Skeletal maturity indicators /certified fixed orthodontic courses by Indian dental academy

4,732 views

Published on

Welcome to Indian Dental Academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.


Indian dental academy has a unique training program & curriculum that provides students with exceptional clinical skills and enabling them to return to their office with high level confidence and start treating patients

Published in: Education
0 Comments
18 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total views
4,732
On SlideShare
0
From Embeds
0
Number of Embeds
32
Actions
Shares
0
Downloads
58
Comments
0
Likes
18
Embeds 0
No embeds

No notes for slide

Skeletal maturity indicators /certified fixed orthodontic courses by Indian dental academy

  1. 1. Skeletal Maturity Indicators INDIAN DENTAL ACADEMY Leader in Continuing Dental Education www.indiandentalacademy.com www.indiandentalacademy.com
  2. 2. Introduction Chronological age is often not sufficient for assessing the developmental stage and somatic maturity of the patient. The biological age is determined from the skeletal, dental and morphologic age and the onset of puberty. Due to individual variations in timing, duration and velocity of growth, skeletal age assessment is essential in formulating viable orthodontic treatment plans. www.indiandentalacademy .com
  3. 3. SKELETAL MATURITYINDICATORS PROVIDEAN OBJECTIVEDIAGNOSTICEVALUATION OFSTAGE OF MATURITYIN AN INDIVIDUAL www.indiandentalacademy .com
  4. 4. METHODS AVAILABLE TO ASSESS THE SKELETALMATURITYOF AN INDIVIDUAL-- 1.USE OF HAND WRIST X-RAYS 2.EVALUATION OF SKELETAL MATURATION USING CERVICAL VERTEBRAE 3.ASSESMENT OF MATURITY BY CLINICAL AND RADIOGRAPHIC EXAMINATION OF DIFFERENT STAGES OF TOOTH DEVELOPMENT. www.indiandentalacademy .com
  5. 5. Clinical Importance To determine the amount of significant facial cranial growth potential left and potential vector of facial development. To decide the onset of treatment timing and type of effective treatment. To evaluate the treatment prognosis. To understand the role of genetics and environment on the skeletal maturation pattern. www.indiandentalacademy .com
  6. 6. Anatomical Region Suitable For SkeletalMaturational Assessment Head and Neck : Skull Cervical Vertebrae Upper Limb :Shoulder Joint-Scapula Elbow Hand Wrist and Fingers Lower Limb : Femur and Humerus Hip joint Knee Ankle Foot tarsals and Meta tarsals Tooth mineralization as an indicator. Frontal sinus www.indiandentalacademy .com
  7. 7. Hand Wrist Radiographs Assessment of the skeletal age is often made with the help of a hand radiograph which can be considered the Biological clock. Hand wrist region is made up of numerous small bones. These bone show a predictable and scheduled pattern of appearance, ossification and union from birth to maturity. Hence, this region is one of the most suited to study growth. www.indiandentalacademy .com
  8. 8. Anatomy of Hand-Wrist The hand wrist region is made of four groups of bones 1.Distal ends of long bones of forearm. 2.Carpal 3.Metacarpals 4.Phalanges www.indiandentalacademy .com
  9. 9. Anatomy of skeleton of Hand www.indiandentalacademy .com
  10. 10. Indication Of Hand Wrist Radiographs In patients who exhibit major discrepancy between dental and chronologic age. Determination of skeletal maturity status prior to treatment of skeletal malocclusion. To assess the skeletal age in a patient whose growth is affected by infections, neoplastic or traumatic conditions. Help to predict future skeletal maturation rate and status. To predict the pubertal growth spurt. www.indiandentalacademy .com
  11. 11. Methods Of Assessing Skeletal Age Bjork ,Grave and Brown method Fishman’s skeletal maturity indicators Hagg and Taranger method Atlas method by Greulich and Pyle www.indiandentalacademy .com
  12. 12. www.indiandentalacademy.com
  13. 13. CARPELS INDEXCONSISTS OF EIGHT SMALL IRREGULARLY SHAPED BONES ARRANGEDIN 2 ROWS- - PROXIMAL ROW AND DISYAL ROW SCAPHOID LUNATE PROXIMAL ROWS TRIQUETRAL PISIFORM TRAPEZIUM TRAPEZOID DISTAL ROW CAPITATE HAMMATE www.indiandentalacademy .com
  14. 14. Fishman Skeletal Maturity Indicators  Proposed by Leonard S Fishman in 1982.  Make use of anatomical sites located on thumb, third finger, fifth finger and Radius . www.indiandentalacademy .com
  15. 15. www.indiandentalacademy.com
  16. 16. The Fishman’s system of interpretation Uses four stages of bone maturation 1.Epiphysis equal in width to diaphysis 2.Appearence of adductor sesamoid of thumb 3.Capping of epiphysis. 4.Fusion of epiphysis www.indiandentalacademy .com
  17. 17. Fishman method –Eleven SMIs Width of Epiphysis equal to Diaphysis SMI-1 Third finger-Proximal Phalanx SMI-2 Third finger-Middle Phalanx SMI-3 Fifth finger-Middle Phalanx SMI-4 Appearance of adductor sesamoid of the thumb Capping of Epiphysis SMI-5 Third finger –Distal Phalanx SMI-6 Third finger-Middle Phalanx SMI-7 Fifth finger-Middle Phalanx Fusion of Epiphysis and Diaphysis SMI-8 Third finger-Distal Phalanx SMI-9 Third finger-Proximal Phalanx www.indiandentalacademy SMI-10 Third finger-Middle Phalanx .com SMI-11 Seen in Radius
  18. 18. Maturation Assessment by Hagg andTaranger Analyzed from radiograph taken between the ages of 6 and 18 years, by assessing of the ossification of the ulnar sesamoid of the metacarpophalangeal joint of first finger. Certain specified stages of 3 epiphyseal bone -Middle and distal phalanges of third finger [MP3 and DP3] and distal epiphysis of Radius. www.indiandentalacademy .com
  19. 19. Sesamoid Sesamoid is usually attained during the acceleration period of the pubertal growth spurt [onset of peak height velocity] www.indiandentalacademy .com
  20. 20. Anatomy of skeleton of Hand www.indiandentalacademy .com
  21. 21. Modified MP3 Cervical Vertebrae MP3-F Stage CVMI-1 Start of the curve of pubertal growth spurt . Initiation stage of cervical vertebrae C2,C3 and C4 inferior vertebral body Epiphysis is as wide as metaphysis borders are flat. End of epiphysis are tapered and rounded. Superior vertebral borders are tapered Radiolucent gap [cartilageous epiphyseal growth from posterior to anterior [wedge shape] plate] between epiphysis and metaphysis is wide. 80-100% of pubertal growth remains. www.indiandentalacademy .com
  22. 22. MP3-FG Stage CVMI-2 Acceleration of the curve of pubertal growth spurt. Acceleration stage of cervical vertebrae. Epiphysis is as wide as metaphysis. Concavities are developing in lower Distinct medial and lateral border of epiphysis forms borders of C2 and C3. line of demarcation at right angle to distal border. Lower border of C4 vertebral body is flat. Metaphysis begins to show slight undulation. C3 and C4 are more rectangular in shape. Radiolucent gap between metaphysis and epiphysis is wide. 65-85% of pubertal growth remains. www.indiandentalacademy .com
  23. 23. • MP3-G Stage CVMI-3 Maximum point of pubertal growth spurt. Transition stage of cervical vertebrae Sides of epiphysis have thickened and cap Distinct concavities are seen in lower borders its metaphysis, forming sharp distal edge of C2 and C3. on one or both the sides. Concavity is developing in lower border of C4. Marked undulations in metaphysis give it “Cupid’s bow’’ appearance. C3 and C4 are rectangular in shape. Radiolucent gap is moderate. 25-65% of pubertal growth remains. www.indiandentalacademy .com
  24. 24. MP3-HI Stage CVMI-5 Maturation of the curve of pubertal growth spurt Maturation stage of cervical vertebrae. Superior surface of epiphysis shows smooth Accentuated concavities of C2, C3 and C4 concavity. inferior vertebral body borders are obser Metaphysis shows smooth, convex surface, fitting into reciprocal concavity of epiphysis. C3 and C4 are square in shape. No undulation present in metaphysis. 5-10% of pubertal growth remains. Radiolucent gap is insignificant. www.indiandentalacademy .com
  25. 25. MP3-I Stage CVMI-6 End of pubertal growth spurt Completion stage of cervical vertebrae. Fusion of epiphysis and metaphysis complete. Deep concavities are present in C2, C3 No radiolucent gap. Dense, radiopaque epiphyseal line forms and C4 inferior vertebral body borders. integral part of proximal portion of middle C3 and C4 are greater in height than in width. phalanx. Pubertal growth is completed. www.indiandentalacademy .com
  26. 26. Third finger distal phalanx DP3-1:Fusion of Epiphysis and Metaphysis is completed. -This is attained during the deceleration period of pubertal growth spurt [ end of PHV] . www.indiandentalacademy .com
  27. 27. Radius R-1:Fusion of the epiphysis and Metaphysis has began. -This stage is attained 1 year before or at the end of growth spurt. R-1J:Fusion is almost completed but there is still a small cap at one or both margin. R-J:Characterised by fusion of the epiphysis and metaphysis. These stages were not attained before end of PHV. www.indiandentalacademy .com
  28. 28. Bjork , Grave And Brown Method Male Female Stage1 PP2 = 10.6yr 8.1 Stage2 MP3 = 12.2 8.1 Stage3 Pisi, 12.6 9.6 H1,R= Stage4 S & H2 13.0 10.6 Stage5 MP3,R 14.0 11.0 PP1cap Stage6 DP3U 15.0 13.0 Stage7 PP3U 15.9 13.3 Stage8 MP3U 15.9 13.9 www.indiandentalacademy .com Stage9 RU 18.5 16.0

×