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 skel- etal 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 veloc- ity, amount of incremental growth
and timing. Clinical indications for the use of hand-wrist radiographs
to assess skeletal maturity are provided.
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