Lateral comparisons using Fishman's skeletal maturation assessment

Abstract

Objective: To assess lateral differences between ossification events and stages of bone development in the hands and wrists utilizing Fishman's skeletal maturation indicators (SMIs). Materials and Methods: The skeletal ages of 125 subjects, aged 8 to 20 years, were determined with left and right hand-wrist radiographs using Fishman's SMI assessment. Each subject was also given the Edinburgh Handedness Questionnaire to assess handedness. The skeletal ages of both hand-wrist radiographs were analyzed against each other, handedness, chronologic age, and gender. Results: There were no significant differences overall in right and left SMI scores (P 5 .70); 79% of all patients showed no difference in right and left SMI scores, regardless of handedness, gender, or age. However, when patients were categorized based on clinical levels of SMI score for the right hand-wrist, there was a significant difference (P 5 .01) between the SMI 1-3 group and the SMI 11 group. Subjects in the SMI 1-3 group were more likely to show a left . right SMI score, while subjects in the SMI 11 group were likely to show a right . left SMI score. Conclusion: Although no significant overall lateral differences in SMI scores were noted, it may be advisable to obtain a left hand-wrist radiograph and/or additional diagnostic information to estimate completion of growth in young surgical patients. (Angle Orthod. 2015;85:408-412.)

Bone Age Evaluated With Conventional Ultrasound

“…The most obvious difference occurred in the radius with the right exceeding left in 57% children. But, more studies 6,8,14 on radiographic bone age revealed no inter‐side differences. This may due to the precision error of the evaluation method used in their studies 14 .…”

“…What is more, the differences between left and right bones of hand and wrist were proved to be insignificant when it comes to evaluating bone age as a whole 3,4 . But, lateral asymmetry did exist if the bones were compared one by one 4–8 …”

“…3,4 But, lateral asymmetry did exist if the bones were compared one by one. [4][5][6][7][8] In recent studies, [9][10][11] ossification ratio, the ratio of the height of the ossification center to the epiphysis of the bone, measured by ultrasound, has been confirmed an effective modality to estimate bone age quantitatively in patients from birth to near adulthood. Ultrasonic bone age derived from the summation of ossification ratios of radius, ulna, and femur in the left side could diagnose abnormal bone age with high sensitivity and specificity using radiographic bone age as a reference standard.…”

Relación de la edad cronológica con la maduración ósea cervical mediante el método de Baccetti

“…En ortodoncia y ortopedia maxilar, es muy importante valorar el momento en el que se producen los cambios, tanto biológicos como estructurales, con relación al crecimiento y desarrollo de los maxilares, para identificar el inicio del crecimiento puberal y así fundamentar el tratamiento y corrección de las diferentes alteraciones tanto dentarias como esqueléticas ( 1-4 ), a fin de obtener un resultado positivo en el momento de la planificación y permitir que los diversos tipos de dispositivos funcionales corrijan las discrepancias o alteraciones que se puedan presentar ( 5,6 ). Para obtener la efectividad o una respuesta positiva en cuanto a la aplicación adecuada de los aparatos funcionales, es importante conocer y evaluar en gran medida la maduración esquelética y su potencial de crecimiento de forma individual en cada individuo, para así contar con información importante y anticiparnos a los resultados que nos proponemos en el tratamiento ( [7][8][9] ). Se debe de tener en cuenta que el porcentaje del crecimiento tanto de las estructuras esqueléticas como de las dentarias no es constante en el desarrollo ( 9, 10 ).…”

“…La valoración de la maduración de las vértebras cervicales ha demostrado ser un método que presenta una alta y recíproca relación con el análisis de maduración ósea mano-muñeca ( [21][22][23][24] ). Por tanto, en este estudio se utilizan las radiografías laterales de cabeza que se solicitan en ortodoncia y se evita así el uso de radiografías adicionales y, lo más importante, la exposición adicional del paciente a la radiación ( [25][26][27][28][29] ).…”