Document Type : Original Article

Authors

1 Assistant Professor, Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences

2 Assistant Professor, Department of Oral and Maxillofacial Radiology, School of Dentistry, Shiraz University of Medical Sciences

3 Dentist

Abstract

Statement of Problem: Evaluation of skeletal growth which is necessary in growth modification and orthognathic surgery is usually done by using skeletal maturity indicators of hand and wrist radiographs. The use of growth stages of cervical vertebrae seen in lateral cephalometrics films currently has been suggested to avoid over exposure.Purpose: The purpose of the present study was to investigate the degree of agreement between hand and wrist bones developmental stages and cervical vertebral maturation stages.Materials and Method: The subjects of this cross-sectional study consisted 58 females and 61 males ranging from 8 to 17 years old divided into 10 groups. A total of 119 hand, wrist and lateral cephalometry radiographs were obtained and analyzed. The hand and wrist radiographs were evaluated according to the Fishman system, which uses four stages of bone maturation found at six sites located on thumb, third finger, fifth finger and radius. Cervical vertebral maturation was determined from lateral cephalometry radiographs based on a system developed by Hassel and Farman.Results: In all age groups, the skeletal maturity stage in the hand and wrist bones and cervical vertebrae of female subjects were ahead of male subjects. The Kappa test revealed a high degree of agreement between skeletal maturation indicator in hand and wrist bones and cervical vertebrae in all of the samples (d. of a.=0.846, p<0.001), females (d. of a.=0.791, p<0.001) and male (d. of a.=0.892, p<0.0001). The chronological conformity between 2 methods showed a high degree of agreement in all age groups except in 8 and 17 years old ages. The highest chronological agreement was seen in 15 years old age group, although the degree of agreement in 8 years old age group was low and in 17 years old age group was moderate.Conclusion: According to the results of this study, hand and wrist radiographs can be easily replaced by cervical vertebral maturation analysis for evaluation of skeletal developmental stage.Key words: Skeletal age, Hand and wrist radiograph, Cervical vertebral growth