The relationship of facial vertical development with skeletal maturation and dental age

Abstract

Purpose

This study aimed to determine whether there is a correlation between three different types of vertical facial development, chronological age, skeletal maturation, and dental maturation.

Materials and Methods

Lateral cephalometric, panoramic, and hand-wrist radiographs of 150 orthodontic patients (75 males and 75 females; mean ages 13.54 and 13.74 years, respectively) were analyzed. Skeletal maturation was determined using the Greulich-Pyle atlas method via hand and wrist bones. Dental maturation was assessed using the Demirjian Index on the left mandibular canines, first premolars, second premolars, and second molars. The SN-GoMe angle was evaluated on lateral cephalometric radiographs.

Results

A statistically significant difference in median skeletal age between genders was found in the hyperdivergent group (p = 0.024), with females showing more advanced skeletal age than males. A significant positive correlation between chronological age and skeletal age was observed in both the hypodivergent (p < 0.001) and hyperdivergent (p < 0.001) groups. In the normodivergent group, a very strong correlation between chronological and skeletal age was also found (p < 0.001). Additionally, significant gender-based differences were noted in the development of the canine (p = 0.003) and first premolar (p = 0.048) teeth in the hyperdivergent group.

Conclusion

Maturational stages may differ between males and females of the same chronological age attending orthodontic clinics, largely due to gender-based developmental differences. Chronological and skeletal ages are compatible; however, vertical facial parameters should also be considered in growth and development assessments.

Keywords

• Orthodontics
• growth and development
• demirjian ındex
• greulich-pyle atlas
• skeletal maturation
• dental maturation
• vertical facial development

References

1. Proffit WR, Fields HW, Larson B, Sarver DM. Contemporary orthodontics-e-book. Elsevier Health Sciences; 2018, p.20-5. google scholar
2. Franchi L, Baccetti T, De Toffol L, Polimeni A, Cozza P. Phases of the dentition for the assessment of skeletal maturity: a diagnostic performance study. Am J Orthod and Dentofacial Orthop 2008;133:395–400; quiz 476.e1-2. [CrossRef] google scholar
3. Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod and Dentofacial Orthop 1995;107:58–66. [CrossRef] google scholar
4. Flores-Mir C, Nebbe B, Major PW. Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: a systematic review. Angle Orthod 2004;74:118–24. google scholar
5. Nahoum HI. Vertical proportions and the palatal plane in anterior open-bite. Am J Orthod. 1971;59:273–82. [CrossRef] google scholar
6. Faul F, Erdfelder E, Lang AG, Buchner A. G* Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods 2007;39:175–91. [CrossRef] google scholar
7. Lee YS, Choi SH, Kim KH, Hwang CJ. Evaluation of skeletal maturity in the cervical vertebrae and hand-wrist in relation to vertical facial types. Korean J Orthod 2019;49:319-325. [CrossRef] google scholar
8. Björk A. Timing of interceptive orthodontic measures based on stages of maturation. Trans Eur Orthod Soc 1972;61–74. google scholar

9. Grave KC, Brown T. Skeletal ossification and the adolescent growth spurt. Am J Orthod 1976 Jun 1;69:611–9. [CrossRef] google scholar
10. Demirjian A, Goldstein H, Tanner JM. A new system of dental age assessment. Hum Biol 1973;211–27. google scholar
11. Baccetti T, Franchi L, McNamara JA. The Cervical Vertebral Maturation (CVM) Method for the Assessment of Optimal Treatment Timing in Dentofacial Orthopedics. Semin Orthod 2005 Sep 1;11:119–29. [CrossRef] google scholar
12. Chertkow S, Fatti P. The Relationship Between Tooth Mineralization and Early Radiographic Evidence of the Ulnar Sesamoid. Angle Orthod 1979 Oct 1;49:282–8. google scholar
13. Demirjian A, Buschang PH, Tanguay R, Patterson DK. Interrelationships among measures of somatic, skeletal, dental, and sexual maturity. Am J Orthod 1985;88:433–8. [CrossRef] google scholar
14. Uysal T, Sari Z, Ramoglu SI, Basciftci FA. Relationships between dental and skeletal maturity in Turkish subjects. Angle Orthod 2004;74:657–64. google scholar
15. Sadowsky PL. Craniofacial growth and the timing of treatment. Am J Orthod and Dentofacial Orthop 1998;113:19–23. [CrossRef] google scholar
16. Ricketts RM. Facial and denture changes during orthodontic treatment as analyzed from the temporomandibular joint. Am J Orthod 1955;41:163–79. [CrossRef] google scholar
17. Singer J. Physiologic timing of orthodontic treatment. Angle Orthod 1980;50:322–33. google scholar
18. Bala M, Pathak A, Jain RL. Assessment of skeletal age using MP3 and hand-wrist radiographs and its correlation with dental and chronological ages in children. J Indian Soc Pedod Prev Dent 2010;28:95–9. [CrossRef] google scholar
19. Haiter-Neto F, Kurita LM, Menezes AV, Casanova MS. Skeletal age assessment: a comparison of 3 methods. Am J Orthod and Dentofacial Orthop 2006;130:435-e15. [CrossRef] google scholar
20. Darendeliler F, Bundak R. Boy kısalığına yaklaşım. Güncel pediatri 2005;3:1. google scholar
21. Garamendi P, Landa MI, Ballesteros J, Solano MA. Reliability of the methods applied to assess age minority in living subjects around 18 years old: a survey on a Moroccan origin population. Forensic Sci Int 2005;154:3–12. [CrossRef] google scholar
22. Baccetti T, Franchi L, McNamara JA. The cervical vertebral maturation method: some need for clarification. Am J Orthod and Dentofacial Orthop 2003;123:19A-20A. [CrossRef] google scholar
23. Kimura K. Skeletal maturity of the hand and wrist in Japanese children by the TW2 method. Ann Hum Biol 1977;4:353–6. [CrossRef] google scholar
24. Garn SM, Rohmann CG. The number of hand‐wrist centers. Am J Phys Anthropol 1960;18:293–9. [CrossRef] google scholar
25. Buken B, Safak AA, Yazici B, Buken E, Mayda AS. Is the assessment of bone age by the Greulich–Pyle method reliable at forensic age estimation for Turkish children? Forensic Sci Int 2007;173:146–53. [CrossRef] google scholar
26. Torun Sayar G, Oktay H. Evaluation of the relationships between chronological age, skeletal maturation, dental maturation, and sagittal jaw relationships. Turk J Orthod 2015;28:86-91. [CrossRef] google scholar
27. Krailassiri S, Anuwongnukroh N, Dechkunakorn S. Relationships between dental calcification stages and skeletal maturity indicators in Thai individuals. Angle Orthod 2002;72:155–66. google scholar
28. Cardoso HF V. Environmental effects on skeletal versus dental development: using a documented subadult skeletal sample to test a basic assumption in human osteological research. Am J Phys Anthropol 2007;132:223–33. [CrossRef] google scholar
29. Gupta M, Divyashree R, Abhilash PR, Bijle MNA, Murali K V. Correlation between chronological age, dental age and skeletal age among monozygoyic and dizygotic twins. J Int Oral Health 2013;5:16-22. google scholar
30. Kumar S, Roy AS, Garg A, Hamid S Bin, Tyagi S, Kumar A. Correlation between maxillary canine calcification and skeletal maturation. J Clin Diagn Res 2017;11:ZC13-6. [CrossRef] google scholar
31. Kumar S, Singla A, Sharma R, Virdi MS, Anupam A, Mittal B. Skeletal maturation evaluation using mandibular second molar calcification stages. Angle Orthod 2012;82:501–6. [CrossRef] google scholar
32. Janson GRP, Martins DR, Tavano O, Dainesi EA. Dental maturation in subjects with extreme vertical facial types. The European Journal of Orthodontics 1998;20:73–8. [CrossRef] google scholar
33. Baijal R, Bansal P, Singla S, Goel R, Arora K, Choudhary S. Cephalometric Comparison of Dentofacial Variables in Class I and Class II Jaw Bases: A Study for Different Growth Patterns. World Journal of Dentistry 2022;13:S14–8. [CrossRef] google scholar
34. Neves LS, Pinzan A, Janson G, Canuto CE, de Freitas MR, Cançado RH. Comparative study of the maturation of permanent teeth in subjects with vertical and horizontal growth patterns. Am J Orthod and Dentofacial Orthop 2005;128:619–23. [CrossRef] google scholar