Skeletal Maturation Stages Research Articles

Salivary IGF-1 and Alkaline Phosphatase-Based Modeling for Skeletal Maturity Prediction in Orthodontic Patients.

Results A strong positive correlation was found between CA and cervical stages (r = 0.836, P < 0.001). Based on the regression model analysis, the model which combined IGF-1, ALP, and CA provided the best prediction at P < 0.001 with McFadden's pseudo R2 value of 0.552 for cervical stage prediction and 0.646 for growth phase prediction. In particular, its predictive ability for the prepubertal, pubertal, and postpubertal growth phases was 95%, 80%, and 90%, respectively. Conclusions A new model with the combination of salivary IGF-1 and ALP with CA can be used as a less invasive method to determine the cervical stage and also growth phase with high predictive ability in healthy subjects.

Comparison of the reproducibility of two cervical vertebrae maturation methods

Aim: Facial orthopaedic treatments based on the stimulation or restrictions of craniofacial bone growth are more effective when carried out during the pubertal growth spurt. The aim of this cross-sectional study was to evaluate the reproducibility of two cervical vertebrae methods (CVM) with manual tracing and direct visual inspection. Methods: A sample of 60 lateral cephalometric radiographs (10 of each of the 6 CVM stages) was randomly selected from 171 records. 5 orthodontists classified these radiographs according to the skeletal maturation stage in 2002 and 2005, and the application of both methods was conducted by direct visual inspection and evaluation through manual tracing. Results: The average reliability of the two methods determination and the two forms of evaluation was substantial. The direct visual inspection evaluation showed the highest reliability and agreement interexaminer values for both methods, as well as the intraexaminers evaluation. Conclusion: The reproducibility of CVM method was substantial, indicating its clinical use to determine the skeletal maturity and the ideal moment for treatment execution.

Transversal craniofacial development between skeletal maturation stages: A multi-center posteroanterior cephalometric study

Objectives: The aim of this study is to evaluate the dentofacial transversal norms according to the stages of skeletal maturation in growing Turkish individuals and to determine differences between the genders. Materials and Methods: In our multi-centered, cross-sectional retrospective study, in which transversal measurements were made according to skeletal maturation stages (SMSs), posteroanterior radiographs of 572 individuals (292 female, 280 male) with skeletal and dental Class I relationships and good occlusion were examined at the age range of 7–18 years. SMSs were determined using Björk, Grave and Brown hand-wrist radiography. A linear regression model was used for changes of transversal measurements between SMSs, and t-test was used to determine transverse changes between the genders. Results: There was no statistically significant difference between females and males in cranial, facial, and nasal width values up to SMS 5. In maxillary, mandibular, maxillary intermolar, and mandibular intermolar width measurements, males had higher values in most stages of skeletal maturation compared to females. Apart from nasal width and maxillomandibular ratio values in females, the regression model in which transversal measurements were dependent variables, and SMS were independent variables was found to be significant. According to cumulative growth percentages, the growth completion in transversal measurements occurred earlier in females. Conclusion: Transversal measurements determined according to the stages of skeletal maturation can be a guide for orthodontists in the clinic to determine values that deviate from normal.

Concordances and correlations between chronological, dental and bone ages: A retrospective study in French individuals

Bone and dental maturations are subject to physiological, environmental and pathological variables and are unique to each individual. Numerous methods for age estimation appeared to answer a new demand explained by the contemporary migratory movements and the increase of the crime rates. The objective of this study was to observe the relationships between skeletal and dental maturation stages to estimate which methods can be applied to a French population. This retrospective study was based on panoramic and cephalometric radiographs belonging to 192 (101 females and 91 males) orthodontic patients aged between 9 and 19 years, inhabitants of the Provence-Alpes-Côte d′Azur region. The Demirjian method based on dental calcification was used to estimate dental age. For the assessment of skeletal maturity and bone age, the Cervical Vertebral Maturation (CVM) method (Baccetti et al.) and its computerized version (Decocq et al.) were used. Spearman’s correlation tests were performed to estimate the correlation between dental calcification stages and those of cervical vertebral maturation among the study population. The methods of Lin’s concordance correlation coefficient and Bland and Altman were used to analyze the concordance between bone, dental and chronological ages. A moderate but statistically significant correlation was obtained between dental and skeletal developmental stages (R = 0.383–0.618). The tooth showing the highest correlation with vertebral stages was the second molar for both sexes. Earlier vertebral maturation stage affiliation was observed in girls. The results confirmed that bone and dental maturations can be assessed to estimate relevant biological ages for children in orthodontic or forensic contexts.

Skeletal Maturation in Different Vertical Facial Growth Pattern.

ObjectiveTo assess whether there are differences in skeletal maturation among subjects with horizontal, vertical, and neutral facial growth patterns.Material and methodsThe study was performed on 48 latero-lateral craniographs of patients with horizontal, 48 with vertical and 50 with neutral growth patterns aged 12 to 18 years. Eight variables from the Zagreb 82 MOD, Bracchetti and Accord analysis, were selected for measuring angular and linear parameters on latero-lateral craniographs. The assessment of skeletal maturation was done by using the CVMS method.ResultsStatistical analysis showed significant differences in skeletal maturity (p <0.001) between subjects with horizontal and vertical growth pattern and between the subjects with neutral and vertical growth pattern (p <0.05), while no significant difference was found between patients with horizontal and neutral growth pattern. In the younger group (12 – 15 years) there was a statistically significant difference (p <0.05) among subjects with horizontal and vertical growth patterns. In the older group (16 – 18 yrs) there was a statistically significant difference (p > 0.05) in skeletal maturity among subjects with vertical growth patterns compared with horizontal and neutral. In terms of stages of skeletal maturity, patients with a horizontal and neutral growth pattern in the younger group were on average in the fourth stage, and those with a vertical growth pattern in the third stage. In the older group, patients with a horizontal and neutral growth pattern were on average in the fifth stage of skeletal maturity and those with a vertical growth pattern in the fourth stage.ConclusionAccording to the growth pattern, patients differ in the stage of skeletal maturity.

Correlation between Dental and Skeletal Maturity in Korean Children

The aim of this study was to investigate the relationships between the stages of calcification of various teeth and skeletal maturity stages among Korean subjects. The samples were derived from hand-wrist, panoramic radiographs, and lateral cephalograms of 743 subjects (359 males and 384 females) with ages ranging from 6 to 14 years. Calcification of seven permanent mandibular teeth on the left side were rated according to the system of Demirjian. To evaluate the stage of skeletal maturation, hand-wrist radiographs were analyzed by skeletal maturity indicators (SMI) system of Fishman and lateral cephalograms by cervical vertebral maturation (CVM) method of Baccetti. Statistically significant relationships were found between dental calcification and skeletal maturity stages according to Spearman rank-order correlation coefficients (r = 0.40-0.84, p &lt; 0.001). The second molar showed the highest correlation and central incisor showed the lowest correlation for female and male subjects. For both sexes, canine stage G and second molar stage F were related to SMI 6 and CS 3. Because of the high correlation coefficients, this study suggests that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator of the pubertal growth period in Korean patients.

Transverse dentofacial dimensions according to skeletal maturation

Aim: This study aimed to determine the dentofacial transverse dimensions according to the hand-wrist and cervical vertebrae skeletal maturation stages in order to evaluate the differences between the sexes, to identify the correlations between transverse measurements, and to compare the transverse measurements of individuals of different origins with those of Turkish individuals.&#x0D; Methodology: Transverse measurements were performed using the posteroanterior radiographs of 265 Turkish individuals (150 females, 115 males) at 7–17 years of age. Skeletal maturation was evaluated using hand-wrist radiographs and lateral cephalometric radiographs, and the results were used to categorize the patients into 3 stages of hand-wrist skeletal maturity (prepubertal/pubertal/postpubertal) and 2 stages of cervical vertebrae maturity (prespurt/postspurt). Seven measurements were evaluated. A multivariate linear regression model was used to evaluate the correlations between transverse measurements and the variables of skeletal age and sex.&#x0D; Results: Sex was a significant explanatory factor for all transverse variables. In the postpubertal and postspurt stages, all transverse measurement values were found to be higher in males. Postpubertal term was a significant explanatory factor for maxillary, mandibular, mandibular intermolar, and maxillary intermolar widths, whereas pubertal term was only a significant explanatory factor for maxillary intermolar width.&#x0D; Conclusion: Skeletal age and sex should be taken into account when determining transverse dentofacial measurements.&#x0D; &#x0D; How to cite this article: Sezen Erhamza T, Akan B, Nazik Ünver F, Evli Dalgalı P. Transverse dentofacial dimensions according. Int Dent Res 2021;11(2):99-108. https://doi.org/10.5577/intdentres.2021.vol11.no2.7&#x0D; &#x0D; Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Post-pubertal effects of the Alt-RAMEC/FM and RME/FM protocols for the early treatment of Class III malocclusion: a retrospective controlled study.

To assess the stability of the effects of the modified Alt-RAMEC and facial mask (FM) protocol at a post-pubertal observation. Twenty-one Class III patients (11 males and 10 females, 6.5 ± 0.7 years) treated consecutively with the Alt-RAMEC/FM approach and presenting with lateral cephalograms taken before treatment (T1), after treatment (T2), and at post-pubertal observations (T3) were compared with 22 Class III patients (9 males and 13 females, 6.9 ± 1.2 years) treated with the rapid maxillary expansion (RME) and FM protocol and with 15 Class III untreated subjects (7 males and 8 females, 6.2 ± 2.2 years). At T3, all patients showed a post-pubertal skeletal maturation stage (CS4-CS6). Descriptive statistics and statistical comparisons between the three groups at T1 and for the T3-T1, T2-T1, and T3-T2 changes were assessed by means of the ANOVA or Kruskal-Wallis test. During the overall observation period, Alt-RAMEC/FM and RME/FM protocols produced statistically significant favourable effects when compared with the Control group (ANB + 2.8° and +2.2°, respectively; Wits appraisal +4.4 mm and +2.7 mm, respectively). No statistically significant differences were found between the outcomes of the Alt-RAMEC/FM and RME/FM protocols neither at the post-pubertal or short-term observations. Retrospective study and the comparison with an historical control sample of subjects with untreated Class III malocclusion. The Alt-RAMEC/FM protocol cannot be recommended as the approach of choice for the therapy of Class III dentoskeletal disharmony in very young subjects compared to the conventional RME/FM protocol.

SKELETAL MATURATION EVALUATION USING MANDIBULAR SECOND MOLAR CALCIFICATION STAGES

Objective: To examine the relationship between skeletal maturity and mandibular second molar calcification stages and assessing mandibular second molar as a diagnostic tool for skeletal maturity evaluation.&#x0D; Study Design: Cross sectional study.&#x0D; Place and Duration of Study: Orthodontic department, Sandeman Provincial Hospital, Quetta, from Jan to Jun 2019.&#x0D; Methodology: The sample size of the study 240 comprised of equal number of males and females. Inclusion criteria was defined to include the patients (male and female) with the age from 9-16 years; on the same time, patients without facial asymmetry and without prior history of facial or neck trauma/injury or surgery were considered for the present study. Exclusion criteria was defined to exclude those patients from the study hoe had the history of bone disease and major illness in past; known cases of muscular dystrophy; any congenital malformation of cervical vertebrae and tooth caries; Low quality x-ray with poor contrast.&#x0D; Results: The study revealed association between Demirjian Index and Cervical Vertebrae Maturation Index stages (0.875) with the statistical significance. Demirjian Index Stage H indicated the greater percentage distribution at stage 4 and 6 of Cervical Vertebrae Maturation for males. Similarly, in females, demirjian index stages G and H showed the greater percentage at stage 4 and 6 of cervical vertebrae maturation index respectively.&#x0D; Conclusion: Analysis indicated that cervical vertebrae maturation index and Demirjian Index (DI) occurred earlier in femalesthan males.

The Correlation between Dental Stages and Skeletal Maturity Stages.

Introduction The determination of skeletal maturity stages is very important in orthodontic treatment planning, especially skeletal discrepancies in growing individuals. A hand-wrist radiograph is considered the most accurate approach for skeletal maturity detection. Dental calcification stages have been suggested as an alternative diagnostic method to decrease radiation exposure. The recent study is aimed at detecting the efficacy of dental calcification stages in assessing skeletal maturity during the prepubertal and pubertal growth periods. Methods Patients' records were collected from the Aleppo Orthodontic Center. Dental maturity stages were assessed from a panoramic radiograph using the Demirjian method, while skeletal maturity stages were determined using the Björk method. Four permanent left mandibular teeth were included (canine, 1st premolar, 2nd premolar, and 2nd molar) for the study. Results From 517 records, 295 records (145 males and 150 females) were included. The Spearman rank-order correlation coefficients between skeletal maturation and dental maturation were strong and statistically significant (ranging from 0.789 to 0.835). The highest correlation was between skeletal stages and the second molar (r = 0.829 and 0.88 in males and females, respectively). Receiver operating characteristic (ROC ) curve suggested a high validity of the sum of dental stages for the four teeth in identifying MP3= stage (sensitivity was 70%, specificity was 92.77%, and ROC area was 0.81) but not for MP3cap (sensitivity was 50.85%, specificity was 81.36%, and ROC area was 0.66). Conclusions The correlation between the skeletal maturity stages and the dental calcification stages was high. The orthodontist can use the dental stages as a definite diagnostic tool for prepubertal growth period.

Assessment of the Relationship between Skeletal Maturity and the Calcifications Stages of Permanent Canines and Second Premolars.

This study aimed to evaluate the relationship between the calcification stages of permanent maxillary and mandibular canines and second premolars and skeletal maturity in both sexes. This study included 138 patients (82 females, 56 males) who were treated in the Department of Orthodontics, Altınbaş University. The mean age of the patients was 12.31±1.76 years, ranging from 7.8 years to 15.8 years. Dental maturity stages of canines and second premolars were evaluated according to the Demirjian index on digital panoramic radiograph. The skeletal maturation stage was determined using the cervical vertebral maturation (CVM) index. The Pearson correlation analysis was performed to assess the association among CVM stages and calcification stages of canines, second premolars, sex, and chronological ages. A statistically significant correlation was found between CVM and the calcification stages of the canines and second premolars (p<0.05). The calcification stages of the canines and second premolars had the highest distribution of Stage F and Stage G at CVM2 (p<0.01). For the canines and second premolars, Stage H corresponded to CVM3 in female patients and a high percentage of Stage G corresponded to CVM3 in the male group. A significant correlation was found between the calcification stages of maxillary and mandibular canines, second premolars, and skeletal maturity in both sexes. It was observed that calcification stages and cervical maturations were advanced in female subjects compared with male subjects.

A Simplified Skeletal Maturity Scale and Thumb Ossification Composite Index to Assess Skeletal Maturity and Predict Height Velocity in Japanese Females with Adolescent Idiopathic Scoliosis.

Introduction Since Little et al. first reported that peak height velocity (PHV) could be described as a reliable clinical marker for the prediction of remaining growth and curve progression of adolescent idiopathic scoliosis (AIS) in clinical practice, much attention has been paid to PHV as a possible predictor of curve progression in patients with AIS. However, PHV itself is only identified retrospectively, so its value is not available at the first outpatient clinic visit. Using the simplified skeletal maturity scale (SSMS) and the thumb ossification composite index (TOCI) staging systems, this study aims to assess skeletal maturity and predict height velocity (HV) in Japanese female patients with AIS. Methods This study involved 95 female patients with AIS, ranging from 9 to 17 years old. A standing AP radiograph of the entire spine and a hand radiograph were retrospectively obtained to establish the skeletal maturity stage in accordance with the SSMS and TOCI systems. Height measurements were recorded at each visit; HV was calculated as the height change (cm) divided by the time interval (years). Results The TOCI stage rating increased identically to the SSMS stage rating increase. The chi-square test showed that there was a significant correlation between the two scoring systems (χ2=720.4). The Cramer V correlation also demonstrated a very strong correlation (Cramer V=0.62). Regarding the relationship between HV and each SSMS and TOCI stage, HV decreased as SSMS and TOCI stages increased. η2 equaled to 0.67 in both groups and displayed a strong correlation between HV and SSMS and TOCI stages. Conclusions These findings suggest that evaluation of the rate of HV using these radiological assessments is of supreme importance for determining the status of pubertal maturity and predicting the remaining amount of adolescent growth at the outpatient clinic visit.

Evaluation and management of elbow injuries in the adolescent overhead athlete.

With an increased interest in youth sports, the burden of overhead throwing elbow injuries accompanying early single-sport focus has steadily risen. During the overhead throwing motion, valgus torque can reach and surpass Newton meters (N m) during the late cocking and early acceleration phases, which exceeds the tensile strength (22.7–33 N m) of the ulnar collateral ligament. While the ulnar collateral ligament serves as the primary valgus stabilizer between and degrees of elbow flexion, other structures about the elbow must contribute to stability during throwing. Depending on an athlete’s stage of skeletal maturity, certain patterns of injury are observed with mechanical failures resulting from increased medial laxity, lateral-sided compression, and posterior extension shearing forces. Together, these injury patterns represent a wide range of conditions that arise from valgus extension overload. The purpose of this article is to review common pathologies observed in the adolescent overhead throwing athlete in the context of functional anatomy, osseous development, and throwing mechanics. Operative and non-operative management and their associated outcomes will be discussed for these injuries.

Mandibular orthopedic advancement in different facial patterns and distinct stages of skeletal maturation.

ABSTRACTThe Herbst appliance can be very effective in treatment of Class II patients with mandibular retrognathism. Because of the continuous action in a full-time basis, treatment time using it normally takes from six to ten months, and is usually followed by a second phase of full fixed appliances, in order to obtain both occlusal refinement and long term stability. Despite Herbst appliance’s effectiveness in the occlusal and dentoalveolar perspectives, its facial results may differ among patients with different growth patterns, as well as in distinct stages of skeletal maturation. In the current paper, two patients with different facial patterns are presented, who were treated under the same protocol, using Herbst and full fixed appliances in different skeletal maturation stages, and both dentoalveolar and facial results are compared and discussed.

Nasomaxillary effects of miniscrew-assisted rapid palatal expansion and two surgically assisted rapid palatal expansion approaches

This retrospective study was performed to evaluate nasomaxillary changes in 36 patients at an advanced stage of skeletal maturity who underwent miniscrew-assisted rapid palatal expansion (MARPE) or surgically assisted rapid palatal expansion (SARPE) with/without an alar base cinch. Cone beam computed tomography images taken before and after expansion were analysed. Changes in the width of the dental arch (D66S, D66I), maxillary base (MxMol), and nasal floor and nasal cavity in the molar and canine regions (NaFMol, NaFCan, NaCMol, NaCCan) were compared, as well as changes in the choanal aperture (CA) and nasal soft tissue (NW). The MARPE technique produced smaller dental changes (D66S; P=0.025) and greater nasomaxillary expansion (MxMol, P=0.010; NaCMol, P=0.016; NaCCan, P=0.017; NaFMol, P=0.001; CA, P=0.002) than both SARPE techniques. Changes in NW did not differ significantly between the groups (P=0.200). MARPE uniformly increased the anterior and posterior widths of the nasal cavity. SARPE expanded the nasal cavity in a ‘V-shape’ pattern. Changes in the nasal cavity and choanal aperture related to the amount of dental arch expansion were greater for MARPE than for SARPE. All three approaches increased the width of the nasal soft tissue, although the cinch in SARPE limited this increase.

Supracondylar Humerus Fractures in Older Children: Success of Closed Reduction and Percutaneous Pinning.

The incidence of supracondylar humerus (SCH) fracture declines and fracture types change as children grow. Optimal treatment method is unclear in older children. The aim of the study was to determine if fracture type and configuration of distal humerus fractures changes as patients approach skeletal maturity, and to assess the success of closed reduction and percutaneous pin (CRPP) in extra-articular SCH fractures in this transitional age group. Inclusion criteria for this retrospective review were (1) distal humerus fractures with extension types 2 and 3, flexion type, T-type; (2) surgically managed, and (3) modified Sauvegrain score ≥1. Reviewed parameters included fracture type and configuration, grade of skeletal maturity, fixation technique, and loss of reduction. Primary analysis was to determine the distribution of fracture type and configuration with age or grade of skeletal maturity. Secondary analysis was used to determine the factors affecting treatment success of CRPP in extra-articular fractures. A total of 142 patients were included (58 males and 84 females). Fracture types revealed significant changes with increased age (P=0.031) and skeletal maturity grade (P<0.005). Skeletal maturity was a better predictor of changing fracture type than chronological age. T-type fractures were only seen in patients with modified Sauvegrain score ≥6 and flexion-type fractures were only seen in patients with modified Sauvegrain score ≤4. Loss of reduction rate after CRPP was 5%. The success of CRPP was not affected by age, sex, modified Sauvegrain score, fracture type, direction of displacement, coronal fracture pattern, number of pins or medial pin use. Fracture obliquity in the sagittal plane (P=0.05), suboptimal pin spread (P<0.01), and lack of bicolumnar fixation (P<0.01) were found as statistically significant factors associated with failed CRPP. The distribution of fracture type changed with increased age and skeletal maturity. CRPP of extra-articular fractures in older children is a reliable option regardless of the stage of skeletal maturity. Determinants of a good outcome include optimal pinning technique with adequate pin spread at the fracture site and bicolumnar fixation. Level IV-retrospective case series.

The relevance of body mass index in forensic age assessment of living individuals: an age-adjusted linear regression analysis using multivariable fractional polynomials

In forensic age assessment of living individuals, developmental stages of skeletal maturation and tooth mineralization are examined and compared with a reference population. It is of interest which factors can affect the development of these features. We investigated the effect of body mass index (BMI) on the developmental stages of the medial epiphysis of the clavicle, the distal epiphysis of the radius, the distal epiphysis of the femur, the proximal epiphysis of the tibia, and the left lower third molar in a total of 581 volunteers, 294 females and 287 males aged 12–24 years, using 3 T MRI. BMI values in the cohort ranged from 13.71 kg/m2 in a 12-year-old female to 35.15 kg/m2 in an 18-year-old female. The effect of BMI on the development of the characteristics was investigated using linear regression models with multivariable fractional polynomials. In the univariable analysis, BMI was associated with all feature systems (beta between 0.10 and 0.44; p < 0.001). When accounting for the physiological increase of BMI with increasing age, the effect of BMI was lower and in the majority of the models no longer clinically relevant. Betas decreased to values between 0.00 and 0.05. When adding feature variables to a model already including age, r2 values increased only minimally. For an overall bone ossification score combining all characteristics, the adjusted ß was 0.11 (p = 0.021) and 0.08 (p = 0.23) for females and males, respectively. Low ß and r2 values (0.00 (adjusted)–0.16 (crude)) were present in both models for third molar development already in the unadjusted analyses. In conclusion, our study found no to little effect of BMI on osseous development in young adults. Teeth development in both sexes was completely independent of BMI. Therefore, dental methods should be part of every age assessment.

Therapeutic effectiveness of AdvanSync2 at different stages of skeletal maturity in skeletal Class II malocclusion: A single-blind clinical trial

Objectives: AdvanSync2 (Ormco, Glendora, California, USA) is a molar-to-molar fixed Class II corrector, based on the philosophy of Herbst which allows the bonding of the both upper and lower arches simultaneously along with fixed functional therapy. The purpose of this study was to cephalometrically compare the skeletal and dentoalveolar effects of AdvanSync2 in the correction of Class II malocclusions in circumpubertal and post-pubertal patients. Materials and Methods: Forty-eight samples were selected and divided into two groups based on their CVMI staging, Group A, i.e., at CVMI Stages 2 and 3 (18 girls and six boys) and Group B, i.e., CVMI Stages 4, 5, and 6 (19 girls and five boys). Cephalograms taken at pre- and post-AdvanSync2 stages were compared and analyzed. Results: The results showed that there was a significant increase in mandibular length in both groups. Both the groups also showed sagittal maxillary restriction, maxillary molar distalization, and retroclination of maxillary incisors. On comparison between Group A and Group B, there was no statistically significant differences in terms of maxillary position, size of maxilla, as well as upper and lower incisor inclinations in Group A except for improvement of mandibular position (SNB; P ≤ 0.01) and greater amount of chin growth (B -Pg; P ≤ 0.01) with respect to Group B. Conclusion: AdvanSync2 can be used as an effective fixed functional appliance in post-pubertal group for sagittal mandibular correction in skeletal Class II patients.

Assessment of Relationship Between Insulin-Like Growth Factor- 1 Levels And Mp3 Radiographs in Determining Skeletal Maturity

Context: The clinical importance of evaluating skeletal maturation has long been recognized by the health professions. Skeletal maturation is an integral part of individual patterns of growth and development.With many orthodontic patients, pubertal growth needs to be factored into the diagnostic equation.Accurate prediction of the timing of the pubertal growth spurt and the amount of remaining growth affects the treatment decisions in orthodontics, orthognathic surgery and dental implantology.IGF-1 mirrors growth hormone levels. Thus, IGF-I might be a good indicator of residual mandibular growth. Aims: To establish a relationship between IGF-1 levels evaluated from blood samples and MP3 stages of skeletal maturity. To investigate the relationship between the IGF-1 and the skeletal age. Methods and Material: The sample size consisted of 40 subjects between the age group of 5 – 25 including both the sexes. The periapical radiographs for MP3 and blood sample for IGF-1 was collected. Sample was sent to the lab to determine IGF-1 values. Statistical analysis used: Descriptives, ONE way ANOVA, POST HOC test, Spearman coefficient. Results: Results showed that IGF-1 levels at the peak pubertal growth were statistically higher than the start of pubertal growth, acceleration, deceleration, maturation of growth spurt and on completion of growth. There was statistically significant positive correlation between IGF-1 and MP3 stages. Conclusions: From the present study it can be concluded that IGF-1 can be successfully used as a skeletal maturity indicator. Key-words: IGF-1, MP3, GH Key Messages:The results of this study shows that mean IGF-I levels at pubertal and post pubertal stages were significantly higher than at the other stages. From the present study it can be concluded that IGF-1 can be successfully used as a skeletal

CORRELATION OF SKELETAL MATURATION STAGES OF MP3 WITH ONSET OF MENARCHE AMONGST RURAL AND URBAN SCHOOL GIRLS

Introduction: The purpose of this study was to evaluate and correlate skeletal maturation stages of Middle phalanx of third finger (MP3) with the onset of menarche in rural and urban school girls. Materials and methods: 100 urban school girls and 100 rural school girls were randomly selected comprising of 50 menarche unattained girls and 50 menarche attained girls respectively for each group. For each subject, radiographs of middle phalanx of middle finger and record about onset of menarche were taken after every three months for a total duration of one and half year comprising a total of 6 visits. Results: The results showed onset of menarche at HI MP3 stage for 50%, HMP3 stage for 47.5% and GMP3 stage for 2.5% in rural girls (subgroup D2) whereas onset of menarche was at HMP3 stage for 41.6%, HI MP3 stage for 50% and GMP3 stage for 8.33% in urban girls (subgroup B2). No significant difference in the MP3 skeletal stage distribution of two groups was seen after applying Chi-square test (P&gt;0.05). The mean menarche attaining age of the rural girls was 12.6±.84 years and urban girls was 11.8±.79 years. Conclusions: The correlation between MP3 skeletal maturation and onset of menarche, established the onset of menarche at H and HI stage for both rural and urban school girls. The results show earlier mean menarche-attaining age for urban girls than rural girls