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Assessment of maturation indicators in individuals with different skeletal malocclusion

Bewertung von Reifungsindikatoren bei unterschiedlichen skelettalen Malokklusionen

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Abstract

Purpose

The aim of this study was to comparatively evaluate hand–wrist bones, cervical vertebrae and tooth development stages according to skeletal classification.

Methods

The orthodontic initial records of 297 patients were used and separated into three groups according to the skeletal malocclusion. Three groups including 99 people each were sampled representing malocclusions with Angle classes I, II and III, respectively. The panoramic, cephalometric and hand–wrist radiographs of all patients included in this study were used to compare dental and skeletal maturation indicators. Calcification of teeth was rated according to the system of Demirjian. To evaluate the stage of skeletal maturation hand–wrist radiographs were analyzed according to the Grave and Brown method. Also, Hassel and the Farman method was used to classifying vertebral developmental stages. Spearman rank correlation tests, as well as Fisher exact χ2 tests with r×c tables, were used for the comparison of categorical variables.

Results

Hand–wrist, vertebral and dental development stages showed a statistically significant relationship (p < 0.01) for both genders and in all malocclusions. The association between the different maturation indicators used in this study and the type of malocclusion was also statistically significant for both genders. It was observed that the peak period of skeletal maturation according to the hand–wrist radiograph findings correlated with the cervical vertebrae stage C3 in girls (63.2%) and C2–C3 in boys (43.5–43.5%). The weakest correlation was seen between the dental development stages and the skeletal developmental stages in the class II group (r = 0.443–0.220 [girls]; r = 0.604–0.410 [boys]).

Conclusion

The use of the dental development stage as a reliable indicator of maturation was limited. According to the Demirjian method, the calcification stage of the second molar might indicate that the individual is in the pubertal peak period.

Zusammenfassung

Zweck

Ziel dieser Studie war es, Handwurzelknochen, Halswirbel und Zahnentwicklungsstadien nach Skelettklassifikation vergleichend zu bewerten.

Methoden

Die kieferorthopädischen Erstaufzeichnungen von 297 Patienten wurden verwendet und entsprechend der skelettalen Malokklusion in 3 Gruppen unterteilt. Es wurden 3 Gruppen mit jeweils 99 Personen beprobt, die Angle-Klasse‑I-, -II- bzw. -III-Malokklusionen repräsentierten. Anhand der Orthopantomogramme sowie der kephalometrischen Aufnahmen und der Handwurzelröntgenaufnahmen aller in die Studie aufgenommenen Patienten wurden Indikatoren für die Zahn- und Skelettreifung verglichen. Der dentale Mineralisationsgrad wurde nach dem System von Demirjian bewertet. Zur Beurteilung des Skelettalters wurden Handwurzelröntgenbilder nach der Methode von Grave und Brown analysiert. Ferner wurde die Hassel-Farman-Methode verwendet, um vertebrale Entwicklungsstadien zu klassifizieren. Für den Vergleich kategorialer Variablen wurden Spearman-Rangkorrelationstests sowie exakte Fisher‑χ2-Quadrat-Tests mit R×C-Tabellen verwendet.

Ergebnisse

Handwurzelknochen‑, Wirbelkörper- und Zahnentwicklungsstadien zeigten eine statistisch signifikante Beziehung (p < 0,01) für beide Geschlechter und bei allen Malokklusionen. Der Zusammenhang zwischen den verschiedenen in dieser Studie verwendeten Reifungsindikatoren und der Art der Malokklusion war für beide Geschlechter ebenfalls statistisch signifikant. Es wurde beobachtet, dass die Spitzenzeit der Skelettreifung gemäß den Befunden des Handwurzelknochenröntgenbildes mit dem Halswirbelstadium C3 bei Mädchen (63,2 %) und C2–C3 bei Jungen (43,5–43,5 %) korrelierte. Die schwächste Korrelation wurde zwischen den Zahnentwicklungsstadien und den Skelettentwicklungsstadien in der Klasse-II-Gruppe beobachtet (r = 0,443–0,220 [Mädchen] bzw. r = 0,604–0,410 [Jungen]).

Schlussfolgerung

Die Verwendung des Zahnentwicklungsstadiums als verlässlicher Indikator für die Reifung war begrenzt. Nach der Demirjian-Methode könnte der Mineralisierungsgrad des zweiten Molaren darauf hinweisen, dass sich das Individuum in der Hochphase der pubertären Wachstumsphase befindet.

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Funding

There is no funding body in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript

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Authors and Affiliations

  1. Private practice, Izmir, Turkey

    Tuğçe Koçak

  2. Department of Orthodontics, Faculty of Dentistry, Izmir Katip Celebi University, 35640, Izmir, Turkey

    Burçin Akan DDS, PhD

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  1. Tuğçe Koçak
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  2. Burçin Akan DDS, PhD
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Correspondence to Burçin Akan DDS, PhD.

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T. Koçak and B. Akan declare that they have no competing interests.

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This research was approved by the Research and Ethics Committee of Izmir Katip Celebi University of Medicine and Health Sciences (Ref. No. 209). Written informed consent to participate was obtained from all participants included in the study.

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Koçak, T., Akan, B. Assessment of maturation indicators in individuals with different skeletal malocclusion. J Orofac Orthop 82, 187–197 (2021). https://doi.org/10.1007/s00056-021-00286-2

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