Title: Maturation for the Evaluation of the Skeletal Maturity among Solapur Population: A Cross Sectional Study

Authors: Dr Vandana R. Dodmani, Dr Sunilkumar P. , Dr Chandrashekhar Gouda B. Patil, Dr Akash B. Lavate, Dr Sneha V. Hoshing, Dr T. Rajesh Singh, Dr Sukumar V. Lipare

 DOI:  https://dx.doi.org/10.18535/jmscr/v6i6.71

Abstract

Introduction: There are various methods to evaluate the developmental status of a patient. But still  the hand wrist and cervical vertebral maturity remains the standard for the evaluation of skeletal maturity.The aims of this study were to evaluate the association between frontal sinus morphology and cervical vertebral maturation for the assessment of skeletal maturity.

Methods: A study was performed on the pretreatment lateral cephalograms of 30 subjects aged 8 to 21 years. The sample was divided into 6 groups based on the cervical vertebral maturation stages. The frontal sinus index was calculated by dividing the frontal sinus height and width, and the cervical stages were evaluated on the same radiograph. The Kruskal-Wallis test was applied to compare frontal sinus index values at different cervical stages, and the post hoc Dunnett T3 test was applied to compare frontal sinus index values between adjacent cervical stages for each sex. A P value of #0.05 was considered statistically significant.

Results: The height and width of the frontal sinus were significantly larger in the male subjects than in the females. A significant association was found between the frontal sinus height and width and cervical stages (P #0.001) in both sexes. Similarly, a weak negative correlation was found between the sinus index and the cervical stages in male subjects), whereas no correlation was found in female subjects. However, the post hoc analysis showed that the values of the sinus index were comparable between any 2 adjacent cervical stages.

Conclusions: The frontal sinus index could not differentiate between the pre pubertal, pubertal and postpubertal stages. Therefore, it cannot be used as a reliable maturity indicator.

Keywords:  lateral cephalogram, frontal sinus, cervical vertebral stages

References

  1. Tanner JM. Growth at adolescence an introduction. In: Carlson D, Ribbens K, eds. Monograph 20, Craniofacial Growth Series. Ann Arbor: Center for Human Growth and Development, University of Michigan, 1987.
  2. Scammon R. The first seriatim study of human growth. Am J Phys Anthropol 1927;10:328-35.
  3. Tanner JM. A history of the study of human growth. Cambridge: Cambridge University Press, 1981.
  4. Falkner F, Tanner JM. Human growth. Vols 1-3. New York: Plenum Press, 1988.
  5. Poznanski A. The hand in radiologic diagnosis. Vol. 1.2nd ed. Philadelphia: WB Saunders, 1976.
  6. Finkel D, Whitfield K, McGue M. Genetic and environmental influences on functional age: a twin study. J Gerontol B Psychol Sci Soc Sci 1995;50:104-13.
  7. Malgorzata M, Tiziano B. Duration of pubertal peak in skeletal Class I and Class III. Angle Orthod 2010;80:54-7.
  8. Tarvade SM, Ramkrishna S. Skeletal maturity indicators. J Orthod Res 2015;3:158-61
  9. Houston WJ, Miller JC, Tanner JM. Prediction of the timing of the adolescent growth spurt from ossification events in hand-wrist films. Br J Orthod 1979;6:145-52.
  10. Houston WJ. Relationships between skeletal maturity estimated from hand-wrist radiographs and the timing of the adolescent growth spurt. Eur J Orthod 1980;2:81-93.
  11. Canavese F, Charles YP, Dimeglio A. Skeletal age assessment from elbow radiographs. Review of the literature. Chir Organi Mov 2008; 92:1-6.
  12. Abdel-Kader HM. The reliability of dental x-ray film in assessment of MP3 stages of the pubertal growth spurt. Am J Orthod Dentofacial Orthop 1998;114:427-9.
  13. Madhu S, Hegde AM, Munshi AK. The developmental stages of the middle phalanx of the third finger (MP3): a sole indicator in assessing the skeletal maturity? J Clin Pediatr Dent 2003;27:149-56.
  14. Lamparski DG. Skeletal age assessment utilizing cervical vertebrae [thesis]. Pittsburgh, Pa: University of Pittsburgh; 1972.
  15. Hassel B, Farman AG. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995;107:58-66.
  16. Franchi L, Baccetti T, McNamara JA. Mandibular growth as related to cervical vertebral maturation and body height. Am J Orthod Dentofacial Orthop 2000; 118:335-40.
  17. Wong RW, Alkhal HA, Rabie AB. Use of cervical vertebral maturation to determine skeletal age. Am J Orthod Dentofacial Orthop 2009;136:484.e1-6.
  18. Nestman TS, Marshall SD, Qian F, Holton N, Franciscus RG, Southard TE. Cervical vertebrae maturation method morphologic criteria: poor reproducibility. Am J Orthod Dentofacial Orthop 2011;140:182-8.
  19. Gabriel DB, Southard KA, Qian F, Marshall SD, Franciscus RG, Southard TE. Cervical vertebrae maturation method: poor reproducibility. Am J Orthod Dentofacial Orthop 2009;136: 478.e1-7.
  20. Ruf S, Pancherz H. Frontal sinus development as an indicator for somatic maturity at puberty? Am J Orthod Dentofacial Orthop 1996;110:476-82.
  21. Ruf S, Pancherz H. Can frontal sinus development be used for the prediction of skeletal maturity at puberty? Acta Odontol Scand 1996;54:229-34.
  22. Ertuk N. Fernrontgenuntersuchungen uber die entwicklung der stirnhohle. Fortschr Kieferothop 1968;29:245-8.
  23. Baccetti T, Franchi L, McNamara JA Jr. The cervical vertebral maturation (CVM) method for the assessment of optimal treatment timing in dentofacial orthopedics. Semin Orthod 2005; 11:119-29.
  24. Shapiro R, Schorr S. A consideration of the systemic factors that influence frontal sinus pneumatization. Invest Radiol 1980;15:191-202.
  25. Hanson CL, Owsley DW. Frontal sinus size in Eskimo populations. Am J Phys Anthropol 1980;53:251-5.
  26. Pond_e JM, Andrade RN, Via JM, Metzger P, Teles AC. Anatomical variations of the frontal sinus. Int J Morphol 2008;26:803-8.
  27. Patil AA, Revankar AV. Reliability of the frontal sinus index as a maturity indicator. Indian J Dent Res 2013;24:523.
  28. Duque CS, Casiano RR. Surgical anatomy and embryology of the frontal sinus. In: Stilianos E, Kountakis B, Wolfgang A, editors. The frontal sinus. Berlin, Germany: Springer; 2005. p. 21-31.
  29. Dolan KD. Paranasal sinus radiology, part 1A: introduction and the frontal sinuses. Head Neck Surg 1982;4:301-11.
  30. Brown WA, Molleson TI, Chinn S. Enlargement of the frontal sinus. Ann Hum Biol 1984;11:221-6

Corresponding Author

Dr Vandana R. Dodmani

C/O Dr. Raghuvir  B. Dodmani,  56, Railway lines,

Wonderland Appartments, Flat no. 12, Solapur-  413001

Contact no. 8999006378