Farklı İskeletsel Yapıdaki Bireylerde Maturasyon İndikatörlerinin Değerlendirilmesi

Abstract

Amaç: Bu çalışmanın amacı, Sınıf I, Sınıf II ve Sınıf III bireylerde diş yaşı, kronolojik yaş, el-bilek maturasyonu ve servikal vertebra maturasyonu arasındaki ilişkileri değerlendirmektir.
Yöntem: Bu çalışmada 8-18 yaş arası 289 kişinin (151 kız, 138 erkek) panoramik, el-bilek ve sefalometrik radyografileri değerlendirildi. Sagital iskelet maloklüzyonuna göre olgular Sınıf I, Sınıf II ve Sınıf III olacak şekilde üç ana gruba ayrıldı. Bireylerin diş yaşları Demirjian yöntemine göre belirlendi. Olguların el-bilek radyografileri Fishman maturasyon göstergeleri kullanılarak değerlendirildi. Servikal vertebra maturasyon evreleri, Bacetti ve ark. tarafından geliştirilen yöntemle değerlendirildi. Değişkenler arasındaki ilişkileri ölçmek için Spearman sıralama korelasyon katsayıları kadın ve erkek için ayrı ayrı kullanıldı.
Bulgular: Tüm gruplarda hem kadın hem de erkek bireyler için değerlendirilen tüm değişkenler arasında Spearman korelasyon katsayısında farklı düzeylerde anlamlı bir pozitif korelasyon görüldü (p< 0.01). En düşük korelasyon, Sınıf II grupta kronolojik yaş ile iskelet diş yaşı arasında bulundu (r: 0.413). Servikal vertebra maturasyonu ile el-bilek maturasyonu arasındaki korelasyon, tüm gruplarda her iki cinsiyet için yüksekti (p< 0.01).
Sonuç: Çalışmamızın sonuçlarına göre, pubertal büyüme atılımı ve gelişim evrelerini tanımlamak için; servikal vertebra maturasyonu el-bilek maturasyonu değerlendirmesine alternatif olarak kullanılabilir. Ancak, daha büyük örneklem büyüklüğüne sahip gelecek çalışmalar, diş yaşının güvenilirliği kanıtlamada yardımcı olabilir.

Keywords

• Kronolojik yaş
• Diş yaşı
• Servikal vertebra
• El bilek

The Assessment of Maturation Indicators in Individuals with Different Skeletal Pattern

Abstract

Objective: The aim of this study is to evaluate the relationships among dental age, chronological age, hand-wrist maturation and cervical vertebral maturation in Class I, Class II and Class III individuals.
Method: Panoramic, cephalometric and hand-wrist radiographs of 289 individuals (151 girls, 138 boys) aged between 8 and 18 were evaluated in this study. Subjects divided into three main groups as Class I, Class II and Class III according to their sagittal skeletal malocclusion. The dental ages of the individuals were defined according to the Demirjian’s method. The Fishman maturation indicators were used for evaluating the hand-wrist radiographs and the method improved by Bacetti et al. were used for evaluating the maturation stages of the cervical vertebrae. The Spearman correlation analysis was used to evaluate the relationships between the variables separately for males and females.
Results: The Spearman correlation coefficient indicated a significant positive correlation at different levels between all variables evaluated for both female and male individuals in all groups (P< 0.01). The lowest correlation was found between chronological age and dental age skeletal in Class II group (r: 0.413). The correlation between cervical vertebra maturation and hand-wrist maturation were highly positive for both sexes in all groups (P< 0.01).
Conclusion: According to the results of our study, to define the growth spurt and developmental stages, cervical vertebrae maturation could be used as an alternative to hand-wrist maturation assessment. However, additional studies with a larger sample size may be helpful in proving the reliability of the dental age.

Keywords

• Chronological age
• Dental age
• Cervical vertebrae
• Hand-wrist

References

1. 1. Moore, R. N., Moyer, B. A., & DuBois, L. M. (1990). Skeletal maturation and craniofacial growth. Am J Orthod Dentofacial Orthop. 98(1):33-40.
2. 2. Hägg, U., & Taranger, J. Maturation indicators and the pubertal growth spurt. (1982). Am J Orthod. 82(4):299-309.
3. 3. Baccetti, T., Franchi, L., Giuntini, V., Masucci, C., Vangelisti, A., & Defraia, E. (2012). Early vs late orthodontic treatment of deepbite: a prospective clinical trial in growing subjects. Am J Orthod Dentofacial Orthop. 142(1):75-82.
4. 4. Franchi, L., Pavoni, C., Faltin Jr, K., McNamara Jr, J.A., & Cozza, P. (2013). Long-term skeletal and dental effects and treatment timing for functional appliances in Class II malocclusion. Angle Orthod. 83(2):334-340.
5. 5. Westwood, P. V., McNamara Jr, J. A., Baccetti, T., Franchi, L., & Sarver, D. M. (2003). Long-term effects of Class III treatment with rapid maxillary expansion and facemask therapy followed by fixed appliances. Am J Orthod Dentofacial Orthop. 123(3):306-320.
6. 6. Cha, K. S. (2003). Skeletal changes of maxillary protraction in patients exhibiting skeletal class III malocclusion: a comparison of three skeletal maturation groups. Angle Orthod. 73(1):26-35.
7. 7. Johnston, F. E., Paul Hufham, H., Moreschi, A. F., & Terry, G. P. (1965). Skeletal maturation and cephalofacial development. Angle Orthod. 35(1):1-11.
8. 8. Flores-Mir, C., Nebbe, B., & Major, P. W. (2004). Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: a systematic review. Angle Orthod. 74(1):118-124.

9. 9. Krailassiri, S., Anuwongnukroh, N., & Dechkunakorn, S. (2002). Relationships between dental calcification stages and skeletal maturity indicators in Thai individuals. Angle Orthod. 72(2):155-166.
10. 10. Flores-Mir, C., Mauricio, F. R., Orellana, F. M., & Major, P. W. (2005). Association between growth stunting with dental development and skeletal maturation stage. Angle Orthod. 75(6):935-940.
11. 11. Demirjian, A., Buschang, P. H., Tanguay, R., & Patterson, D. K. (1985). Interrelationships among measures of somatic, skeletal, dental, and sexual maturity. Am J Orthod. 88(5):433-438.
12. 12. Sağlam A. M. Ş., & Gazilerli, Ü. (2002). The relationship between dental and skeletal maturity. J Orofacial Orthop. 63(6):454-462.
13. 13. Mappes, M. S., Harris, E. F., Behrents, R. G. (1992). An example of regional variation in the tempos of tooth mineralization and hand-wrist ossification. Am J Orthod Dentofacial Orthop.101(2):145-151.
14. 14. Fishman, L. S. (1982). Radiographic evaluation of skeletal maturation. Angle Orthod. 52(2):88-112.
15. 15. Greulich, W. W., & Pyle S. I. (1959). Radiographic atlas of skeletal development of the hand and wrist. California: Stanford University Press. 127-179.
16. 16. Roche, A., Chumlea, W., & Thissen, D. (1989). The FELS method of assessing the skeletal maturity of the hand-wrist. Am J Hum Biol. (2)175-183.
17. 17. Lamparski, D. (1972). Skeletal age assessment utilizing cervical vertebrae [Master of dental science thesis]. Pittsburgh: University of Pittsburgh, School of Dental Medicine.
18. 18. Baccetti, T., Franchi, L., & McNamara, J. A. (2002). An improved version of the cervical vertebral maturation (CVM) method for the assessment of mandibular growth. Angle Orthod. 72(4):316-323.
19. 19. Hassel, B., & Farman, A. G. (1995). Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop.107(1):58-66.
20. 20. Baccetti, T., Franchi, L., McNamara Jr, J. A. (2005). The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod. 11(3):119-129.
21. 21. Perinetti, G., & Contardo, L. (2017). Reliability of growth indicators and efficiency of functional treatment for skeletal Class II malocclusion: current evidence and controversies. BioMed Res Int. 2017.
22. 22. Fishman, L. S. (1979). Chronological versus skeletal age, an evaluation of craniofacial growth. Angle Orthod. 49(3):181-189.
23. 23. Malot-Steinberg, J. (1978). Prévision de l'éruption dentaire. Rev Orthop Dento Faciale.12(3):233-242.
24. 24. Olze, A., Bilang, D., Schmidt, S., Wernecke, K. D., Geserick, G., & Schmeling, A. (2005). Validation of common classification systems for assessing the mineralization of third molars. Int J Legal Med.119(1):22-26.
25. 25. Björk, A., & Helm, S. (1967). Prediction of the age of maximum puberal growth in body height. Angle Orthod. 37(2):134-143.
26. 26. Uysal, T., Ramoglu, S. I., Basciftci, F. A., & Sari, Z. (2006). Chronologic age and skeletal maturation of the cervical vertebrae and hand-wrist: is there a relationship? Am J Orthod Dentofacial Orthop. 130(5):622-628.
27. 27. Alkhal, H. A., Wong, R. W., & Rabie, A. B. M. (2008). Correlation between chronological age, cervical vertebral maturation and Fishman's skeletal maturity indicators in southern Chinese. Angle Orthod. 78(4):591-596.
28. 28. Flores-Mir, C., Burgess, C. A., Champney, M., Jensen, R. J., Pitcher, M. R., & Major, P. W. (2006). Correlation of skeletal maturation stages determined by cervical vertebrae and hand-wrist evaluations. Angle Orthod. 76(1):1-5.
29. 29. Gandini, P., Mancini, M., & Andreani, F. (2006). A comparison of hand-wrist bone and cervical vertebral analyses in measuring skeletal maturation. Angle Orthod.76(6):984-989.
30. 30. Kucukkeles, N., Acar, A., Biren, S., & Arun, T. (1999). Comparisons between cervical vertebrae and hand-wrist maturation for the assessment of skeletal maturity. J Clin Pediatr Dent. 24(1):47-52