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1.
Am J Orthod Dentofacial Orthop ; 156(3): 383-390, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474268

RESUMO

INTRODUCTION: The aim of this study was to evaluate the height growth of Class I and III orthodontic patients according to the Fishman skeletal maturation index (SMI) and to compare it with that of a general population. METHODS: The study sample included 81 Class I and 71 Class III adolescents who had height measurements and hand-wrist radiographs taken annually and categorized according to SMI. Height completion rate, residual height, height increase per sequential SMI stage, and height velocity were analyzed. Sex differences were evaluated and comparisons between Class I and Class III groups were made. In addition, the height of orthodontic patients was indirectly compared with that of the general population. RESULTS: In boys and girls, height completion rate was >90% at SMI 6, residual height was fewer than 10 cm at SMI 7, and height increase per sequential SMI stage was greatest from SMI 6 to SMI 7. Height velocity was greatest from SMI 5 to SMI 6 in boys and from SMI 4 to SMI 5 in girls. CONCLUSIONS: There was no significant difference in body height parameters for all SMI stages between Class I and Class III adolescents. Adolescents who had orthodontic treatment were not shorter in stature at growth completion compared with the general population.


Assuntos
Estatura , Má Oclusão de Angle Classe III/terapia , Má Oclusão de Angle Classe II/terapia , Ortodontia Corretiva , Adolescente , Determinação da Idade pelo Esqueleto , Desenvolvimento Ósseo , Criança , Feminino , Gráficos de Crescimento , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Humanos , Estudos Longitudinais , Masculino , Radiografia , República da Coreia , Estudos Retrospectivos , Fatores Sexuais , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento
2.
Eur J Appl Physiol ; 119(1): 301-310, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30377779

RESUMO

PURPOSE: We compared the modulation of force steadiness by different types of electrical nerve stimulation in young (n = 13, 25 ± 4 years) and older (n = 12, 78 ± 5 years) adults. METHODS: The protocol involved four types of isometric contractions with the wrist-extensor muscles at 10% of the maximal force. Three of the contractions involved electrical nerve stimulation that comprised two forms of neuromuscular electrical stimulation (NMES) to evoke muscle contractions and a voluntary contraction with superimposed transcutaneous electrical nerve stimulation (TENS) at an intensity less than motor threshold. RESULTS: The coefficient of variation (CV) for force during voluntary wrist extension was less (P = 0.03) for young (1.82 ± 0.43%) than older adults (2.80 ± 1.08%). The CV for force did not differ between age groups during the three types of electrical nerve stimulation but was reduced relative to the value observed during voluntary wrist extension for older adults. In contrast, the CV for force increased during the voluntary contraction with superimposed TENS for young adults but not for older adults. Moreover, there were significant negative correlations in older adults between the CV for force during the voluntary contraction and its decrease with electrical nerve stimulation. CONCLUSION: Differences in the CV for force between the evoked and voluntary contractions for the two age groups suggest that the variance in common synaptic input to motor neurons during steady voluntary contractions with the wrist extensors is greater for older adults than young adults.


Assuntos
Envelhecimento/fisiologia , Contração Muscular , Estimulação Elétrica Nervosa Transcutânea/métodos , Punho/fisiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Potencial Evocado Motor , Feminino , Humanos , Masculino , Músculo Esquelético/crescimento & desenvolvimento , Músculo Esquelético/inervação , Músculo Esquelético/fisiologia , Estimulação Elétrica Nervosa Transcutânea/normas , Punho/crescimento & desenvolvimento , Punho/inervação
3.
Folia Morphol (Warsz) ; 77(3): 503-508, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29297181

RESUMO

BACKGROUND: The aim of this study is to evaluate the relationship between frontal sinus morphology and hand-wrist bone maturation by using postero-anterior (PA) cephalometric radiographs. MATERIALS AND METHODS: The study sample consisted of 220 patients divided into 11 groups based on the hand-wrist radiographs. The right and left maximum height, width and area of the frontal sinus parameters were measured in PA cephalometric radiographs of 220 subjects aged 8-18 years. The hand-wrist skeletal maturation stages were evaluated on the hand-wrist radiographs using the method of Fishman. The Kendall tau-b values were analysed to evaluate the correlation between the hand-wrist skeletal maturation stages and the frontal sinus parameters. RESULTS: The right and left frontal sinus areas and widths were found to be larger in males than in females (p < 0.05). In males, a significant difference was observed in all frontal sinus parameters in different maturation stages (p < 0.001), while a statistically significant correlation was found in females between the left frontal sinus area, right frontal sinus height, right frontal sinus width and different maturation stages (p < 0.05). CONCLUSIONS: The relationship between frontal sinus dimensions obtained from PA cephalometric radiographs and hand-wrist maturation stages suggests that frontal sinuses can be used in determining growth and development.


Assuntos
Desenvolvimento Ósseo , Cefalometria , Seio Frontal , Adolescente , Criança , Estudos Transversais , Feminino , Seio Frontal/diagnóstico por imagem , Seio Frontal/crescimento & desenvolvimento , Humanos , Masculino , Estudos Retrospectivos , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento
4.
J Pediatr Endocrinol Metab ; 31(2): 185-190, 2018 Jan 26.
Artigo em Inglês | MEDLINE | ID: mdl-29306926

RESUMO

BACKGROUND: Childhood obesity and its consequences have reached alarming proportions worldwide and in India. Wrist circumference is emerging as an easily measurable reproducible parameter for screening children at risk of obesity-related morbidities such as hypertension and insulin resistance. The objectives of this study were: (1) to compute age and gender-specific wrist circumference percentiles for 3-18-year-old apparently healthy Indian children and adolescents; (2) to assess the relationship of wrist circumference with measures of obesity and adiposity such as body mass index (BMI), fat percentage and blood pressure (BP) and (3) to suggest age and gender-specific cut-offs for wrist circumference percentile for the risk of hypertension in Indian children and adolescents. METHODS: This was a cross-sectional study on samples of 10,199 3-18-year-old children (5703 boys) from randomly selected schools from five major cities in India. Height, weight, waist and wrist circumference and BP were recorded. Body composition was measured using bioelectrical impedance analysis (BIA). Wrist circumference percentiles were computed using the LMS method. RESULTS: The average wrist circumference of boys and girls was 10.4 cm and 10.0 cm at 3 years and increased to 15.1 cm and 13.9 cm, respectively, at 18 years. Compared to their Caucasian counterparts, Indian children's wrists were smaller. Receiver operating characteristic (ROC) curve analysis derived the 70th percentile of wrist circumference as the cut-off for identifying the risk of hypertension. CONCLUSIONS: Contemporary cross-sectional reference percentile curves for wrist circumference for 3-18-year-old Indian children are presented. The 70th percentile of the current study is proposed as the cut-off to screen children for cardiometabolic risk factors such as hypertension.


Assuntos
Desenvolvimento do Adolescente , Tamanho Corporal , Desenvolvimento Infantil , Gráficos de Crescimento , Saúde da População Urbana , Punho/crescimento & desenvolvimento , Adolescente , Fatores Etários , Composição Corporal , Índice de Massa Corporal , Tamanho Corporal/etnologia , Criança , Pré-Escolar , Estudos Transversais , Impedância Elétrica , Feminino , Humanos , Índia , Masculino , Instituições Acadêmicas , Caracteres Sexuais
5.
Diagn Interv Radiol ; 23(3): 194-198, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28345523

RESUMO

PURPOSE: We aimed to establish a practical method to evaluate skeletal age using cervical vertebrae. METHODS: The study consisted of hand-wrist and cephalometric radiographs of 324 subjects (167 girls, 157 boys; age range, 7.3-17.2 years). Skeletal ages of the subjects were calculated from hand-wrist radiographs, and cervical vertebral bodies were measured using cephalometric radiographs. A single formula based on C3 and C4 vertebral body heights with different coefficients for each gender was derived using ridge regression analysis. RESULTS: The correlation coefficients for vertebral and hand-wrist bone age were 0.825 and 0.856 for girls and boys, respectively. The correlations among vertebral bone age and C3 and C4 vertebral body heights were also found to be significant. The intraclass correlation (ICC) score was found to be 0.914, which shows high consistency between the two measurements of the same investigator for each C3 and C4 vertebral body height result. CONCLUSION: The formula derived for evaluating skeletal age in cephalometric radiographs is reliable and can be applied to both girl and boy subjects for legal requirements or therapeutic needs of age estimation.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Cefalometria/instrumentação , Vértebras Cervicais/crescimento & desenvolvimento , Mãos/crescimento & desenvolvimento , Articulação do Punho/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Adolescente , Cefalometria/métodos , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/diagnóstico por imagem , Criança , Feminino , Mãos/diagnóstico por imagem , Humanos , Masculino , Reprodutibilidade dos Testes , Estudos Retrospectivos , Punho/diagnóstico por imagem , Articulação do Punho/diagnóstico por imagem
6.
Acta Odontol Scand ; 75(2): 106-112, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27934543

RESUMO

OBJECTIVES: The need for accurate techniques of estimating age has sharply increased in line with the rise in illegal migration and the political, economic and socio-demographic problems that this poses in developed countries today. The methods routinely employed for determining chronological age are mainly based on determining skeletal maturation using radiological techniques. The objective of this study was to correlate five different methods for assessing skeletal maturation. MATERIALS AND METHODS: 606 radiographs of growing patients were analyzed, and each patient was classified according to two cervical vertebral-based methods, two hand-wrist-based methods and one tooth-based method. Spearman's rank-order correlation coefficient was applied to assess the relationship between chronological age and the five methods of assessing maturation, as well as correlations between the five methods (p < 0.05). RESULTS: Spearman's rank correlation coefficients for chronological age and cervical vertebral maturation stage using both methods were 0.656/0.693 (p < 0.001), respectively, for males. For females, the correlation was stronger for both methods. The correlation coefficients for chronological age against the two hand-wrist assessment methods were statistically significant only for Fishman's method, 0.722 (p < 0.001) and 0.839 (p < 0.001), respectively for males and females. CONCLUSIONS: The cervical vertebral, hand-wrist and dental maturation methods of assessment were all found to correlate strongly with each other, irrespective of gender, except for Grave and Brown's method. The results found the strongest correlation between the second molars and females, and the second premolar and males. CLINICAL RELEVANCE: This study sheds light on and correlates with the five radiographic methods most commonly used for assessing skeletal maturation in a Spanish population in southern Europe.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Vértebras Cervicais/diagnóstico por imagem , Dente Molar/diagnóstico por imagem , Punho/diagnóstico por imagem , Adolescente , Vértebras Cervicais/crescimento & desenvolvimento , Criança , Feminino , Humanos , Masculino , Dente Molar/crescimento & desenvolvimento , Radiografia , Estatísticas não Paramétricas , Punho/crescimento & desenvolvimento
7.
J Indian Soc Pedod Prev Dent ; 34(4): 310-4, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27681393

RESUMO

BACKGROUND: Growth can be one of the most uncertain variations, but understanding the same is very important for diagnosis and treatment planning. Skeletal age and dental age have been used to determine a child's developmental age. Several researchers have evaluated the association between dental and skeletal maturity with chronologic age on different population. The purpose of the present study was to find out whether dental age estimation can be replaced for skeletal age estimation in the Dakshina Kannada population. METHODS: A total of 104 samples equally distributed among both genders in the age group of 9-14 years were selected. Skeletal age was estimated using hand-wrist radiographs and Fishman's skeletal maturation index and dental age was measured using Demirjian's method. RESULTS: Spearman's rank-order correlation coefficients were used to measure the association between the skeletal maturity and dental maturity. The mean ages of male and female samples were determined as 11.89 ± 1.867 years and 12.21 ± 1.473 years, respectively. Chronological age was found to be positively correlated to dental age and skeletal age and found to be statistically significant (P < 0.01). The correlation between dental age and skeletal age was also found to be statistically significant with P < 0.001 and correlation coefficient of 0.683 and 0.704 for males and females. CONCLUSION: The present study showed a strong relation between the developmental ages in mixed dentition population; hence, dental age can be considered as a replacement in the study population.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelos Dentes/métodos , Fatores Etários , Adolescente , Criança , Desenvolvimento Infantil/fisiologia , Feminino , Ossos da Mão/diagnóstico por imagem , Ossos da Mão/crescimento & desenvolvimento , Humanos , Índia , Masculino , Odontogênese , Radiografia/métodos , Radiografia Panorâmica , Estudos Retrospectivos , Dente/diagnóstico por imagem , Dente/crescimento & desenvolvimento , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento
8.
PLoS One ; 11(6): e0156646, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27294398

RESUMO

In a previous study, we found that wrist circumference, in particular its bone component, was associated with insulin resistance in a population of overweight/obese children. The aim of the present study was to evaluate the intra- and inter-operator variability in wrist circumference measurement in a population of obese children and adolescents. One hundred and two (54 male and 48 female) obese children and adolescents were consecutively enrolled. In all subjects wrist circumferences were measured by two different operators two times to assess intra- and inter-operator variability. Statistical analysis was performed using SAS v.9.4 and JMP v.12. Measurements of wrist circumference showed excellent inter-operator reliability with Intra class Correlation Coefficients (ICC) of 0.96 and ICC of 0.97 for the first and the second measurement, respectively. The intra-operator reliability was, also, very strong with a Concordance Correlation Coefficient (CCC) of 0.98 for both operators. The high reproducibility demonstrated in our results suggests that wrist circumference measurement, being safe, non-invasive and repeatable can be easily used in out-patient settings to identify youths with increased risk of insulin-resistance. This can avoid testing the entire population of overweight/obese children for insulin resistance parameters.


Assuntos
Pesos e Medidas Corporais , Obesidade Pediátrica/diagnóstico , Punho/crescimento & desenvolvimento , Adolescente , Pesos e Medidas Corporais/normas , Pesos e Medidas Corporais/estatística & dados numéricos , Criança , Pré-Escolar , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Obesidade Pediátrica/patologia , Reprodutibilidade dos Testes , Circunferência da Cintura , Punho/patologia
9.
Cereb Cortex ; 26(1): 402-413, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26491066

RESUMO

Preterm birth engenders an increased risk of conditions like cerebral palsy and therefore this time may be crucial for the brain's developing sensori-motor system. However, little is known about how cortical sensori-motor function matures at this time, whether development is influenced by experience, and about its role in spontaneous motor behavior. We aimed to systematically characterize spatial and temporal maturation of sensori-motor functional brain activity across this period using functional MRI and a custom-made robotic stimulation device. We studied 57 infants aged from 30 + 2 to 43 + 2 weeks postmenstrual age. Following both induced and spontaneous right wrist movements, we saw consistent positive blood oxygen level-dependent functional responses in the contralateral (left) primary somatosensory and motor cortices. In addition, we saw a maturational trend toward faster, higher amplitude, and more spatially dispersed functional responses; and increasing integration of the ipsilateral hemisphere and sensori-motor associative areas. We also found that interhemispheric functional connectivity was significantly related to ex-utero exposure, suggesting the influence of experience-dependent mechanisms. At term equivalent age, we saw a decrease in both response amplitude and interhemispheric functional connectivity, and an increase in spatial specificity, culminating in the establishment of a sensori-motor functional response similar to that seen in adults.


Assuntos
Encéfalo/crescimento & desenvolvimento , Imagem por Ressonância Magnética , Movimento/fisiologia , Córtex Sensório-Motor/crescimento & desenvolvimento , Punho/fisiologia , Encéfalo/fisiologia , Humanos , Lactente , Imagem por Ressonância Magnética/métodos , Punho/crescimento & desenvolvimento
10.
Pediatr Endocrinol Rev ; 13(1): 444-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-26540759

RESUMO

Bone (skeletal) age determination is the simplest and most used index for the assessment of developmental and physiological age in healthy children and those with growth disorders. At present the test is done by manual or automated reading of the hand and wrist X-rays, necessitating two visits by the child: to the pediatrician and radiology departments. A newly developed simple quantitative ultrasound technique (QUST) using several hand and wrist bones, which can be performed in the pediatrician's office could combine the child's growth and biological age evaluation in one visit.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Determinação da Idade pelo Esqueleto/normas , Adolescente , Desenvolvimento Ósseo , Criança , Pré-Escolar , Grupos Étnicos , Feminino , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Humanos , Lactente , Recém-Nascido , Masculino , Ultrassonografia , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento , Adulto Jovem
11.
Ann Hum Biol ; 42(4): 358-67, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26313328

RESUMO

BACKGROUND: Age estimation of individuals is important in human biology and has various medical and forensic applications. Recent interest in MR-based methods aims to investigate alternatives for established methods involving ionising radiation. Automatic, software-based methods additionally promise improved estimation objectivity. AIM: To investigate how informative automatically selected image features are regarding their ability to discriminate age, by exploring a recently proposed software-based age estimation method for MR images of the left hand and wrist. SUBJECTS AND METHODS: One hundred and two MR datasets of left hand images are used to evaluate age estimation performance, consisting of bone and epiphyseal gap volume localisation, computation of one age regression model per bone mapping image features to age and fusion of individual bone age predictions to a final age estimate. RESULTS: Quantitative results of the software-based method show an age estimation performance with a mean absolute difference of 0.85 years (SD = 0.58 years) to chronological age, as determined by a cross-validation experiment. Qualitatively, it is demonstrated how feature selection works and which image features of skeletal maturation are automatically chosen to model the non-linear regression function. CONCLUSION: Feasibility of automatic age estimation based on MRI data is shown and selected image features are found to be informative for describing anatomical changes during physical maturation in male adolescents.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Mãos/crescimento & desenvolvimento , Aprendizado de Máquina , Imagem por Ressonância Magnética , Punho/crescimento & desenvolvimento , Adolescente , Áustria , Humanos , Masculino , Software , Adulto Jovem
12.
Biomed Environ Sci ; 28(3): 235-8, 2015 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-25800451

RESUMO

We assessed genetic and environmental effects on bone development of the hand and wrist, and on key anthropometric measures in Chinese young twins. In total, 139 monozygotic and 95 dizygotic twin pairs aged from 5 to 18 years were recruited. The twin correlations of total hand and wrist scores for monozygotic (MZ) and dizygotic (DZ) twins were 0.71 and 0.36, respectively. Bivariate model analysis showed moderate genetic correlations only for total skeletal maturity vs. weight and total skeletal maturity vs. waist circumference (r, 0.51 and 0.46, respectively). Our findings demonstrated that genetic factors played important roles in bone development of the hand and wrist in Chinese young twins, and that these genetic effects might be distinct from those influencing anthropometric measures.


Assuntos
Desenvolvimento Ósseo/genética , Exposição Ambiental , Ossos da Mão/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Adolescente , Criança , Pré-Escolar , China , Humanos , Gêmeos Dizigóticos , Gêmeos Monozigóticos
13.
Arch Dis Child ; 100(2): 138-43, 2015 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-25409981

RESUMO

AIM: To examine ethnic and sex differences in the pattern of skeletal maturity from adolescence to adulthood using a novel longitudinal analysis technique (SuperImposition by Translation And Rotation (SITAR)). SETTING: Johannesburg, South Africa. PARTICIPANTS: 607 boys and girls of black as well as white ethnicity from the Birth to Twenty bone health study, assessed annually from 9 to 20 years of age. OUTCOME MEASURE: Bone maturity scores (Tanner-Whitehouse III radius, ulna, and short bones (TW3 RUS)) assessed longitudinally from hand-wrist radiographs were used to produce individual and mean growth curves of bone maturity and analysed by the SITAR method. RESULTS: The longitudinal analysis showed that black boys matured later by 7.0 SE 1.6 months (p<0.0001) but at the same rate as white boys, whereas black girls matured at the same age but at a faster rate than white girls (by 8.7% SE 2.6%, p=0.0007). The mean curves for bone maturity score consistently showed a midpubertal double kink, contrasting with the quadratic shape of the commonly used reference centile curves for bone maturity (TW3). CONCLUSIONS: Skeletal maturity was reached 1.9 years earlier in girls than boys, and the pattern of maturation differed between the sexes. Within girls, there were no ethnic differences in the pattern or timing of skeletal maturity. Within boys, however, skeletal maturity was delayed by 7 months in black compared with white ethnicity. Skeletal maturation, therefore, varies differentially by sex and ethnicity. The delayed maturity of black boys, but not black girls, supports the hypothesis that boys have greater sensitivity to environmental constraints than girls.


Assuntos
Desenvolvimento Ósseo/fisiologia , Grupos Étnicos , Ossos da Mão/crescimento & desenvolvimento , Fatores Sexuais , Punho/crescimento & desenvolvimento , Adolescente , Adulto , Criança , Feminino , Gráficos de Crescimento , Ossos da Mão/diagnóstico por imagem , Humanos , Estudos Longitudinais , Masculino , Radiografia , África do Sul , Punho/diagnóstico por imagem , Adulto Jovem
14.
Fa Yi Xue Za Zhi ; 30(6): 422-6, 2014 Dec.
Artigo em Chinês | MEDLINE | ID: mdl-25816571

RESUMO

OBJECTIVE: To realize the automated assessment of the levels of epiphysis of distal radius and ulna by support vector machine (SVM). METHODS: The X-ray films of the left wrist joints were taken from 140 teenagers aged from 11 to 19 years old as training samples. The levels of epiphysis of distal radius and ulna were divided into five developmental levels. Each level contained 28 samples. Another 35 cases were selected as independent verifying samples. SVM classification models of the five developmental levels of epiphysis of distal radius and ulna were established. The internal cross validation was made by leave one out cross validation (LOOCV), while the external validation was made by histogram of oriented gradient (HOG), and then the accuracy (PA) of testing results was calculated, respectively. RESULTS: The PA of SVM, LOOCV and HOG of distal radius epiphyseal level were 100%, 78.6%, and 82.8%, respectively; whereas the PA of SVM, LOOCV and HOG of distal ulna epiphyseal level were 100.0%, 80.0% and 88.6%, respectively. CONCLUSION: The SVM-based automatic models of the growth stage of distal ra- dius and ulna appear to have certain feasibility, and may provide a foundation for software development of bone age assessment by forensic medicine.


Assuntos
Desenvolvimento Ósseo/fisiologia , Epífises/crescimento & desenvolvimento , Processamento de Imagem Assistida por Computador/métodos , Máquina de Vetores de Suporte , Adolescente , Criança , Feminino , Humanos , Masculino , Rádio (Anatomia)/crescimento & desenvolvimento , Ulna/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Articulação do Punho/crescimento & desenvolvimento , Adulto Jovem
15.
J Child Neurol ; 29(2): 203-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-23611885

RESUMO

The purpose of this retrospective study was to analyze the effect of peripheral nerve injury on the skeletal maturation process. The bone ages of the affected and unaffected hand-wrists of 42 children with obstetrical brachial palsy were determined according to the Greulich and Pyle atlas. In 23 patients, the bone ages of the both sides were identical (bone-age-symmetrical group), in 19 patients the bone age of the affected side was delayed (bone-age-delayed group). The mean bone age of the affected side was delayed 0.48 ± 0.25 years that of the unaffected side (P = .000), and the delay of bone age was inversely correlated with chronological age (R (2) = .45, P < .02) in the bone-age-delayed group. Skeletal retardation can be recognized after appearance of ossification centers by plain radiography, dating from the third month of life, in early infancy. Thus, bone age determination method might be helpful for predicting potential future limb shortness.


Assuntos
Traumatismos do Nascimento/complicações , Desenvolvimento Ósseo , Neuropatias do Plexo Braquial/diagnóstico por imagem , Neuropatias do Plexo Braquial/etiologia , Mãos/diagnóstico por imagem , Punho/diagnóstico por imagem , Determinação da Idade pelo Esqueleto , Fatores Etários , Pré-Escolar , Feminino , Lateralidade Funcional , Mãos/crescimento & desenvolvimento , Humanos , Masculino , Estudos Retrospectivos , Punho/crescimento & desenvolvimento
16.
Am J Orthod Dentofacial Orthop ; 144(6): 838-47, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24286907

RESUMO

INTRODUCTION: The aim of this study was to examine the agreement of skeletal age assessment based on hand-wrist radiographs with cephalogram-based cervical vertebrae evaluation. To circumvent bias and loss of information from staging, a quantitative approach was applied to determine morphologic changes. METHODS: We analyzed 730 sets of radiographs (cephalogram and hand-wrist) of untreated subjects (352 boys, 378 girls; age range, 6-18 years) from a growth study, each sex as a separate sample. Skeletal age was determined on the hand-wrist radiographs according to the method of Greulich and Pyle. Morphometric changes of the vertebral bodies C2 through C4 were measured (concavity, anterior height, and angle) and tested for correlations with the method of Greulich and Pyle. All correlating variables were included in a multiple linear regression to generate a calculated skeletal age. To establish the agreement between the method of Greulich and Pyle and calculated skeletal age, Bland-Altman plots were made, limits of agreement were identified, and cross-tables (before and after peak height velocity) were computed. Similarly, the agreement between the method of Greulich and Pyle and each subject's chronologic age was estimated for comparison. RESULTS: Concavity of C2, C3, and C4; anterior height of C3 and C4; and the angle of C3 correlated with skeletal age highly significantly (P <0.0001) in both sexes, and calculated skeletal age was established based on a linear regression. The agreement between the method of Greulich and Pyle and calculated skeletal age was modest (limits of agreement: boys, ±3.5 years; girls, ±3.3 years) and substantially weaker than the agreement between the method of Greulich and Pyle and chronologic age (limits of agreement: boys, +2.1 to -1.7 years; girls, +2.2 to -1.2 years). Similarly, calculated skeletal age resulted in considerably more false predictions of peak height velocity (boys, 18.9%; girls, 12.9%) than did chronologic age (boys, 7.1%; girls, 7.4%). CONCLUSIONS: Morphometric assessment of age-dependent changes in the cervical spine offers no advantage over chronologic age, in either assessing skeletal age or predicting the pubertal growth spurt.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Vértebras Cervicais/diagnóstico por imagem , Mãos/diagnóstico por imagem , Punho/diagnóstico por imagem , Adolescente , Fatores Etários , Análise de Variância , Pontos de Referência Anatômicos , Cefalometria/métodos , Vértebras Cervicais/anatomia & histologia , Vértebras Cervicais/crescimento & desenvolvimento , Criança , Estudos Transversais , Feminino , Mãos/anatomia & histologia , Mãos/crescimento & desenvolvimento , Humanos , Modelos Lineares , Masculino , Variações Dependentes do Observador , Reprodutibilidade dos Testes , Fatores Sexuais , Punho/anatomia & histologia , Punho/crescimento & desenvolvimento
17.
J Orofac Orthop ; 73(3): 215-24, 2012 May.
Artigo em Inglês | MEDLINE | ID: mdl-22576864

RESUMO

AIM: The purpose of this study was to investigate whether growth increments of the mandibular ramus in the vertical direction can be predicted using cephalometric variables in combination with a hand-wrist radiograph. PATIENTS AND METHODS: Our data comprised cephalograms taken at the beginning (T1) and end (T2) of orthodontic treatment, and hand-wrist radiographs taken at T1 of 49 adolescent patients with a Class I malocclusion. Cephalograms were scanned and analyzed with the aid of a computer. Relative growth increments (in %) of body height and different cephalometric variables during the observation period were recorded. Growth changes were compared statistically to each other and to the growth prediction assessed with the hand-wrist radiograph according to Greulich and Pyle (GPP). Stepwise linear regression (SPSS®) was used to statistically analyze the impact of gender, age, body height, growth prediction as assessed with a hand-wrist radiograph, and cephalometric variables at T1 on changes in the increase in the height of the mandibular ramus. RESULTS: Growth prediction assessed via hand-wrist radiographs at the beginning of treatment did not enable a reliable prediction of the remaining vertical growth of the mandibular ramus. Only the patient's gender and height of the mandibular ramus at the beginning of treatment had a statistical impact on growth changes in the ramus height that occurred during the observation period. CONCLUSION: Our results suggest that the vertical growth potential of the mandibular ramus cannot be predicted by analyzing hand-wrist radiographs or by evaluating cephalometric variables other than the initial mandibular ramus height.


Assuntos
Determinação da Idade pelo Esqueleto/métodos , Mãos/diagnóstico por imagem , Mãos/crescimento & desenvolvimento , Mandíbula/diagnóstico por imagem , Mandíbula/crescimento & desenvolvimento , Punho/diagnóstico por imagem , Punho/crescimento & desenvolvimento , Adolescente , Determinação da Idade pelo Esqueleto/estatística & dados numéricos , Distribuição por Idade , Cefalometria/métodos , Cefalometria/estatística & dados numéricos , Criança , Feminino , Alemanha , Humanos , Masculino , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
18.
Clin Anat ; 24(8): 1010-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-21544875

RESUMO

To have knowledge of the physiological closure of a particular physeal plate is necessary to understand fractures close to the end of growth (transitional fractures). Most frequent fractures involve the distal radius in adolescents. However, there are no systematic investigations on the topic of growth plate closure concerning the distal radius plate, so far. Twenty-two healthy female volunteers underwent MRI investigations of their left wrist. Absolute width, percentage and localization of the physeal part, closed at the time of investigation were recorded. Sequential MRI scans were performed. In this series T1-weighted sequences were most useful to distinguish open and closed parts of the physis. Total area was 291-469 mm(2) (average, 399 mm(2) ). It did positively correlate with body height (P < 0.01), but not with weight (P = 0.241) or BMI (P = 0.394). Physeal closure took place at 15-18 years. There was no significant correlation between menarche and closure (P = 0.091). Bony bridging of the growth plate begins centroradial and ends with a small limbus dorsoradial. Sequential scans showed that there are only a few months from beginning to end of physeal closure. Physiological closure of the distal radius growth plate takes place in late adolescence, varying individually. There seems to be no influence of the menarche in female individuals. The process happens within a very short time of less than a year. This may be one rationale for the fact, that transitional fractures of the distal radius are rare.


Assuntos
Lâmina de Crescimento/fisiologia , Rádio (Anatomia)/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Adolescente , Feminino , Lâmina de Crescimento/anatomia & histologia , Humanos , Imagem por Ressonância Magnética , Rádio (Anatomia)/anatomia & histologia , Punho/anatomia & histologia
19.
Rev. clín. pesq. odontol. (Impr.) ; 6(3): 207-213, set.-dez. 2010. tab, graf
Artigo em Inglês | LILACS, BBO - Odontologia | ID: lil-617386

RESUMO

Objectives: The aim of the study was to compare the cervical vertebrae maturity, using a lateral cephalogram,which is routinely taken before orthodontic treatment and is included as a part of the patient’srecord, with hand-wrist maturation method. Materials and methods: The study group comprised ofsixty subjects of Bangalore, Indian, origin, aged between 9-18 years. Hand wrist radiograph and lateralcephalograms were taken for these subjects. Assessment of skeletal maturation was done using SkeletalMaturity Indicators (SMI’s) from hand-wrist radiograph and Cervical Vertebrae Maturity Indicators(CVMI’s) from lateral cephalogram. A pair wise comparison for skeletal age assessment stages was doneusing Wilcoxon sign rank test and proportions was compared using Chi-Square test for statistical analysis.Results: Skeletal maturity assessed using the cervical vertebrae maturation index (CVMI) method andhand-wrist skeletal maturational index (SMI) method showed no statistical signifi cant difference for malesand females. However, females showed maturation at an early age as compared to males. Conclusions:Since properly utilized cervical vertebrae assessment provided a reliable assessment of pubertal growthspurt, it would be benefi cial to use a lateral cephalogram for skeletal maturity assessment and thereby eliminate the need for an additional radiograph (hand-wrist radiograph). This is cost effective and will alsoreduce the radiation exposure to the patient.


Objetivos: O objetivo do presente estudo foi comparar a maturidade das vértebras cervicais, por meio de umcefalograma lateral, que é rotineiramente obtido antes de tratamentos ortodônticos, com um método de medição dematuração de mão e punho. Materiais e métodos: O grupo estudado consistiu de sessenta indivíduos da região deBangalore, Índia, com idades entre 9 e 18 anos, de ambos os sexos. Radiografi as de mão e punho e cefalogramas emnorma lateral foram obtidos. A determinação da maturação esquelética foi determinada com o uso de Indicadoresde Maturidade Esquelética para radiografi as de mão e punho e Indicadores de Maturidade de Vértebras Cervicaispara cefalogramas em norma lateral. A comparação por pareamento para determinação da idade esqueletal foi feitautilizando o teste de ranqueamento de Wilcoxon e as proporções comparadas pelo teste Qui-Quadrado para análiseestatística. Resultados: A maturidade esquelética determinada pelo índice de maturação esquelética não mostroudiferença estatística signifi cante para homens e mulheres. Entretanto, em mulheres a maturação ocorreu em idademais precoce quando comparadas com os homens. Conclusões: Uma vez utilizado adequadamente, o método dedeterminação da maturidade das vértebras cervicais proporciona um indicativo confi ável do crescimento no estirãoda puberdade, o qual pode ser útil no estabelecimento da maturidade esqueletal por meio de cefalogramas laterais,eliminando assim a necessidade de radiografi as adicionais de mão e punho. Essa eliminação das radiografi as de mãoe punho é custo-efetiva e igualmente reduz a exposição do paciente à radiação ionizante.


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Determinação da Idade pelo Esqueleto/métodos , Desenvolvimento Ósseo/fisiologia , Vértebras Cervicais/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento , Fatores Etários , Vértebras Cervicais , Punho
20.
Dental press j. orthod. (Impr.) ; 15(2): 58-70, mar.-abr. 2010. ilus, graf, tab
Artigo em Inglês, Português | LILACS | ID: lil-552084

RESUMO

OBJETIVO: avaliar o grau de correlação existente entre o crescimento mandibular e a maturação esquelética em jovens brasileiras melanodermas. MÉTODOS: examinou-se 140 telerradiografias, obtidas em norma lateral e 140 radiografias de mão e punho de jovens do gênero feminino, brasileiras, melanodermas, com 8 a 14 anos de idade, com oclusão normal ou má oclusão de Classe I, de Angle, não submetidas a tratamento ortodôntico prévio. Nas radiografias da mão e do punho, avaliou-se o desenvolvimento dos centros de ossificação da falange proximal do 3º dedo e da epífise distal do osso rádio, apoiando-se no método descrito por Eklõf e Ringertz; e nas telerradiografias, obtidas em norma lateral, analisou-se a pneumatização do seio frontal, de acordo com o método descrito por Rüf e Pancherz, e as medidas cefalométricas representativas do crescimento mandibular (Co-Go, Co-Gn, Go-Gn e Fg-Pg). Os dados obtidos foram submetidos à análise estatística, utilizando-se a Correlação de Pearson, para determinar o grau de relacionamento entre as variáveis. RESULTADOS E CONCLUSÃO: ocorreu uma correlação altamente significativa entre os centros de ossificação observados na radiografia de mão e punho e as medidas cefalométricas representativas do crescimento mandibular (r = 0,777). Apesar de estatisticamente significativa, ocorreu uma baixa correlação entre a pneumatização do seio frontal e os eventos da maturidade esquelética (r = 0,306), assim como a relação entre a pneumatização do seio frontal e as medidas cefalométricas representativas do crescimento mandibular (r = 0,218).


OBJECTIVE: To assess the degree of correlation between mandibular growth and skeletal maturation in young melanodermic Brazilian women. METHODS: The authors examined 140 lateral teleradiographies and an additional 140 radiographies of hands and wrists of young female Brazilian melanodermic subjects aged 8 to 14 years with normal occlusion or Angle Class I malocclusion, who had not been subjected to previous orthodontic treatment. Using the hand and wrist radiographies, the authors evaluated the development of ossification centers in the proximal phalanx of the 3rd finger and the distal epiphysis of the radius bone, drawing on the method described by Eklõf and Ringertz. The lateral teleradiographies enabled an analysis of frontal sinus pneumatization according to the method described by Ruf and Pancherz, and of the cephalometric measurements representative of mandibular growth, namely, Co-Go, Co-Gn, Go-Gn, Fg-Pg. The data were statistically analyzed using Pearson's Correlation to determine the degree of relationship between variables. RESULTS AND CONCLUSIONS: A highly significant correlation was found between ossification centers observed on the hand and wrist radiographies and cephalometric measurements representative of the mandibular growth (r = 0.777). Although statistically significant, there was a low correlation between frontal sinus pneumatization and the progression of skeletal maturity (r = 0.306), as well as a relationship between frontal sinus pneumatization and the cephalometric measurements representative of mandibular growth (r = 0.218).


Assuntos
Humanos , Feminino , Criança , Adolescente , Determinação da Idade pelo Esqueleto , Crescimento e Desenvolvimento , Mandíbula/crescimento & desenvolvimento , Cefalometria , Seio Frontal , Mãos/crescimento & desenvolvimento , Punho/crescimento & desenvolvimento
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