The document discusses methods for predicting craniofacial growth, including various cephalometric and non-cephalometric techniques, as well as the significance of facial growth trends identified by Tweed. It emphasizes the importance of understanding growth patterns for effective orthodontic treatment planning and evaluation. Additionally, factors such as tooth mineralization and frontal sinus development are explored as indicators of growth spurts and mandibular growth potential.

1. Growth Predection

2. • 1. Introduction.
• 2. Method of Predicting Craniofacial Growth.
• 3. Tweed’s facial growth trends.
• 4. Prediction of mandibular growth rotations.
• 5. Arcial growth prediction (Ricketts, 1972).
• 6. Tooth mineralization as an indicator of the
pubertal growth spurt.
• 7. Frontal sinus as a predictor of mandibular
growth.

3. • 8. Visualized treatment Objective.
• 9. Hand wrist radiograph.
• 10. Skeletal Maturity Indicators (SMI).
• 11. Cervical vertebrae evaluation (Hassel and
Farman,in 1995).
• 12. Computerised growth prediction.

4. 1. Introduction
• Growth prediction is an estimation of the
amount of growth to be expected.
• In orthodontics the term refers to the
estimation of amount and direction of growth
of the bones of the craniofacial skeletal and
overlying soft tissues.

5. • Successful prediction requires specifying both
the amount and the direction of growth, in
relation to the reference point.

6. 2. Method of Predicting Craniofacial Growth
Bjork, in 1969, described three methods for
predicting the craniofacial development
• 1. Longitudinal method
• 2. Metric method
• 3. Structural method

7. Longitudinal method
• This is a commonly used method in which
tracing periodic cephalometric radiographs
follows the course of development.
• In the period of most rapid growth this may
be established within a year or two.

8. Limitation:
Pattern and rate of growth is not constant and
pattern recorded at a juvenile age may will be
changed by adolescents.

9. Metric method
prediction of the facial development on the
basis of the facial morphology determined
metrically from a single radiographic film.

10. Structural method
This is based on the information concerning of
the remodelling process of the mandible during
growth, gained from the implant studies by
Bjork.

11. Classification of growth prediction methods
Cephalometric method
1. Moorrees mesh
2. Johnston’s transformation
grid.
3. Jacobson’s grid
4. Broadbent’s method
5. Fishman’s method
6. Sneath’s transformation grid
7. Bjork’s implant growth
rotation studies
8. Rickett’s arcial growth of
mandible
9. VTOs (Holdaway’s,
Rickett’s and other methods)
Non-cephalometric methods.
1. Moss’s logarithmic spiral
2. Hirschfield and Moyers
method
3. Mckeown’s allometric
method
4. Todd’s equation
5. Finite element method

12. 3. Tweed’s facial growth trends
Tweed, in 1954, presented his work on diagnostic facial
triangle. It is a clinical treatment planning tool that
attempts to establish the prognosis of treatment.

14. The following three planes form this triangle;
1. Frankfort horizontal plane
2. Mandibular plane
3. Mandibular incisor plane
Three angles formed are named as;
1. Frankfort mandibular plane angle (FMA)
2. Incisor mandibular plane angle (IMPA)
3. Frankfort mandibular incisor plane angle (FMIA)

16. Facial growth
trends
TypeA
25%
TypeB
15%
Type C
60%

17. Type A growth trend
• Growth is approximately equal in both vertical and
horizontal directions.
• No change in ANB angle.
• Maxilla nad mandible grow together.
• If it is associated with Class 1 molar relationship
and ANB not exceeding 4.5 degrees, no treatment
is indicated

18. TYPE A subdivision
• Maxilla protrudes(class II) with ANB exceeding
4.5.
• Restriction of growth of maxilla and allowing
mandible to grow is needed.
• The class II molar relationship is corrected with
serial extraction procedures in combination with
head gear.
• prognosis is good.

19. Type B growth trend
• Growth is downward and forward with the middle
face growing forward more rapidly than the lower.
• Predominently vertical.
• Increase in ANB angle.
• Has poor prognosis as point B will not catch up
with point A

20. TYPE B subdivision:
• When ANB angle less than 4* Prognosis is fair.
• When ANB angle ranges from 7* to as much
as 12* prognosis is poor.
• Extraction of all first premolars is mandatory
for patients with high ANB angles.

21. Type C growth trend
• The lower face is growing downward and
forward more rapidly than the middle face.
• Predominentely horizontal.
• Decrease in ANB reading.
• The prognosis is excellent for treatment of
patient with Type C.

22. TYPE C Subdivision
• Mandible grows at avery rapid rate than
maxilla
• Mand Incisors touch lingual surface of
maxillaty incisors.
• This causes mand incisors to tip lingually or
maxillaty incisors to tip labially

25. 6. Tooth mineralization as an indicator of
the pubertal growth spurt

26. 7. Frontal sinus as a predictor of
mandibular growth
• enlargement of the frontal sinus from 8 years until 2 years
passed the maximum body height.
• There is a close relation between the enlargement of the
frontal sinus and body height growth.
• As a result, it is showed that the frontal sinus development
can be used as one of the growth maturity indicators.
• In clinical practice, this might also be helpful especially during
the evaluation of growth spurt and for determining the time
of Orthodontics treatmen

27. correlation between the frontal sinus and the
mandibular
growth.
• The author concluded that although the frontal sinus is
exposed to muscles attachment it .
• The frontal sinus as seen on a lateral cephalogram is a
valuable indicator of excessive mandibular growth.
• Patient having a large frontal sinus,most probably
present an excessive mandibular growth.

29. 8. Visualized treatment Objective

30. 9. Hand wrist radiograph