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Introduction. In general, class II is more prevalent than class III (Danaie et al, 2006) (McLain et al, 1985). Introduction. Bimaxillary protrusion and class III malocclusion prevalence is more in Saudi population than in western communities (Jones WB, 1987). Introductio
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1. Introduction Malocclusion has a high prevalence among populations
(Josefsson et al. 2007)
(Chew et al.2006)
The need for orthodontic treatment among Saudi children is 60%
(Al Emran et al. 1990)
2. Introduction In general,
class II is more prevalent
than class III
(Danaie et al, 2006)
(McLain et al, 1985)
3. Introduction Bimaxillary protrusion and class III malocclusion prevalence is more in Saudi population than in western communities
(Jones WB, 1987)
4. Introduction Skeletal discrepancies,
what is the cause?
5. Introduction The reason of skeletal discrepancies is the different growth potentials of different bones of the craniofacial complex
(Riedel, 1952)
6. Introduction Orthopedic intervention is commonly used to affect the growth potential of skeletal components
(Proffit et al, 1998)
(Vig et al, 2000)
7. Introduction The pubertal growth spurt is typically used to modify the growth of the related structures
( DiBiase A, 2002)
( Arvystas MG, 1998)
8. Introduction How can we detect the
pubertal growth spurt
9. Introduction The chronological age is a poor indicator of skeletal development
(Fishman LS, 1979)
10. Introduction Many diagnostic tools were developed to aid in detection of the growth spurt
11. Introduction Hand & wrist radiographs is the most commonly used and the most reliable tool
(Bjork, 1972)
(Grave, 1994)
(Hagg et al, 1980)
12. Introduction Dental development was widely investigated as a potential predictor of skeletal maturity
(Sierra, 1987)
(Anderson et al, 1975)
(Green, 1961)
13. Introduction Dental maturity is either assessed by the tooth eruption stages or tooth calcification stages
Tooth calicification stages are more reliable
(Nolla, 1960)
(Hotz, 1959)
14. Introduction The relationship between dental maturity and chronological age has been investigated in different populations
(Green, 1961)
(Uysal et al, 2004)
(Krailassiri et al, 2002)
15. Introduction The ability to assess skeletal maturity by the dental development stages using the OPG has many advantages
Dental development stages is easy to identify
No need for additional exposure for H&W x-ray
16. Introduction The relationship between skeletal maturity and chronological age for Saudi male children has been recently established
(Al Hadlag et al, 2007)
17. Introduction The aims:
1- to establish the dental age for a group of Saudi male children
18. Introduction The aims:
2- to establish the relationship between dental, skeletal, and chronological ages in the study sample
19. Introduction The aims:
3- to find the best dental maturity indicator of the skeletal maturity stage in the study sample
20. Materials & Methods The study is a cross sectional descriptive study
148 OPG 148 H&W radiographs were obtained from the records of patients attending Collage of Dentistry, KSU
21. Materials & Methods Criteria:
1- Saudi males with age ranges from 9 to 15 years
2- Free of any serious illness
3- With normal growth and development
22. Materials & Methods Criteria:
4- With no abnormal dental condition, e.g. impaction, transposition and congenitally missing teeth
5- With no previous history of trauma or disease to the face and the hand-wrist region
23. Materials & Methods Criteria:
6- With no history of orthodontic treatment
24. Materials & Methods Dental maturity:
From the OPG
Using Demirjian method
25. Materials & Methods Demirjian method:
7 left mandibular teeth were used
Each tooth was given a letter
from A to H
Depending on its calcification stage
26. Materials & Methods Demirjian method:
Then each tooth was given a score
The total score of the teeth is converted into an age
27. Materials & Methods
28. Materials & Methods Skeletal maturity stages:
From the Hand & Wrist
Using the Fishmans method
6 stages were used
29. Materials & Methods Fishmans method
PP2: the epiphysis of the proximal phalanx of the second finger equals its diaphysis
MP3: the epiphysis of the middle phalanx of the third finger equals its diaphysis
S stage: the first mineralization of the ulnar sesamoid bone
MP3cap: the epiphysis the middle phalanx of the third finger caps its diaphysis
DP3u: complete epiphyseal union of the distal phalanx of the third finger
MP3u: complete epiphyseal union the middle phalanx of the third finger
A pre-PP2 stage was assigned to any subject who has not reached PP2 stage.
30. Materials & Methods Skeletal age:
Greulich and Pyles Radiographic Atlas of Skeletal Development of the Hand and Wrist
31. Materials & Methods One examiner took the dental assessments
The other took the skeletal assessments
Chronological age was taken by referring to records
32. Materials & Methods
33. Results Intra-examiner Reliability
34. Results
35. Results Comparison between skeletal and chronological ages
36. Results
37. Results Investigation of the relation between skeletal and dental maturity markers
41. Challenges No saudi literature
3000 records yielded only 130 pairs
DOB documentation is neglected
Lack of digitalization of records
We lacked previous knowledge about this issue
