The relationship between menarche and the ossification stages of the phalanx of the first and third finger

성장기 여아에서 첫째 및 셋째 수지 지절 변화와 초경시기

  • Kim, Kyung-Ho (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Choy, Kwang-Chul (Department of Orthodontics, College of Dentistry, Yonsei University) ;
  • Jung, Kil-Yong (Department of Orthodontics, College of Dentistry, Yonsei University)
  • 김경호 (연세대학교 치과대학 교정학교실, 두개안면 기형연구소) ;
  • 최광철 (연세대학교 치과대학 교정학교실, 두개안면 기형연구소) ;
  • 정길용 (연세대학교 치과대학 교정학교실)
  • Published : 2002.08.01

Abstract

Among many maturation indicators of growing patients, menarche and skeletal maturity are useful to assess growth and development, and the changes of the first and third finger are relatively important in hand-wrist X-rays. The objective of this study was to evaluate the relationship between menarche and the changes of the phalanx of the first and third finger and compare skeletal maturation among different malocclusion types. The sample used in this study was 29 Class 1,27 Class II and 27 Class III females whose hand-wrist X-rays had been taken with 6 month interval before the appearance of ulnar sesamoid ossification till the phalanges of the fingers were almost fused. The results were as follows. 1. There was no skeletal maturity difference among malocclusion types. 2. There was no difference in the mean chronologic age of menarche among different malocclusion types and that was $12.30\pm0.98$ years. 3. The ulnar sesamoid was observed at $10.35\pm1.01$ years, and on distal phalanx of the first finger, epiphyseal capping appeared at $11.26\pm1.04$ years and fusion at $13.12\pm1.06$ years. The epiphyseal capping on middle phalanx of the third finger was observed at $11.57\pm1.02$ years and fusion at $13.72\pm1.04$ years. 4. The timing of menarche occurred around the same time as the fusion process of distal phalanx of the first finger(p<0.001, r=0.82) and the initiation of fusion of middle phalanx of the third finger(p<0.001, r=0.78). Therefore, we can give the aid when we evaluate the growth and development of growing females seeing the changes at phalanx of the first and third finger.

성장기 환자의 발육 상태를 나타내는 여러 지표 중 수완부 골성숙도와 초경시기가 유용하게 사용될 수 있으며 수완부 골성숙도에서는 첫째와 셋째 수지의 변화가 비교적 중요한 의미를 가지고 있다. 이에 본 연구에서는 첫째 수지 및 셋째 수지의 지절 변화와 초경 및 부정교합과의 연관성을 조사하기 위해, 성장기 여아 중 I급 부정교합자 29명, II급 부정교합자 27명, III급 부정교합자 27명을 대상으로 약 6개월 간격으로 모지척측 종자골 출현 전부터 수지 지절의 융합이 거의 이루어지는 시기까지 누년적으로 촬영한 수완부골 방사선 사진과 초경시기를 평가하여 다음과 같은 결론을 얻었다. 1. 부정교합에 따른 골성숙도의 차이는 없었다. 2. 부정교합에 따른 초경연령의 차이는 없었으며, 초경의 평균 연령은 $12.30\pm0.98$세였다. 3. 모지척측 종자골 출현은 $10.35\pm1.01$세, 첫째 수지의 원심부 지절에서 Capping단계는 $11.26\pm1.04$세, 융합시기는 $13.12\pm1.06$세이고 셋째 수지의 중간 지절의 capping은 $11.57\pm1.02$세, 융합은 $13.72\pm1.04$세에 일어났다. 4.초경은 첫째 수지 원심부 지절의 융합이 진행되는 시기와(P<0.001, r=0.82),셋째 수지 중간 지절의 융합이 시작되는 시기와(p<0.001, r=0.78) 비슷한 시기에 나타났다. 이상의 결과로 첫째 또는 셋째 수지 지절 변화만으로 성장기 여아에서의 발육상태를 평가할 때 도움을 줄 수 있음을 알 수 있었다.

Keywords

References

  1. Moore RN, Moyer BA, DuBois LM. Skeletal maturation and craniofacial growth. Am J Orthod Dentofac Orthop 1990 : 98 : 33-40 https://doi.org/10.1016/0889-5406(90)70029-C
  2. Fishman LS. Chronological versus skeletal age, an evaluation of craoiofacial growth. Angle Orthod 1979 : 49 : 181-9
  3. Fishman LS. Radiographic evaluation of skeletal maturation: A clinically oriented method based on hand-wrist films. Angle Orthod 1982 : 52 : 88-112
  4. Fishman LS. Maturational patterns and predictionduring adolescence. Angle Orthod 1987 : 57 : 178-93
  5. Johnston FE, Hufham HP, Moreschi AF, Terry GP. Skeletal maturation and cephalofacial development. Angle Orthod 1965 : 35 : 1-11
  6. Bjork A, Helm S. Prediction of the age of maximum puberal growth in body height. Angle Orthod 1967 : 37 : 134-43
  7. Bambha JK, Van Natta P. A longitudinal study of occlusion and tooth eruption in relation to skeletal maturation. Am J Orthod 1959 : 45 : 847-55 https://doi.org/10.1016/0002-9416(59)90225-8
  8. Bambha JK. Longitudinal cephalometric roentgenographic study of face and craoium in relation to body height. J Am Dent Assoc 1961 : 63: 776-99 https://doi.org/10.14219/jada.archive.1961.0289
  9. Hunter CJ. The correlationof facial growth with body height and skeletal maturation at adolescence. Angle Orthod 1966 : 36 : 44-54
  10. Hagg U, Taranger J. Maturation indicators and the pubertal growth spurt. Am J Orthod 1982 : 82 : 299-309 https://doi.org/10.1016/0002-9416(82)90464-X
  11. 박진성, 서정훈, 정상교합자의 사춘기 성장과 수완부골 성숙단계에 관한 연구, 대치교정지 1985 : 15: 197-209
  12. Gam SM, Rohmann CG. Variability in the order of ossificationof the bony centers of the hand and wrist. Am J Phys Anthrop 1960 : 18 : 219-30 https://doi.org/10.1002/ajpa.1330180309
  13. KondoT. Craoiofacial growth before and after the end of fusion in the distal phalanx of the first digit- A longitudinal study. 日本橋正誌 1991 : 50 : 293-302
  14. Leite HR, O'Reilly MT, Close JM. Skeletal age assessment using the first, second and third fingers of the hand. Am J Orthod Dentofac Orthop 1987s: 92 : 492-8 https://doi.org/10.1016/0889-5406(87)90231-9
  15. Greulich WW. Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd ed. Standford, California: Stanford University Press, 1959
  16. Tanner JM, Whitehouse RH, Marshall WA, Healy MJR, Goldstein H Assessment of skeletal maturity and prediction of adult height(TW2 method). London: Academic Press, 1975
  17. Grave KC, Brown T. Skeletal ossification and the adolescent growth spurt. Am J Orthod 1976 : 69 : 611-9 https://doi.org/10.1016/0002-9416(76)90143-3
  18. Goto S. A study of the ossification of the distal phalanx of the first digit. 日本橋正誌 1987 : 46 : 534-46
  19. Goto S, Kondo T, Iwata R, et. al. A cross-sectional study of the relationship between the ossification of the distal phalanx of the first digit and the cranio-facial growth and development. Aichi-Gakuin J Dent Sci 1989 : 27 : 837-44
  20. Iwata R. The relation of complete fusion time on the distal phalanx of the first digit and mandibular growth, 日本橋正誌 1994 : 53 : 1-9
  21. Rees M. Menarche when and why? Lancet 1993 : 342 : 1375-6 https://doi.org/10.1016/0140-6736(93)92746-G
  22. Wheeler MD, Physical changes of puberty, Endocrinology and Metabolism Clinics of North America, 1991 : 20 : 1-14
  23. 김영준, 손병화. 생장기 소녀에서 하악골 성장변화와 발육연령의 상호관계에 대한 누년적 연구 대치교정지 1992 : 22 : 603-15
  24. Rajagopal R, Kansal S, A comparison of modified MP3 stages and the cervical vertebrae as growth indicators, J Clin Orthod 2002 : 36 : 398-406
  25. Nanda RS, Nanda SK Considerations of dentofacial growth in longterm retention and stability : Is active retention needed? Am J Orthod Dentofac Orthop 1992 : 101 : 297-302 https://doi.org/10.1016/S0889-5406(05)80321-X
  26. Mitani H, Sato K. Comparison of mandibular growth with other variables during puberty, Angle Orthod 1992 : 62 : 217-22
  27. Bergersen EO, The male adolescent facial growth spurt: Its prediction and relation to skeletal maturation, Angle Orthod 1972 : 42 : 319-38
  28. Krogman WM, The meaningful interpretation of growth and growth data by the clinician, Am J Orthod 1958 : 44 : 411-32 https://doi.org/10.1016/0002-9416(58)90002-2
  29. Tofani MI. Mandibular growth at puberty. Am J Orthod 1972 : 62 : 176-95 https://doi.org/10.1016/0002-9416(72)90141-8
  30. 김경호 부정교합자의 수완부 골성숙도에 관한 누년적 연구(1) 대치교정지 1999 : 29 : 183-95
  31. 김석훈, 정규림, 정상교합자와 부정교합자의 골성숙도 차이에 관한 연구 대치교정지 1990 : 20 : 111-22
  32. Pileski RCA, Woodside DG, James GA. Relationship of the ulnar sesamoid bone and maximum mandibular growth velocity, Angle Orthod 1973 : 43 : 162-70
  33. Zacharias L, Wurtman RJ, Schatzoff M. Sexual maturation in contemporary American girls, Am J Obstet Gynec 1970 : 108 : 833-46 https://doi.org/10.1016/0002-9378(70)90552-1
  34. 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 https://doi.org/10.1016/0002-9416(85)90070-3
  35. 장기영, 이동주. 부정교합자의 사춘기성장과 성적 성숙간의 상호관계에 관한 누년적 연구 대치교정지 1989 : 19: 99-111
  36. 장연희, 정규림. 초경시기와 골성숙도의 연관성에 관한 연구 대치교정지 1995 : 25 : 415-23
  37. 김정호, 백형선, 손은수. 부정교합 분류에 따른 초경시기와 골성숙도에 관한 연구 대치교정지 1998 : 28 : 581-9
  38. Smith RJ, Misuse of hand-wrist radiographs. Am J Orthod 1980 : 77 : 75-8 https://doi.org/10.1016/0002-9416(80)90225-0