• Journal of the korean academy of Pediatric Dentistry
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• v.23 no.2
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• pp.537-548
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• 1996

To investigate the relationship between the calcification stages of mandibular canines and the skeletal maturity stage of the hand-wrist in subjects with normal occlusion and Class III malocclusion, hand-wrist radiographs and panoramic radiographs were taken from subjects of normal occlusions(94 males, 88 females) and Class III malocclusions(75 males, 76 females) who had no systemic diseases and no history of orthodontic or prosthodontic treatment. Fishman's method for the skeletal maturity stages of the hand-wrist and Demirijian's method for the calcification stages of mandibular canines were used and analyzed. The results were as follows : 1. In subjects with normal occlusion and Class III malocclusion, skeletal maturity of the hand-wrist and calcification of mandibular canines at various ages occured earlier in females than in males(p<0.05). 2. Comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular canines between subjects with normal occlusion and Class III malocclusion, there were no significant differences between the groups. 3. The correlation coefficient between the calcification stages of mandibular canines and the skeletal maturity stages of the hand-wrist. in subjects with normal occlusion and Class III malocclusion showed a high association(p<0.01). 4. In stage 4 of the skeletal maturity of the hand-wrist, the frequency distribution of calcification G stage among the various calcification stages was highest both in normal occlusion and in subjects with Class III malocclusion. However, there was no significant difference in the frequency distribution of calcification stages between the groups.

• The korean journal of orthodontics
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• v.49 no.5
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• pp.319-325
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• 2019

Objective: To evaluate differences in skeletal maturity in relation to vertical facial types and to compare differences in the skeletal maturity of the cervical vertebrae and hand-wrist in females. Methods: This study included 59 females aged 7 to 9 years with skeletal Class I malocclusion. The participants were categorized into three groups (low, normal, and high) according to the mandibular plane angle. Skeletal maturity was measured using skeletal maturity indicators (SMIs) and the Tanner-Whitehouse III (TW3) method on hand-wrist radiographs and by using cervical vertebrae maturation indicators (CVMIs) on lateral cephalometric radiographs. Results: The SMI was higher in the high-angle group than in the low-angle group (p = 0.014). The median TW3 bone age was 11.4 months higher in the high-angle group than in the low-angle group (p = 0.032). There was no significant difference in CVMI among the three groups. Skeletal maturity showed a weakly positive correlation with the mandibular plane angle (SMI, r = 0.391; TW3, r = 0.333; CVMI, r = 0.259). Conclusions: The skeletal maturity of the hand-wrist in females with a high mandibular plane angle was higher than that in females with a low mandibular plane angle. Obtaining additional hand-wrist radiographs may facilitate evaluation of skeletal maturity of females. In females with a high mandibular angle, the time to commence orthodontic treatment may be earlier than that in females with a low mandibular angle.

• The korean journal of orthodontics
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• v.50 no.3
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• pp.181-187
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• 2020

Objective: This study aimed to evaluate the differences in cephalometric characteristics and skeletal maturation in girls with central precocious puberty (CPP) via lateral and hand-wrist radiographs. We also aimed to identify the indicators that are most effective for determining skeletal maturity in these patients. Methods: The study included 70 Korean girls (mean age, 8.5 ± 0.5 years) diagnosed with CPP at the Department of Pediatrics, and 48 normal healthy age-matched girls who visited the Department of Orthodontics and had no history of hormone treatment or growth problems. Skeletal maturation was evaluated using lateral cephalometric and hand-wrist radiographs using cervical vertebrae maturation indicators (CVMI) and skeletal maturity indicators (SMI). Results: The mean mandibular plane angle was smaller in the CPP group than in the control group (35.8° ± 4.9° vs. 39.0° ± 6.5°), resulting in greater posterior facial height (p = 0.003). SMI was significantly greater in the CPP group (3.5 ± 1.4 vs. 2.0 ± 1.0) than in the control group (p = 0.001) and was significantly associated with CPP (r = 0.492; p = 0.001), whereas CVMI was not. Conclusions: In comparison with the control group, the CPP group exhibited a smaller mandibular plane angle, greater posterior facial height, and greater skeletal maturation. SMI may be more suitable than CVMI for determining skeletal maturation in CPP. Hand-wrist radiography is recommended in addition to lateral cephalogram for predicting growth in girls with CPP.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.243-258
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• 2008

The purpose of this study was to investigate the relationship between the stages of calcification of various teeth and skeletal maturity stages among Korean individuals. The study subjects consisted 154 female and 179 male ranging from 7 years to 16 years of age. A total of 333 hand-wrist, cephalo-lateral and panoramic radiographs were obtained and analyzed. The tooth development of the mandibular canines, first, second premolars, and second molars were assessed according to the Dermijian's system. Skeletal maturity stages were determined from hand-wrist radiographs by using the SMI system and cephalo-lateral radiographs by using the CVMS, respectively. The results were as follows. 1. The mean ages of each stage of skeletal maturity were consistently younger in female subjects. 2. There was a high correlation between skeletal maturity of hand-wrist and cervical vertebrae in the both sexes. 3. There was a high correlation between skeletal maturity and dental calcification stage of mandibular canines, first premolar, second premolars, and second molar. 4. The mandibular second molar was tooth showing the highest correlation. 5. Percent distributions of the relationship between calcification stages of individual teeth and stages of skeletal maturity were obtained in both sexes. In summary, this suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period.

• Journal of the korean academy of Pediatric Dentistry
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• v.50 no.3
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• pp.334-346
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• 2023

The aim of this study was to assess the correlation between serum levels of insulin-like growth factor-1 (IGF-1), insulin-like growth factor binding protein-3 (IGFBP-3), and hand-wrist radiographs using a skeletal maturity indicator (SMI) and the middle phalanx of the third finger (MP3). Hand-wrist radiographs and blood samples from 205 patients aged 7 - 17 years were retrospectively analyzed by two dentists using the SMI stages, MP3 stages, and serum IGF-1 and IGFBP-3 levels. Serum IGF-1 levels were highest at the SMI 6 - 8 and MP3 - G stage and lowest at the SMI 1 - 3 and MP3 - F stage (p < 0.0001). Serum IGFBP-3 levels were highest at the SMI 9 - 10 and MP3 - I stage and lowest at the SMI 1 - 3 and MP3 - FG stage (p = 0.010, 0.030). As a result of Pearson correlation analysis, a relatively high correlation was found between skeletal maturity using the SMI and MP3 stages and serum IGF-1 levels (r = 0.698, 0.622, p < 0.0001). According to the results of this study, serum IGF-1 levels can be used as an auxiliary measure to evaluate the skeletal maturity of children and adolescents in dentistry. The range from the mean serum IGF-1 level of 472 ㎍/L in SMI 6 stage to the mean IGF-1 level of 510.63 ㎍/L in MP3 G stage could be considered as the peak height velocity in clinical practice.

• The korean journal of orthodontics
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• v.19 no.3
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• pp.123-133
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• 1989

To predict the pubertal growth peak in stature and study the skeletal maturity degree using hand-wrist radiograph, the author used the 70 malocclusions (male 24, female 46). After longitudinal measurement of stature and skeletal maturity indicators of hand-wrist radiographs were taken during 4 years, the rsults were as follows. 1) The pubertal growth peak in stature occurred mainly at SMI 6-7 (56.5%) in female, SMI 5-6 (37.5%), 6-7 (37.5%) in male (Table 5). 2) It was suggested that the pubertal growth peak in stature was already passed, if SMI 8 occurred. 3) Ages of SMI in female were about 2 years earlier than those of SMI in male, and the sexual difference was gradually decreased in puberty. 4) Duration of SMI was longest at SMI 6-7 in both sex and the mean was 8.5 months. After this stage, the velocity of skeletal maturity in female was decreased than in male. 5) The correlation coefficient between each SMI and pubertal growth peak was very high (Table 8).

• Journal of the korean academy of Pediatric Dentistry
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• v.46 no.3
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• pp.247-254
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• 2019

This study aimed to investigate the correlation between maxillary canine's dental maturity and skeletal maturity of growing children. Cephalometric radiographs, hand-wrist radiographs and panoramic radiographs of 299 children aged 6 - 17 years were analyzed to measure the cervical vertebral maturation stages (CVMS), skeletal maturity indicators (SMI) and Demirjian index (DI). Spearman correlation test was used to analyze the correlation between dental maturity and skeletal maturity. There was significant positive correlation between the DI and CVMS in both boys and girls (p = 0.000). Similarly positive correlation was found between the DI and SMI (p = 0.000). The results of this study suggest that the dental maturity of maxillary canine can be used as auxiliary maturity indicator in growing children.

• Journal of the korean academy of Pediatric Dentistry
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• v.35 no.2
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• pp.235-242
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• 2008

The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class I and class III malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class I malocclusions and 308 children( 153 boys, 155 girls) with class III malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman's method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows : 1. In subjects with class I and class III malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in males(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class I and the class III malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class I and class III malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class I and class III malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class I and class III malocclusion group for skeletal maturity of the hand-wrist and third molar development.

• Journal of the korean academy of Pediatric Dentistry
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• v.48 no.1
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• pp.31-41
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• 2021

The aim of this retrospective study was to evaluate the correlation between the midpalatal suture maturation and skeletal maturation in growing children aged 7 - 15 years and predict the maturational stages of the midpalatal suture corresponding to skeletal maturity assessed by the skeletal maturation indicators (SMI) and middle phalanx of the third finger (MP3) stages. The group of this retrospective study was consisted of randomly selected 132 male and 135 female in age from 7 - 15 years. The maturation of the midpalatal suture was evaluated by using images from cone-beam computed tomography (CBCT) while the skeletal age was assessed by hand-wrist radiography. CBCT images and hand-wrist radiographs used in this study were obtained from all subjects for orthodontic diagnosis before orthodontic treatment. The maturational stages of the midpalatal suture showed strong correlations with both SMI and MP3 stages. The correlation between the midpalatal suture maturation and SMI (Spearman's correlation coefficient, ϒ_S = 0.905, p < 0.05) was slightly greater than that of MP3 stages (ϒ_S = 0.830, p < 0.05). There was a positive significant correlation between the midpalatal suture maturation and chronological age (ϒ_S = 0.868,p < 0.05). CBCT for evaluation of the midpalatal suture maturational stages may be unnecessary in every pediatric patients because SMI and MP3 stages were both replaceable useful methods for assessing maturation of the midpalatal suture before orthopedic treatment. In this retrospective study, the diagnostic reliability of the SMI method for estimating midpalatal suture maturation showed better reliability than the MP3 method.

• Imaging Science in Dentistry
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• v.50 no.3
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• pp.237-243
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• 2020

Purpose: The aim of this study was to evaluate the clinical efficacy of a Tanner-Whitehouse 3 (TW3)-based fully automated bone age assessment system on hand-wrist radiographs of Korean children and adolescents. Materials and Methods: Hand-wrist radiographs of 80 subjects (40 boys and 40 girls, 7-15 years of age) were collected. The clinical efficacy was evaluated by comparing the bone ages that were determined using the system with those from the reference standard produced by 2 oral and maxillofacial radiologists. Comparisons were conducted using the paired t-test and simple regression analysis. Results: The bone ages estimated with this bone age assessment system were not significantly different from those obtained with the reference standard (P>0.05) and satisfied the equivalence criterion of 0.6 years within the 95% confidence interval (-0.07 to 0.22), demonstrating excellent performance of the system. Similarly, in the comparisons of gender subgroups, no significant difference in bone age between the values produced by the system and the reference standard was observed (P>0.05 for both boys and girls). The determination coefficients obtained via regression analysis were 0.962, 0.945, and 0.952 for boys, girls, and overall, respectively (P=0.000); hence, the radiologist-determined bone ages and the system-determined bone ages were strongly correlated. Conclusion: This TW3-based system can be effectively used for bone age assessment based on hand-wrist radiographs of Korean children and adolescents.