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GROWTH ASSESSMENT
&
ITS CLINICAL
SIGNIFICANCE
CONTENTS
• Introduction
• Types of growth data
• Methods of gathering growth data
• Evaluation of growth data
• Basic tenets of growth
• Growth analysis by superimposition technique
• Growth assessment parameters
• Clinical implications
• conclusion
INTRODUCTION
• Advantages:
Studying the natural history of disease &its outcome.
Specific developmental pattern of an individual can be studied.
• Disadvantages:
Time
Expense
Attrition
• CROSS-SECTIONAL STUDIES
measurement made of different individuals or
different samples & studied at different
periods
Advantages:
Quicker
Allows repeating of studies more rapidly
Less costly
• SEMILONGITUDINAL STUDIES
METHODS FOR STUDYING
PHYSICAL GROWH
• Measurement approach
Craniometry
Anthropometry
cephalometry
• Experimental approach
Vital staining
Implant radiography
• Others
Electromyography
Natural markers
Radio isotopes
Comparitive anatomy
Genetic studies
provides imporatant
new information about
the growth pattern
• MAXILLA • MANDIBLE
Hard palate behind primary canines Anterior aspect of symphysis
• Natural markers:
There is a persistance of certain developmental features of bone,
which are used as natural markers.
Clinical implication:
In Dentistry, use of word pattern has both
morphologic & developmental application.
• VARIABILITY: it is the law of nature,
because of infinite number of genetic
possibilities.
MODE
STANDARD DEVIATION
• TIMING:
The timing of developmental events is largely under
genetic control yet altered by the environment.
50% of population is
above & 50% of a
normal group of
children is below this
line.
• B) standard deviation charts:
based upon the scatter of observations around a mean value.
Three growth charts are available.
1.Height Vs age chart:
BIRTH - 20inches
0–6 1 inch / month 26inches
months
6 – 12 0.5 inch / month 32inches
months
1-7 3 inches / year 50inches
years
8 – 15 1 inch / year 62inches
AGE INCREMENT WEIGHT
BIRTH - to 8 lbs
Head circumference
Eye measurements
inter canthal
inter pupillary
outer canthal
Ear length
philtrum length
Width of commissures
Change in facial proportion
Increase in facial proportion is seen as:
Infancy to adolescence,
Increase in size of dental arches
Increase in size of muscles of mastication
Growth of alveolar process
Increase in maxilla
Increase in mandible
Nasal area
Enlargements of orbits ,
Expansion of ethmoid &sphenoid
• NANDA Growth of the face in general tends to be
maximal slightly later than the spurt in body height.
1.Handwrist radiographs
2.Cervical vertebrae
3.Clinical & radiographic examination of different
stages of tooth development
REGIONS USED FOR AGE
ASSESSMENT
HEAD & NECK SKULL , CERVICAL VERTEBRAE
UPPER LIMB SHOULDER JOINT-SCAPULA ,HAND
WRIST
LOWER LIMB FEMUR &HUMERUS
HIP JOINT,KNEE,ANKLE,FOOT-
TARSALS,PHALANGES
• ANATOMY OF
HANDWRIST:
• Carpals
proximal
row
distal row
• Metacarpals
• phalanges
INDICATIONS
• In patients who exhibit major discrepency between
dental & chronological age.
canines
first premolar
second premolar
second molar
• Findings of this study indicates that in
children of Turkish origin the completion of
roots formation of canines & first premolar
may be used as maturity indicators of
pubertal growth spurt
Longitudinal
Metric
structural
• Longitudinal Approach ‘Tweed’
• Type-A: growth of middle &lower face
proceeds in unison with vertical &horizontal
dimensions in being approximately equal
no treatment is indicated.
• Type-A subdivision
Type-B: middle face grows downwards &
forward more rapidly than lower face. poor
prognosis ,point B will not catch up with the
point A.
• Type-B subdivision:
• Type-C :maxilla & mandible grow forwards and
downwards with the mandible growing forwards
more rapidly than the maxilla.
• Type-C subdivision:
• This approach is accurate only when it is performed
retrospectively but not prospectively