Growth patterns and timing and their measurement and growth prediction

Question 1

5 methods of growth timing and rate of growth

Answer 1

1. Measurement of change in height
2. Secondary sexual characteristics
3. Hand-wrist radiographs
4. Radiographic assessment of cervical spine maturation
5. Average growth increments

Question 2

PHV

Answer 2

Peak height velocity, maximum rate of growth

Happens during puberty

Question 3

Ideal time for orthodontics

Answer 3

Pubertal growth spurt gives acceleration of facial growth rate
Raises possibility of wroth modification
Permanent dentition establishes itself

Question 4

General Scammons growth curve

Answer 4

Typical of most systems of body including skeleton and muscle mass

Question 5

Neural growth curve

Answer 5

Shows graph of brain, NS and associated structures (incl. cranial vault, orbits and part of upper face)

Question 6

Genital growth curve

Answer 6

Genital tissues experience particularly rapid growth during adolescence

Question 7

Lymphoid growth curve

Answer 7

Lymphoid tissues grow rapidly in childhood, by 12 represent ~2x size of relative final size
Tonsils in particular reduce in size during adolescence

Question 8

Standing height

Answer 8

Facial growth occurs ~ same time as growth in height
-exception of orbits and part of upper face
Can be used as proxy for growth in facial structures
Stnadiometer, stood in front of with bare feet

Question 9

Plotting an Individuals Growth

Answer 9

De Montebeillard’s graph
Volocity, showing height gain in cm per year
Sharp peak at puberty visible: PHV

Question 10

Growth charts

Answer 10

Tanner growth chart
Also possible to assess growth rate by obtaining sequential weight recordings as well as height (less accurate)
Children in contemporary UK are considerably taller

Question 11

Orthognathic treatment

Answer 11

Px ought to have completed growth before commencement of treatment

Question 12

Limitation of using height measurement to time

Answer 12

> gradient to plotted line can be subtle/ difficult to detect
PHV only detected after it has happened

Question 13

Velocity chart layout

Answer 13

Age along horizontal and height gain per year along vertical axis

Question 14

Changes in velocity

Answer 14

Post-natal growth characterised by rapid, then rapidly declining growth in early years
Levels off from 4-10
Increases again during pubertal growth spurt
Tails off to 0 by 16 for girls and 18 for boys
PHV often reached at same time as PHV for craniofacial tissues

Question 15

Intermittent growth

Answer 15

Not continuous process

Question 16

Assessing sexual maturity

Answer 16

Quite obvious when it is happening

Question 17

Hand wrist radiographs

Answer 17

Large umber of ossification centres present in relatively small area

Question 18

The Atlas Technique

Answer 18

Ulnar sesamoid bone ossifies at start of pubertal growth spurt
No more accurate than height measurements and it uses radiation

Question 19

Further use of radiographs

Answer 19

Cephlaogram : cervical spine maturation
Already taken for other reasons
Bacetti method: examining 3 cervical vertebrae
Peak mandibular growth velocity would occur in within one year of CVMS II

Question 20

Computer programme use in making growth prediction

Answer 20

Ricketts devised visualised treatment objective (VTO)

• uses average growth increments for each age to give expected growth
• much of data produced does not reflect final outcome as there are great variations

Question 21

Craniofacial changes in adults

Answer 21

> in all facial dimensions continues throughout life
Vertical changes most prominent, antero-posterior changes less prominent
Little change in width
Female growth resumes in 20s
Magnitude is small but cumulative
Growth rotation continues, average small < in face height, compensatory changes occurs in dentition

Question 22

Soft tissue changes in adults

Answer 22

> changes occur in soft tissues than hard tissues
Lip incompetentcy < with age
Lower lip grows more, and combined lip growth exceeds lower face height