Is hand-wrist radiography still necessary in orthodontic treatment planning?

The aim of our study is to compare the relationship between hand-wrist and cervical vertebra maturation stages with chronological age and to investigate the effect of malocclusion type on the relationship between these methods.

Hand-wrist and cephalometric radiographs of 1000 patients (526 females, 474 males) with a mean age of 13.41 ± 1.83 were analyzed. The methods of Bacetti et al. were used for the cervical vertebra maturation stage, and Björk, Grave and Brown's methods were used for the hand-wrist maturation stage. One-way ANOVA test was applied to compare skeletal classes between them. Tukey post hoc test was used to determine the differences. The relationship between the malocclusion type, cervical vertebra and hand-wrist maturation stages was evaluated with the Spearman correlation test.

Spearman's correlation coefficient was 0.831, 0.831 and 0.760 in Class I, II and III females, respectively. In males, it was calculated as 0.844, 0.889 and 0.906, respectively. When sex and malocclusion were not differentiated, the correlation was found to be 0.887. All were statistically significant (P < 0.001). The highest correlation was observed in class III males, while the lowest was found in class III females.

Cervical vertebrae can be used safely to assess pubertal spurt without hand-wrist radiography. Diagnosing growth and development stages from cephalometric images is important in reducing additional workload and preventing radiation risk.