Determination of the duration of various pubertal growth stages in Indonesian boys and girls using hand-wrist radiographs

Abstract

IntroductionFunctional orthodontic treatment depends on the stage and duration of intermediate stages of pubertal growth for obtaining optimal results, which is stable over time. Even though there are studies about identification of stages of skeletal maturation, the one that clearly outlines the duration is scarce. The purpose of this study was to determine the stage and duration of intermediate stages of pubertal growth of Indonesian subjects using hand-wrist radiographs. MethodsThe study samples consisted of hand-wrist radiographs from 220 girls aged 8.0 to 16.9 years and 109 boys aged 9.0 to 16.9 years, which is analyzed for 11 skeletal maturation index (SMI) stages (PP3= [proximal phalanges III, epiphyseal = diaphysis] to Ru [radius union]) using the Fishman method. The duration of intermediate stages of pubertal growth, PP3= to S (ossification of adductor Sesamoid of thumb), S to MP3cap (medial phalanges III, capping of epiphysis to diaphysis), and MP3cap to Ru were evaluated. Statistical analysis was performed using IBM SPSS version 21. ResultsThere were significant differences between girls and boys of PP3= to S, S to MP3cap, and MP3cap to Ru. Even though girls exhibited statistically significant longer duration of pubertal growth compared with boys, no difference in duration was observed between boys and girls for PP3= to MP3cap (P > 0.05), which is considered the ideal time for functional orthodontic treatment. ConclusionIt is suggested that functional appliance directed toward growth modification should be initiated in girls much earlier than what is now outlined in the literature to gain its full potential.