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HAND WRIST RADIOGRAPHS
www.indiandentalacademy.com
•HAND WRIST REGION-MADE UP OF NUMEROUS SMALL BONES
•THESE BONES SHOW A PREDICTABLE AND SCHEDULED
PATTERN OF APPEARANCE, OSSIFICATION AND UNION FROM
BIRTH TO MATURITY.
•SKELETAL MATURITY STATUS OF AN INDIVIDUAL CAN BE
DITERMINED.
•THERE ARE A NUMBER OF METHODS .
•ATLAS METHOD –GRULICH AND PYLE
•BJORK ,GRAVE AND BROWN METHOD
•FISHMAN’S SMIs
•HAGG AND TARANGER METHOD
•OTHERS
www.indiandentalacademy.com
ANATOMY OF HAND WRIST
www.indiandentalacademy.com
INDICATIONS FOR HAND WRIST RADIOGRAPH
•MAJOR DISCREPANCY BETWEEN THE DENTAL AND CHRONOLOGICAL AGE
•DITERMINATION OF SKELETAL MATURITY STATUS PRIOR TO TREATMENT
OF SKELETAL CLASS II AND CLASS III MALOCCLUSIONS
•ASSESS THE SKELETAL AGE IN A PATIENT WHOSE GROWTH IS AFFECTED
BY INFECTIONS ,TRAUMA ,NEOPLASM
•TO PREDICT FUTURE SKELETAL MATURITY RATE AND STATUS
•PREDICT PUBERTAL GROWTH
•AID IN RESEARCH-STUDY THE ROLE OF HEREDITARY,ENVIRONMENT
,NUTRITION ETC ON SKELETAL MATURATION PATTERN.
•PATIENTS WITH SKELETAL MALOCCLUSION BETWEEN 16-20 YEARS
NEEDING ORTHOGNATHIC SURGERY
www.indiandentalacademy.com
GREULICH AND PYLE METHOD-1959
•PUBLISHED AN ATLAS CONTAINING IDEAL SKELETAL AGE
PICTURES OF HAND WRIST FOR DIFFERENT CHRONOLOGICAL
AGES AND FOR EACH SEX
•EACH PHOTOGRAPH IN THE ATLAS IS REPRESENTATIVE OF A
PARTICULAR SKELETAL AGE .
•THE PATIENT’S RADIOGRAPH IS MATCHED WITH A
PHOTOGRAPH IN THE ATLAS
www.indiandentalacademy.com
BJORK , GRAVE AND BROWN-1972, 1976
BJORK IN 1972 DIVIDED THE MATURATION PROCESS OF BONE OF THE HAND
BETWEEN 9TH
TO THE 17TH
YEAR INTO EIGHT DEVELOPMENTAL STAGES
DELINIATION OF SINGLE DEVELOPMENTAL STAGES IS FACILITATED BY
INCLUSION OF SIX FURTHER OSSIFICATION CENTERS
APPROPRIATE CHRONOLOGICAL AGE FOR EACH OF THE STAGES WAS
GIVEN BY SCHOPF IN 1978
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com
MALES-10.6YEARS
FEMALES- 8.1 YEARS
MALES-12YEARS
FEMALES- 8.1 YEARS
MALES-12.6YEARS
FEMALES- 9.6 YEARS
www.indiandentalacademy.com
MALES-13YEARS
FEMALES- 10.6 YEARS
MALES-14YEARS
FEMALES- 11 YEARS
www.indiandentalacademy.com
MALES-15YEARS
FEMALES- 13 YEARS
MALES-15.9 YEARS
FEMALES- 13.3 YEARS
MALES-15.9YEARS
FEMALES- 13.9 YEARS
MALES-18.5YEARS
FEMALES- 16 YEARS
www.indiandentalacademy.com
LEONARD S. FISHMAN-1982(ROCHESTER , NY)
www.indiandentalacademy.com
www.indiandentalacademy.com
www.indiandentalacademy.com

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Hand wrist radiographs

  • 2. •HAND WRIST REGION-MADE UP OF NUMEROUS SMALL BONES •THESE BONES SHOW A PREDICTABLE AND SCHEDULED PATTERN OF APPEARANCE, OSSIFICATION AND UNION FROM BIRTH TO MATURITY. •SKELETAL MATURITY STATUS OF AN INDIVIDUAL CAN BE DITERMINED. •THERE ARE A NUMBER OF METHODS . •ATLAS METHOD –GRULICH AND PYLE •BJORK ,GRAVE AND BROWN METHOD •FISHMAN’S SMIs •HAGG AND TARANGER METHOD •OTHERS www.indiandentalacademy.com
  • 3. ANATOMY OF HAND WRIST www.indiandentalacademy.com
  • 4. INDICATIONS FOR HAND WRIST RADIOGRAPH •MAJOR DISCREPANCY BETWEEN THE DENTAL AND CHRONOLOGICAL AGE •DITERMINATION OF SKELETAL MATURITY STATUS PRIOR TO TREATMENT OF SKELETAL CLASS II AND CLASS III MALOCCLUSIONS •ASSESS THE SKELETAL AGE IN A PATIENT WHOSE GROWTH IS AFFECTED BY INFECTIONS ,TRAUMA ,NEOPLASM •TO PREDICT FUTURE SKELETAL MATURITY RATE AND STATUS •PREDICT PUBERTAL GROWTH •AID IN RESEARCH-STUDY THE ROLE OF HEREDITARY,ENVIRONMENT ,NUTRITION ETC ON SKELETAL MATURATION PATTERN. •PATIENTS WITH SKELETAL MALOCCLUSION BETWEEN 16-20 YEARS NEEDING ORTHOGNATHIC SURGERY www.indiandentalacademy.com
  • 5. GREULICH AND PYLE METHOD-1959 •PUBLISHED AN ATLAS CONTAINING IDEAL SKELETAL AGE PICTURES OF HAND WRIST FOR DIFFERENT CHRONOLOGICAL AGES AND FOR EACH SEX •EACH PHOTOGRAPH IN THE ATLAS IS REPRESENTATIVE OF A PARTICULAR SKELETAL AGE . •THE PATIENT’S RADIOGRAPH IS MATCHED WITH A PHOTOGRAPH IN THE ATLAS www.indiandentalacademy.com
  • 6. BJORK , GRAVE AND BROWN-1972, 1976 BJORK IN 1972 DIVIDED THE MATURATION PROCESS OF BONE OF THE HAND BETWEEN 9TH TO THE 17TH YEAR INTO EIGHT DEVELOPMENTAL STAGES DELINIATION OF SINGLE DEVELOPMENTAL STAGES IS FACILITATED BY INCLUSION OF SIX FURTHER OSSIFICATION CENTERS APPROPRIATE CHRONOLOGICAL AGE FOR EACH OF THE STAGES WAS GIVEN BY SCHOPF IN 1978 www.indiandentalacademy.com
  • 9. MALES-10.6YEARS FEMALES- 8.1 YEARS MALES-12YEARS FEMALES- 8.1 YEARS MALES-12.6YEARS FEMALES- 9.6 YEARS www.indiandentalacademy.com
  • 10. MALES-13YEARS FEMALES- 10.6 YEARS MALES-14YEARS FEMALES- 11 YEARS www.indiandentalacademy.com
  • 11. MALES-15YEARS FEMALES- 13 YEARS MALES-15.9 YEARS FEMALES- 13.3 YEARS MALES-15.9YEARS FEMALES- 13.9 YEARS MALES-18.5YEARS FEMALES- 16 YEARS www.indiandentalacademy.com
  • 12. LEONARD S. FISHMAN-1982(ROCHESTER , NY) www.indiandentalacademy.com