Study Of Adolescent Skeletal Maturation During Pubertal Growth Spurt In Tianjin

Objective This study was to investigate the maturation of wrist and cervical vertebrae of 9～15 years old children from Tianjin, analyze the stage of skeletal maturation and predict the puberty growth spurt using the maturation of wrist and cervical vertebrae, offer more proper method of determining skeletal maturation for clinical orthodontists.This study included three parts as follows:PartⅠanalyzed the growth of hand-wrist in Tianjin adolescents and compared with the CHN standard.Materials and methods The samples were derived from hand-wrist radiographs of 207 patients(86male, 121 female), 9～16 years of age, at the Orthodontic Department, Tianjin Stomatological Hospital. The CHN scoring method was utilized to read the growth level of 14 hand-wrists, add the scores and get the individual skeletal maturity scores.Results The following regression formulae were derived form the correlation of skeletal age and chronologic. Male: y=2.863+0.736x, Female: y=2.970+0.710x. The results indicated that the timing of the pubertal growth spurt was advanced comparing with CHN of 90th. PartⅡcompared the skeletal maturation during pubertal growth spurt with different sex.Materials and methods 445 patients (199 male, 246 female), 9～16 years of age, were selected at the Orthodontic Department, Tianjin Stomatological Hospital. Left hand-wrist radiographs derived from 207 patients. 6 anatomical marks were choosed and 11 index of bone were assessed by Fishman method. Skeletal maturation stages of each hand-wrist radiograph (acceleration, peak, deceleration) were determined. 238 patients were taken lateral cephalometeric radiographs. Growth stage of cervical vertebrae stages(C2～C4) and pubertal growth spurt were determined by the Baccetti method.Results The peak of skeletal maturation evaluation using hand-wrist was different, the females developed 2 years quickly than the males. The skeletal maturation stages determined by cervical vertebrae and hand-wrist were identical.PartⅢstudied the changes of cervical vertebrae during the pubertal growth spurt in Tianjin adolescents.Materials and methods The samples were selected from lateral cephalometric radiogrlphs of 238 patients (113male, 125 female), 10～15 years of age, at the Orthodontic Department, Tianjin Stomatological Hospital. To measure the vertebral body height, anteroposterion vertebral body length on C3 and C4 by WinCeph 8.0 cephalograms analysis, calculate the ratio of H3/AP3, H4/AP4 and analyze the ratios with SPSS11.5.Results The changes of H3/AP3, H4/AP4 were correlated to pubertal growth spurt. H3/AP3, H4/AP4 were conclusive to predict and assess the pubertal growth spurt in clinic. Conclusion Study of hand-wrist and cervical vertebra indicated that CHN scoring method of 90th didn't apply to assess the skeletal maturation in Tianjin adolescents. An appropriate standard should be established so that orthodontists could assess the skeletal maturation exactly in Tianjin. The peak of skeletal maturation evaluation using hand-wrist was different, the females developed 2 years quickly than the males. The skeletal maturation stages determined by cervical vertebrae and hand-wrist were identical. H3/AP3, H4/AP4 were conclusive to predict and assess the pubertal growth spurt.