skeletal maturity indicators in orthodontics / fixed orthodontic courses by indian dental academy

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skeletal maturity indicators in orthodontics / fixed orthodontic courses by indian dental academy

  1. 1. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Material &method Sample of 11 groups of 10 males &10 females (20) aged from 10 – 18 yrs radiograph used : lt hand wrist lat ceph Method : Fishman method Lat ceph taken to assess : a) Dens of c2 b) Body of c2 c3 c) Curvature on inferior border of c2 , c3, c4 d) Intervertebral spacing These records were used to assess cervical vertebrae maturation indices www.indiandentalacademy.com
  3. 3. Anatomy of vertebrae www.indiandentalacademy.com
  4. 4. Ossification www.indiandentalacademy.com
  5. 5. www.indiandentalacademy.com
  6. 6. www.indiandentalacademy.com
  7. 7. CVMI 2 www.indiandentalacademy.com
  8. 8. CVMI 3 www.indiandentalacademy.com
  9. 9. CVMI 4 www.indiandentalacademy.com
  10. 10. CVMI 5 www.indiandentalacademy.com
  11. 11. CVMI 6 www.indiandentalacademy.com
  12. 12. Smi grouping       cvmi grouping 1 &2 3&4 5&6 7 &8 9 &10 11 1 2 3 4 5 6 www.indiandentalacademy.com
  13. 13. Cervical vertebrae as maturational indicators PETRICA FERNANDEZ JCO (1998) www.indiandentalacademy.com
  14. 14. Adv : a ) no need for extra radiograph b) detection of abnormalities Disadv : A) subtle changes not appreciated b) postural variation c) radiation protection www.indiandentalacademy.com
  15. 15. Dental age determination Demirjian et al 1973 . Should not rely on last stage of tooth formation 9 stages of dental development have been described : www.indiandentalacademy.com
  16. 16. www.indiandentalacademy.com
  17. 17. Scores given www.indiandentalacademy.com
  18. 18. The calculation is made using a point evaluation system www.indiandentalacademy.com
  19. 19. Tooth mineralization & pubertal growth spurt a study by Seymour Chertkow Relation between the state of maturation of maxillary canine & lower premolars & 2nd molars & known skeletal. Indicators like :    Hook of hamate Sessmoid Epiphysis of middle phalanx of 3rd finger www.indiandentalacademy.com
  20. 20. Results Completion of root formation of mandibular canine prior to apical closure was related to other maturational indicators in white children In black children apical closure had already occurred No sex difference www.indiandentalacademy.com
  21. 21. Relationship between mand canine calcification stages & skeletal maturity BUSCHANG, COUTHINO , MIRANDA Correlation of skeletal. &canine maturity was tested RESULTS : AT STAGE F : do not show sessmoid MP3 , PP5 epiphysis = diaphysis G : presence of sesmoid DP3 , MP3 , PP5 CAP www.indiandentalacademy.com
  22. 22. H : apical closure , fusion of epiphysis with diaphysis CONCLUSION : before PHV I 1 ) initiation of spurt – stage F 2 ) G coincides with eruption of canine 1 yr in boys and 5 months before in girls www.indiandentalacademy.com
  23. 23. www.indiandentalacademy.com
  24. 24. Lower 3rd molar development in relation to skeletal maturity and chronological Age ENGSTROM & SAGNE • IN 60 % PP2 stage - initial crown mineralization • 80% MP3 STAGE - crown formation complete & root formation begins indicates pubertal growth spurt • 70 % DP3u stage – formation of half root length – deceleration phase • AT RU STAGE - 1/3 RD CROWN COMPLETED 1/3 rd –1/2 root developed 1/3 rd root reached full length rd Lower 3 molar developed earlier in boys • www.indiandentalacademy.com -
  25. 25. Maturation evaluation of ossification of mid palatal suture Revello & Fishman (1994) purpose materials and methods : a) occlusal & hand wrist b) 84 pt .( 39 m , 45 f ) Results :   significant correlation Variation exists in the way the suture closes www.indiandentalacademy.com
  26. 26. Location of points www.indiandentalacademy.com
  27. 27. During early stages of maturation : - little or no midpalatal approximation -9 % fusion at smi3 - ant portion of suture is widely open As maturation progresses - approximation increases - 25 % fusion at smi3 During late maturation - inc . Rate of ossification - smi 11 only 50 % suture ossified - no significant sex difference conclusion www.indiandentalacademy.com
  28. 28. Frontal sinus &mandibular growth prediction Rossow , Lambard , Harris Skeletal growth patterns of 103 subjects with cl 1& 3 malocclusions were analyzed as advocated by Ricketts Surface area of frontal sinus was assessed by summagraphics decoder linked to microcomputer www.indiandentalacademy.com
  29. 29. www.indiandentalacademy.com
  30. 30. www.indiandentalacademy.com
  31. 31. Assessment of growth impetus using mp3 maturation & its correlation with cvmi & dental age I. Iso (2003 ) – Ks Negi , Y. sharma PURPOSE : compare changes in middle phalanx of 3rd finger , cervical vertebrae & developmental stages of max. rt canine during skeletal Maturation 160 children (80 +80) www.indiandentalacademy.com
  32. 32. Conclusion :  sexual dimorphism  highly significant correlation between cvmi & mp3  Canine maturation has inconsistent correlation www.indiandentalacademy.com
  33. 33. Correlation between CVMI & MP3 www.indiandentalacademy.com
  34. 34. Cervical vertebral maturation as predictor of adolescent growth spurt KEITH GRAVE ,GRANTTOWN STEND AUS ORTH J , (2003) www.indiandentalacademy.com
  35. 35. Mandibular growth as related to cervical vertebral maturation & body height FRANCHI , BACETTI , MACNAMARA (AJO 2000) Material & method : 24 individuals (15 f , 9 m ), lat ceph taken www.indiandentalacademy.com
  36. 36. www.indiandentalacademy.com
  37. 37. DENTOFACIAL ORTHOPEDICS IN RELATION TO SOMATIC MATURATION HANS PANCHEVZ & HAGG AJO ( 1985 )  mandibular treatment changes was related to somatic maturation in cases with cl 2 mal treated for 7 mnths  somatic maturity assessed by recording standing ht  treatment period were correlated with phv RESULTS : 1) sagital condylar growth more in peak www.indiandentalacademy.com
  38. 38. Tooth mineralization &pubertal growth spurt Richard smith Stage of tooth Hook of hamate Epiphysis of mp3 inference 1 Root length = or >crown Incomplete length calcification Epiphysis = diaphysis Growth spurt not started 2 Walls of root canal parallel open apex Completely calcified increase 3 Apex closed calcified Mp3 cap Shortly before beginning pubertal growth spurt Pubertal growth spurt www.indiandentalacademy.com
  39. 39. conclusion Growth factor is a critical variable in orthodontic treatment Using treatment element of timing of maximum growth in conjunction with knowledge of magnitude &direction one can readily transform orthodontic profession from mere tooth positioning to one involving face forming www.indiandentalacademy.com
  40. 40. Thank you For more details please visit www.indiandentalacademy.com www.indiandentalacademy.com

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