉진해서하악의성장을유도하는것이다 5). 치료효과는하악의성장률에달려있으므로하악골의성숙도와잠재적성장의평가는치료결과를예측하는데필수적인정보를제공한다 1). 두개안면부는성장양상이복잡하고개인차가크다. 두개안면부의성장을평가하는방법으로신장, 체중, 연령, 골성숙도, 치아성숙도등이사용될수있다 6). 하지만성장과발육의평가를위해사용되는연대연령과발육연령의경우신체발육정도는개개인에따라차이가크며연대연령만으로환자의정확한 성장시기를판단하기힘들다 7). 최근에는골성숙도를이용한방법이두개안면부의성장을측정하는지표가되었다 8,9). 1982년 Fishman 10) 은안면부성장과수완부골성장단계의연관성을연구하여 11단계의수완부골성숙도인 skeletal maturity indicators (SMI) 를제안하였다. Lamparski 11) 는경추를이용한 cervical vertebrae maturation stages (CVM) 를제안하였고, 성장을평가하는데수완부만큼적절하며측모두부규격방사선사진에경추가관찰되므로추가적인방사선노출이없다는장점을보고하였다. Hassel과 Farman 4), Garcl a -Fernandez 등 12) 은경추성숙도와수완부성숙도사이에연관성이있음을발견했고, Mitani와 Sato 13) 는경추의변화가하악의크기증가와연관이있다고보고하였다. 따라서본연구의목적은 6 13세정상교합아동을대상으로측모두부규격방사선사진과수완부골사진을촬영하여발달단계를평가하고하악골성장량을비교하는것이다. 동일소아청소년에대해같은날찍은측모두부규격방사선사진과수 교신저자 : 김선미광주광역시북구용봉로 77 번지 / 전남대학교치의학전문대학원소아치과학교실 / 062-530-5668 / smkim1406@hanmail.net 원고접수일 : 2012 년 05 월 13 일 / 원고최종수정일 : 2012 년 10 월 13 일 / 원고채택일 : 2012 년 10 월 23 일 357
J Korean Acad Pediatr Dent 39(4) 2012 완부골방사선사진을평가하여경추및수완부골성숙도를조사한후하악골성장을나타내는계측항목인 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn에서경추와수완골성숙도를비교연구하였다. Ⅱ. 연구대상및방법 1. 연구대상 2008년부터 2010년까지전남대학교치과병원소아치과에내원한성장기소아청소년으로서교정진단을위해같은날측모두부규격방사선사진과수완부골방사선사진을촬영한환아를연구대상으로하였다. 방사선사진상유치열의상, 하악제2유구치의원심면이같은수직평면관계이거나근심계단관계, 혼합치열기의경우 Class I molar key를가지며교정치료를받은적이없고, 치열에총생이없거나미미하며치아들이정상적인해부학구조를가진조건을만족하는 6 13세남자및여자아이 104명을연구대상으로하였다 (Table 1, 2). 2) 경추골성숙도평가경추골성숙도는측모두부규격방사선사진으로촬영한제2 경추부터제6경추까지경추몸통형태를관찰하여 Lamparski 11) 가제안한 6단계로평가하였다 (Fig. 2). Stage 1 (CVS 1). 모든경추의하연이편평하다. 상연은후방에서전방으로 taper되어있다. Stage 2 (CVS 2). 2번째경추의하연이오목하다. 추체의전방높이가증가한다. Stage 3 (CVS 3). 3번째경추의하연이오목하다. Stage 4 (CVS 4). 4번째경추의하연이오목하다. 5번째와 6번째경추의하연이오목해지기시작한다. 모든경추의 body가직사각형모양이다. Stage 5 (CVS 5). 경추 6개모두하연이오목하다. body는거의정사각형이고 body 사이공간이감소한다. Stage 6 (CVS 6). 하연이더오목해진다. body는너비보다높이가더높다. 2. 연구방법 1) 수완부골성숙도평가수완부골성숙도는수완부골방사선사진을통하여 Fishman 10) 이제안한수완부골성숙도 SMI 11단계로평가하였다. SMI는수완부의 6부위 ( 모지척측종자골, 중지의근절골과중절골, 말절골, 약지의중절골, 요골 ) 의골화단계 ( 골단이골간과폭이같아지는시기, 모지척측종자골의출현시기, 골단이골간에 capping되는시기, 골단이골간에융합되는시기 ) 를관찰하여사춘기발육의전과정을 11단계로평가하는방법이다 (Fig. 1). Table 1. Gender distribution Frequency Percent (%) F 64 61.5 M 40 38.5 Total 104 100 Fig. 1. Eleven skeletal maturity indicators (SMIs). Table 2. Age distribution Age Frequency Percent (%) 6 2 1.9 7 8 7.7 8 21 20.2 9 27 26.0 10 11 10.6 11 20 19.2 12 7 6.7 13 8 7.7 Total 104 100 Fig. 2. Six stages cervical vertebral maturation. 358
대한소아치과학회지 39(4) 2012 Table 3. Mean and standard deviation of subjects' age Number 104 Median 9.59 Standard Deviation 1.755 Variance 3.080 Minimum 6 Maximum 13 Fig. 3. Cephalometric landmarks measurements. 연령별 SMI와 CVM의분포를조사하였고, 성별및나이에따른비율을통계분석하였다. 하악골성장계측항목과경추및수완부골성숙도와의상관관계를알아보고자 Spearman의순위상관계수를이용하여분석하였다. 통계처리는컴퓨터소프트웨어 SPSS (PASW) statistics 18.0을이용하였다. Ⅲ. 연구성적 3) 하악골성장평가하악골의성장을평가하기위하여측모두부규격방사선사진을촬영하여일곱군데계측점 (S, N, Ar, Go, Co, Gn, Me) 을연결한선으로 8가지의계측항목을정하였다 (Fig. 3). S는안장 (sella turcica) 의중점, N은이마코봉합 (frontonasal suture) 의최전방점, Ar은후두개저 (posterior cranial base surface) 와하악과두후방면 (condylar head or neck) 의교차점, Go는하악평면 (mandibular plane) 과아래턱가지 (ramus) 의이등분점, Co는 Condyle의최후방점, Gn은하악평면 (mandibular plane) 과 facial plane의이등분점, Me은턱 (symphysis) 의최하방점으로하였다. 4) 통계학적분석표본에대하여측모두부규격방사선사진과수완부골방사선사진은같은날촬영이이루어졌으며, 방사선사진판독경험이있는치과의사 2명이투명지상에서 tracing하여서로비교하며각각의단계를평가하고, 하악골성장을평가하기위한항목을계측하였다. 이연구에서계측치측정에대한신뢰도를평가하기위하여 1주후연구대상자가운데 30명의동일한측모두부규격방사선사진과수완부골방사선사진을무작위로골라재검사하여경추및수완부의골성숙도를다시측정하였다. 이때저자의처음검사와재검사사이의측정오차를 Dahlberg 16) 식을이용하여계산하였다. S = D 2 /2N S: 측정오차, D: 일치하지않은정도, N: 연구대상자수 경추골성숙도재검사에서 30명중 1명이처음결과와다르게나왔고수완부골성숙도재검사에서는 2명에서다른결과를나타냈다. 오차범위는모두 1단계의오차를보였다. Dahlberg 16) 식에의한경추골성숙도의측정오차는 0.12이고, 수완부골성숙도의측정오차는 0.18이었다. 이는경추골및수완부골성숙도측정에대한평균오차를나타내며값이작을수록더욱신뢰할수있다. 시행된표본의평균연령은 9.59세이고최소연령은 6세, 최대연령은 13세였다 (Table 3). Table 4는연령별 SMI와 CVM의분포를나타내고있다. 연령이증가함에따라주로관찰되는 SMI와 CVM의단계는점차증가하지만 10세에 SMI 1 4, CVM 1 3, 11세에 SMI 2 8, CVM 1 5단계로다양하게나타나는것으로보아연령을성숙도평가기준으로삼기는어렵다는것을알수있다. Table 5는성별에따른 CVM에대한 SMI값이다. 표본중여성은 61.5% 남성은 38.5% 로여성의비율이높았다. CVM 2단계에서 SMI 4단계의남, 녀비율이 7:1로여성의성장이더빨리시작됨을알수있었다. Table 6 은각경추골성숙도에해당되는하악골계측항목 (Ar-Go, Co- Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn) 의평균과표본수, 표준편차를나타낸다. 모든계측항목의측정값은경추골성숙도가증가함에따라 5단계를제외하고증가하는양상을보였으며, 이는 5단계의표본수가매우적기때문으로생각된다. 또한수완부골성숙도가증가함에따라하악골계측항목 (Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn) 은표본수가매우적은 5, 10단계를제외하고대체로증가하였다 (Table 7). 하악골계측항목에서경추및수완부골성숙도와의상관관계를조사한결과두항목모두강한상관성을나타냈다 (r = 0.280 0.484, ** : p < 0.01) (Table 8). 359
J Korean Acad Pediatr Dent 39(4) 2012 Table 4. Age distribution of SMI and CVM Age SMI (Frequency) CVM (Frequency) 6 1(2) 1(2) 7 1(7) 1(8) 4(1) 8 1(17) 1(19) 2(4) 2(2) 9 1(7) 1(18) 2(8) 2(9) 3(11) 4(1) 10 1(2) 1(5) 2(4) 2(5) 3(4) 3(1) 4(1) 11 2(3) 1(3) 3(8) 2(14) 4(5) 3(2) 5(1) 5(1) 6(1) 7(1) 8(1) 12 3(3) 1(2) 4(1) 2(2) 6(2) 3(3) 7(1) 13 3(1) 2(2) 4(1) 3(2) 6(2) 4(3) 7(1) 5(1) 8(2) 10(1) Total (104) Total (104) Table 5. Gender distribution of SMI degree for CVM CVM Gender F M Total 1 SMI 1 19 15 34 2 11 5 16 3 2 4 6 4 1 24 1 Total 33 57 2 SMI 1 2 1 1 2 9 12 2 3 7 1 21 4 1 14 8 5 1 1 7 20 1 Total 34 3 SMI 2 1 1 1 4 1 1 1 6 3 4 7 1 1 8 1 1 Total 7 8 4 SMI 7 1 1 8 2 2 Total 3 3 5 SMI 6 1 1 1 10 1 1 1 Total 1 1 2 Fig. 4. Gender distribution of SMI at each CVM stage. 360
대한소아치과학회지 39(4) 2012 Table 6. Mean of mandibular length measurements at each CVM CVM Mandibular length measurements (mm) Ar-Go Co-Go N-Go S-Gn N-Me Co-Gn Go-Me Go-Gn 1. Mean 40.1 48.5 110.2 117.6 112.4 107.7 66.5 74.3 N 57 57 57 57 57 57 57 57 SD 3.7 3.9 5.6 6.0 6.4 5.5 5.0 5.1 2. Mean 42.1 50.9 113.4 121.3 115.5 111.6 69.4 76.6 N 34 34 34 34 34 34 34 34 SD 3.9 3.4 6.3 5.2 5.9 4.8 4.9 4.9 3. Mean 44 51.9 115.3 124.6 120.2 115.3 71.1 77.7 N 8 8 8 8 8 8 8 8 SD 3.4 3.6 4.3 6.3 6.2 9.9 2.9 3.5 4. Mean 47 56.3 118.8 129.5 120.3 118.8 72.1 80.1 N 3 3 3 3 3 3 3 3 SD 1 1.8 8.7 3.2 1.1 3.3 4.6 6.7 5. Mean 41 51.5 113.7 130.7 122.5 119.5 76.7 83.2 N 2 2 2 2 2 2 2 2 SD 1.4 0.7 3.1 10 6.3 7.7 6.1 6.7 Total Mean 41.3 49.8 111.9 119.9 114.4 110.1 68.2 75.7 N 104 104 104 104 104 104 104 104 SD 4 4 6.1 6.5 6.6 6.4 5.2 5.2 Table 7. Mean of mandibular length measurements at each SMI SMI Mandibular length measurements (mm) Ar-Go Co-Go N-Go S-Gn N-Me Co-Gn Go-Me Go-Gn 1. Mean 40.0 48.4 108.3 116.3 110.5 106.6 65.1 72.9 N 35 35 35 35 35 35 35 35 SD 3.2 3.3 5.3 5.9 6.5 5.7 5.0 5.1 2. Mean 39.3 48.2 111.5 118.7 114.5 109.5 68.5 76.1 N 19 19 19 19 19 19 19 19 SD 3.97 4.0 5.7 5.4 5.2 4.7 4.0 4.3 3. Mean 41.8 50.1 113.6 121.4 115.9 111.1 69.2 76.5 N 27 27 27 27 27 27 27 27 SD 3.9 3.7 5.3 5.3 5.8 5.8 4.7 5.0 4. Mean 43.7 52.7 113.9 121.9 115.5 111.6 69.1 76.4 N 10 10 10 10 10 10 10 10 SD 3.9 3.7 6.2 4.4 5.4 3.2 4.4 4.3 5. Mean 47.0 56.0 122.0 129.0 121.0 117.0 75.5 83.0 N 1 1 1 1 1 1 1 1 SD 6. Mean 44.4 52.4 116.2 123.0 118.6 113.2 71.2 77.9 N 5 5 5 5 5 5 5 5 SD 3.7 3.5 2.8 4.1 3.3 4.7 2.41 2.8 7. Mean 43.5 53.1 120.1 125.2 118.9 115.8 74.5 81.8 N 3 3 3 3 3 3 3 3 SD 4.5 4.8 6.9 6.3 2.5 5.7 3.9 5.4 8. Mean 46.6 55.1 116.1 131.3 124.6 124.0 72.0 78.8 N 3 3 3 3 3 3 3 3 SD 0.5 0.2 5.0 6.1 8.1 12.1 4.3 4.4 10. Mean 40.0 52.0 116.0 138.5 127.0 125.0 81.0 88.0 N 1 1 1 1 1 1 1 1 SD Total Mean 41.3 49.8 111.9 119.9 114.4 110.1 68.2 75.7 N 104 104 104 104 104 104 104 104 SD 4.0 4.2 6.1 6.5 6.6 6.4 5.2 5.2 361
J Korean Acad Pediatr Dent 39(4) 2012 Fig. 5. Changes of mandibular length according to CVM stages. Fig. 6. Changes of mandibular length according to SMI stages. Table 8. Correlation between bone maturity and mandibular length measurements Bone maturity Mandibular length SMI CVM AR-Go.403**.359** CO-Go.433**.380** N-GO.484**.325** S-Gn.483**.432** N-Me.456**.379** Co-Gn.466**.428** GO-Me.450**.372** GO-Gn.370**.280** Spearman's rank correlation coefficient (** : p < 0.01) SMI = skeletal maturity indicators, CVM = cervical vertebrae maturation stages Ⅳ. 총괄및고찰 소아청소년기악정형치료시성장에대한평가는매우중요하다. 성장정도에따라치료법이달라질수있으며, 치료효과역시차이를보일수있다 1-4). 특히 Class II 악골열성장교정을위한악기능교정장치의사용시하악골성장을평가하는것은대단히중요하다 17). Björk 18) 는신장의 longitudinal growth records를치료계획을세울때하나의방법으로쓸수있다고했다. Tanner 19) 는신장을이용한악안면평가는누년적인자료가필요하고판단이후향적이므로진단및치료계획수립이어렵다고했다. Marshall 등 20) 은청소년기급성장은모든사람에게서일어나지만시작시기, 기간그리고생애의이기간동안의성장률에있어서는다양한개인차가있어교정치료시개인의성장정도를반드시평가해야한다고했다. 개인의성장평가에서 Fishman 10) 은안면부성장이수완부골방사선사진의성장단계변화와일치한다고주장하였고, Lamparski 11) 는골성숙도를평가하는데경추는임상적으로수완부처럼신뢰할수 있다고주장하였다. 또한 Liliequist와 Lundberg 21) 는환자의연령이성숙도를예측하는수단이될수있으나 SMI와 CVM 에비해부정확할수있다고보고하였다. 따라서, 본연구에서는성장정도의단계를알아보고자여러성장지표중골성숙도를사용하였다. 강등 22) 은최대성장 1년전과일치하는종자골이출현하는 SMI 4단계는 CVM 2단계와유사하고, 대부분성장이완료된 SMI 10단계에서경추골은 CVM 5단계와일치한다고주장하였다. 본연구에서도강등 22) 의연구결과와유사하게 SMI 1, 2 단계는 CVM 1단계, SMI 3, 4단계는 CVM 2단계에해당하는상관관계가나타났다 (Table 5, Fig. 4). 수완부골성숙도는 11 단계이므로 6단계의경추골성숙도보다더세분화되어일정한크기변화는기대하기어렵다 (Table 6, 7, Fig. 5, 6). 모든계측항목의측정값은경추골성숙도가증가함에따라 5 단계를제외하고증가하는양상을보였으며, 이는 5단계의표본수가매우적기때문으로생각된다. 또한수완부골성숙도가증가함에하악골계측항목 (Ar-Go, Co-Go, N-Go, S-Gn, N- Me, Co-Gn, Go-Me, Go-Gn) 은표본수가매우적은 5, 10단계를제외하고대체로증가하였다 (Table 7, Fig. 6). 특히하악골계측항목중 S-Gn, Co-Gn, Go-Me, Go-Gn은경추골성숙도와유사한경향을보였다 (Fig. 5). 하악골계측항목과골성숙도를비교한연구들에서도골성숙도가증가할수록계측항목이일부구간을제외하고는일정한증가를보고하였다 23,24). 이연구들은신체의골격들이매우유사하게성장하고있음을보여준다. 수완부골성숙도평가에서 Fishman의 SMI 1 3단계는사춘기전, 4 7단계는사춘기, 8 11단계는사춘기후이므로 SMI 4 7단계에서악정형치료를하는것이효과적이다 25,26). Kamel 등 27) 은초기교정적인팽창에이상적인시기는 CVM 1 과 2의초기성숙단계동안이고교정적인수술은 CVM 6이나이후에계획해야함을말했다. 본연구결과환자의연대연령보다는경추골및수완부골성숙도가하악골성장과연관성을보 362
대한소아치과학회지 39(4) 2012 였으며 Class II 악골열성장교정을위한악기능교정장치의사용시기는사춘기가시작되는 CVM 2단계와 SMI 4단계가적절할것으로생각된다. 이는너무이른시기에교정치료를시작할경우치료기간이길어지고효율성이감소할수있으며, 최대성장기가지나서치료시기를놓칠경우성장조절치료의효과가거의나타나지않기때문에성장이완료되지않은부정교합환자에서는성장과발육시기를 SMI와 CVM을이용하여적절히파악해야한다. 골성숙도및계측점평가시방사선의선명도에따라평가자의주관적인면이많이작용한다. 이를최소화하기위해가능한선명도가높은방사선사진을가진사람을연구대상자로택함으로써재검사오차수치를비교적줄였다. 하악골계측항목에서경추및수완부골성숙도와의상관관계를비모수적인방법인 Spearman의순위상관계수로조사하였다. 그결과모든계측항목에서하악골성장은경추및수완부골성숙도와강한상관성을나타냈다 (r = 0.280 0.484, ** : p < 0.01) (Table 8). 그러나본연구는표본의수가적고누년적연구가필요하므로향후이에대한지속적인연구가필요할것으로사료된다. Ⅴ. 결론소아청소년기정상교합아동에서경추골및수완부골성숙도에대한하악골성장의연관성을알아보기위하여 6 13세남녀아동 104명을대상으로측모두부규격방사선사진과수완부골방사선사진을이용하여분석하고다음과같은결과를얻었다. SMI와 CVM은유의한상관관계를나타냈다 (p < 0.05). 수완부골성숙도가증가할수록하악골성장을나타내는 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn이증가하였고, 경추골성숙도가증가할수록 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn이증가하였다. 또한 Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go- Gn은경추및수완부골성숙도와각각유의한상관성을보였다 (p < 0.05). 이상의결과는하악골성장이경추및수완부골성숙도와유의한상관성이있음을시사한다. 참고문헌 1. Bishara SE, Jamison JE, Peterson LC, Dekock WH : Longitudinal change in standing height and mandibular parameters between the age of 8 and 17 years. Am J Orthod, 80:115-135, 1981. 2. Burstone CJ : Process of maturation and growth prediction. Am J Orthod, 49:907-919, 1963. 3. Pancherz H, Hagg U : Dentofacial orthopedics in relation to somatic maturation. An analysis of 70 consecutive cases treated with the Herbst appliance. Am J Orthod, 88:273-287, 1985. 4. Hassel B, Farman AG : Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop, 107:58-66, 1995. 5. Petrovic A, Stutzmann J, Lavergne J : Mechanism of craniofacial growth and modus operandi of functional appliances: a cell-level and cybernetic approach to orthodontic decision making. In: Carlson DS, ed. Craniofacial growth theory and orthodontic treatment. Craniofacial Growth Series, Vol 23, Ann Arbor: Center for Human Growth and Development, The University of Michigan, 1990. 6. Choi BS, Choi NK, Chung SS, et al. : Usefulness of cervical vertebrae maturation stage as a mandibular maturation indicator. J Korean Acad Pediatr Dent, 34:551-559, 2007. 7. Kim MG, Yang KH, Kim JS, et al. : The comparative study of correlation on hand-wrist with cervical vertebrae for skeletal maturation in mixed dentition children with normal occlusion. J Korean Acad Pediatr Dent, 38:237-243, 2011. 8. Hunter CJ : The correlation of facial growth with body height and skeletal maturation at adolescence. Angle Orthod, 36:44-53, 1966. 9. Singh IJ, Savara BS, Newman MT : Growth in the skeletal and nonskeletal components of head width from 9 to 14 years of age. Hum Biol, 39:182-191, 1967. 10. Fishman LS : Radiographic evaluation of skeletal maturation. A clinically oriented method based on hand-wrist films. Angle Orthod, 52:81-112, 1982. 11. Lamparski DG : Skeletal age assessment utilizing cervical vertebrae. Am J Orthod, 67:458-459, 1975. 12. Garcl a-fernandez P, Torre H, Flores L, Rea J : The cervical vertebrae as maturational indicators. J Clin Orthod, 32:221-225, 1998. 13. Mitani H, Sato K : Comparison of mandibular growth with other variables during puberty. Angle Orthod, 62:217-222, 1992. 14. Baek SH, Kim KH, Park JW, et al. : Early orthodontic treatment. Jeesung Publishing co., Seoul, 27-95, 2008. 15. Yang WS, Kim TW, Baek SH : Current orthodontic diagnosis. Jeesung Publishing co., Seoul, 96-98, 2007. 16. Dahlberg G : Statistical Methods for Medical and Biological Students. George Allen and Unwin Ltd, London, 122-132, 1948. 363
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대한소아치과학회지 39(4) 2012 Abstract STATISTICAL CORRELATION ANALYSIS OF CVM, SMI AND MANDIBULAR LENGTH WITH NORMAL OCCLUSION IN GROWING CHILDREN Soo-Yung Kim, Kyu-Ho Yang, Nam-Ki Choi, Seon-Mi Kim Department of Pediatric Dentistry, School of Dentistry, Chonnam National University There are orthodontic treatment which involves tooth movements and orthopedic treatment which involves skeletal movement. In childhood and adolescence, especially for the treatment of orthopedic treatment, the evaluation of bone maturity and growth potential is very important. The purpose of this study is to assess the developmental stage and to compare the amount of mandibular growth with cephalometric radiographs and hand-wrist radiograph in 6 to 13-year-old children with normal occlusion. The results are as follows : SMI and CVM showed a significant correlation (p < 0.05). Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go-Me, Go-Gn increased with increasing maturity of hand-wrist and Ar-Go, Co-Go, N-Go, S-Gn, N-Me, Co-Gn, Go- Me, Go-Gn increased with increasing maturity of cervical vertebrae maturation. Also Ar-Go, Co-Go, N-Go, S- Gn, N-Me, Co-Gn, Go-Me, Go-Gn showed a significant correlation with each of the cervical vertebrae maturation stages and hand-wrist maturation stages (p < 0.05). These results suggested that mandibular growth had a significant correlation with cervical vertebrae maturation stages and hand-wrist maturation stages. Key words : Cervical vertebrae maturation stages, Hand-wrist Skeletal maturity indicators, Mandibular growth 365