Growth Assessment Parameter

1. Md. Rifat Waliullah
SDC-13,Roll-55,Is-33
Sapporo Dental College &
Hospital
GROWTH ASSESSMENT
PARAMETERS

2. Contents
 Types of age according to Krogman
 Somatotypic Age
 Chronologic Age
 Height and Weight Age
 Sexual Age
 Facial Age
 Skeletal Age
 Dental Age
 Conclusion
 Reference

3. Types of age according to Krogman
• Chronologic age
• Biologic age
- Morphologic age
- Skeletal age
- Dental age
- Circumpubertal age
• Behavioral age
• Mental age
• Self concept age

4. Somatotypic Age
In the overall assessment of child a general somatotype may be appreciated.
Sheldon defined somatotype by a series of 17 anthropometric measurements and is not related to
nutritional status.
- Endomorph: Stocky abundant subcutaneous fat, digestive viscera that highly developed.A
person with an endomorphic body type has a tendency to put on fat,has a soft roundness of
shape,short tapering limbs,small bones and wide hips
- Mesomorph: Upright, sturdy, athletic,muscle bone and connective tissue predominate.A person
with a mesomorphic body shape usually has a high proportion of muscle and bone,a large trunk,a heavy
chest,broad shoulders and narrow hips.
- Ectomorph: Tall, thin and fragile with minimal subcutaneous fat and muscle tissue.A person with
an ectomorphic body shape has a lean,fragile,delicate body,small bones and is narrow at the shoulders
and hips.

5. In terms of chronologic age ectomorph is a late maturer whereas
endomorph is an early maturer.
Although somatotype may give gestalt about child's developmental
pattern,it is not on accurate predictor of growth.

6. Chronologic Age

7. • This is the most obvious and most easily determined developmental age
parameter, which is figured from child's date of birth.
• There might be difference in children of same chronologic age due to
difference in thing of maturation, diseases and various environmental factors.
• Although it is easy to determine but, chronologic age is not an accurate
indicator of development nor is it a good predictor of growth.

8. Height and Weight Age
• Height has been commonly employed as determinant of
development age.
▪ The standard growth curve commonly employed to
characterize a child's height compared, to that of children
of same chronologic age is used to assess development
age.

10. • Growth of all children up to puberty follows nearly the same curves but the difference in
adolescent growth spurts change the growth curves during and after puberty greatly.
• Because height of each child is related to genetic as well as environmental factors it is clear
that a single measurement is limited as a predictor of development age.
• If at all height age has to be considered then longitudinal height of a child which expresses the
child's own growth curve is of more value.
• Weight and height age are corelated well with each other but weight age alone is a poor
indicator if growth or developmental age owing to a large number of variations.
• Clinical implications of this age are that earlier the spurt occurs shorter it is and therefore
late matures are taller which also accounts for the difference in males and females.

11. Sexual Age
• At puberty differential hormones actions yield characteristic body charges.
• These changes are classified into five stages according to Reynolds EL, Wines IV and
Tanner JM.
• They outlined the stages of secondary sexual characteristics and their relation to
pubertal growth spurt in height and their relation with developmental age.

12. Stage Public hair ratings for girls and
boys
Breast development ratings in girls Genitalia matuirity
rating in boys
Stage 1 No pubic hair Elevtion of papilla only Testes,penis is same
size and proportion
as in childhood
Stage 2 Sparse growth,straight hair Enlargement of breast bud with
increase in areolar diameter
Enlargement of
testes and scrotum
with change in
texture of skin
Stage 3 Dark,coarse,curled hair Further enlargement without
separation of contour of areola
from breast
Enlargement of penis
in length with
continued growth of
testes and scrotum
Stage 4 Adult type hair but cover less
area
Projection of areola to form a
secondary mound
Increase in breadth
of penis with glan
development and
continued
enlargement of
testes
Stage 5 Adult quality and type with
spread to medial surface of
thigh
Further projection of papilla Adult size and shape

13. Facial Age

14. • The ultimate goal of developmental growth assessment of children being
evaluated for craniofacial intervention is facial age.
• Ihe aim is to identify Whether they are on their own facial growth curve and to use
this as a predictor of future growth.
• Various methods used for measurement of facial age andprediction of craniofacial
growth are anthropometric measurement, facial growth velocity curve and
cephalometric radiographs

15. Skeletal Age
• This is a very important aspect of assessing the developmental age of child as skeletal age was
found to more highly correlate with the developmental age than any other growth parameter.
• Each endochondral bone begins with a primary center of ossification which then changes
shape, size and contour till its fusion.
• Any of the skeletal growth centers can be used for skeletal age assessment but hand and wrist
have been most commonly used for assessment of pubertal maturation.
• Advantages of using skeletal age are readily recognizable stage of ossification; regular
sequence of developmental changes occurring from birth to adulthood.

17. Dental Age
• Dental age is estimated according to the last tooth erupted in oral
cavity in normal sequence.
• This is the simplest but, the least accurate method.
• This involves recognizing the teeth clinically present in the oral
cavity in comparison to dental eruption charts.
• The disadvantages of this technique are the wide variations in
time of eruption, influence of local and environmental factors and
the fact that no or several teeth may erupt during the same time
interval.

18. Conclusion
The correct knowledge of facial age, developmental
age,chronologic age, etc. is very necessary for formulating
treatment plan.
These anthropometric measurements are also uselul in the
interdisciplinary evaluation of patients.

19. Reference
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4. Greulich WW, Pyle SI. Radiographic atlas of skeletal development of hand and wrist. Ed. 2; Stanford, California:
Stanford University Press; 1959
5. Tanner JM, Whitehouse RH, Marshall WA. Assessment of skeletal maturity and prediction of adult height. New York;
Academic press Inc. 1975
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