Abstract
Abstract Objectives The assessment of hand-wrist films to identify skeletal maturation stage is a commonly used method for the determination of the status of a growing patient. However, there is limited information available regarding skeletal growth evaluation in subjects with a unilateral cleft lip and palate (UCLP). Therefore, the current study aimed to examine skeletal and chronological ages in subjects with a UCLP for comparison with those of a non-cleft control group to derive clinical guidelines. Methods Hand-wrist films of 45 UCLP subjects (24 male, 21 female) and 45 Angle Class I orthodontic patients (17 male, 28 female) were evaluated. Skeletal age was assessed by comparing ossification events with standard radiographs illustrated in the Greulich-Pyle atlas and recording based on the best match of maturity criteria. Results A high correlation coefficient was observed between skeletal and chronological ages in the overall study sample (p < 0.01) (N = 90). Skeletal age (11.4 years) was delayed in the UCLP group when compared with chronological age (12.3 years), although the difference between the two was statistically insignificant. Skeletal age (13.6 years) was similar to chronological age in the control group (13.1 years). Conclusions The discrepancy between chronological and skeletal age was greater in UCLP subjects compared with controls. Given that the skeletal age of male and female UCLP subjects was delayed in comparison with their chronological ages, it is of particular importance that hand-wrist films should be used instead of chronological age to assess the growth status of UCLP subjects.
Highlights
The determination of growth status and the percentage of remaining facial growth is an essential part of the orthodontic treatment planning process
The hand-wrist radiographs were viewed in a darkened room to facilitate bone identification, and skeletal age was assessed by comparing ossification events in the subjects with standard radiographs found in the Greulich-Pyle atlas and by recording the best match of maturity criteria
Descriptive analysis and correlation coefficients for chronological and skeletal ages for each group are provided in Tables I and II
Summary
The determination of growth status and the percentage of remaining facial growth is an essential part of the orthodontic treatment planning process. Several characteristics can be used to help identify a skeletal growth stage, including chronological age; peak growth velocity in standing height; pubertal markers such as appearance of pubic and axillary hair, voice changes in males and menarche and breast development in females; bone maturation Australasian Orthodontic Journal Volume 33 No 2 November 2017 radiographically); and dental development.[2] dental eruption time is not an exact indicator of a patient’s skeletal age,[3,4] nor is chronological age, due to wide variations between subjects in the onset of the pubertal growth spurt.[5,6] Hägg and Taranger reported a two-year difference in the beginning, peak and end of the pubertal growth period for males and females, but individual variations of approximately six years for each growth event.[7]. The use of the cervical spine has been reported,[8,9] skeletal maturation is generally determined by examining the ossification sequence of the hand-wrist bones.[6,10,11] Hand-wrist films have traditionally been used to assess somatic maturity
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