Mandibular pubertal growth spurt prediction. Part one: Method based on the hand-wrist radiographs.

Many orthodontic treatment modalities will yield a better result in less time if properly correlated with the unique facial growth patterns of the patients. The pubertal growth spurt depends on gender and varies in relationship to the chronologic age. General skeletal maturity usually is used as an indicator to predict timing of mandibular growth velocity peak. Hand-wrist radiographic evaluation is one of the diagnostic tools currently available to determine whether the pubertal growth has started, is occurring or has finished. The overview of topic related literature and skeletal maturity assessment (SMA) system developed by L. Fishman are presented. The SMA system is based on eleven discrete adolescence skeletal maturational indicators of hand-wrist bones, covering the entire period of adolescent development. Maturational stage and level demonstrated close correlation with maxillary and mandibular growth velocity, amount of incremental growth and timing. Clinical indications for the use of hand-wrist radiographs to assess skeletal maturity are provided.