Citation Information :
Shetty RM, Hanumanta S. RMS-MP3 Classification: A Newly Proposed Digital MP3 Classification in Assessing Skeletal Maturity. Int J Clin Pediatr Dent 2019; 12 (4):255-260.
Background: Growth is a crucial inconsistent parameter, which is a primary requisite in diagnosing and planning orthodontic and orthopedic treatment. The use of the epiphyseal development of the middle phalanx of the third finger (MP3) radiograph is advisable instead of hand and wrist radiographs for growth assessment.
Aim: (1) To propose a simple, precise, and reliable classification system of MP3 staging—RMS MP3 classification and (2) to check the reliability of newly proposed RMS-MP3 classification in assessing the skeletal maturity.
Materials and methods: Standardized MP3 digital radiographs of 276 children between 5 years and 13 years of age were included in the study. The epiphysis and diaphysis were measured, and the percentage of epiphysis formed when compared to diaphysis was obtained using our formula. A new classification was designed and proposed. The assessment of the MP3 developmental stages was carried out by all the four investigators (two pedodontists and two nonpedodontists) according to the older classification by Liete et al. and the newly proposed RMS-MP3 classification.
Results: Among nonpedodontists, there was 51% perfect agreement of maturity stages according to old classification and 90% perfect agreement according to newly proposed classification. Among pedodontists, there was 90% perfect agreement of maturity stages according to old classification and 99% perfect agreement according to the newly proposed classification. An estimated 89% of agreement was seen in RMS-MP3 classification among all the four observers when compared to 38% of agreement in the old classification.
Conclusion: The newly proposed RMS-MP3 classification can be an alternative and perfect aid in assessing growth with accuracy, precision, ease, and an increased reliability.
Grave KC, Brown T. Skeletal ossification and the adolescent growth spurt. Am J Orthod 1976 June;69(6):611–619. DOI: 10.1016/0002-9416(76)90143-3.
Todd TW. Atlas of skeletal maturation: Part 1, The hand. St Louis: Moseby and Co.; 1937.
Greulich WW, Pyle SI. Radiographic atlas of skeletal development of the hand and wrist. 2nd ed., California: Stanford University Press; 1959.
Lamparski DJ. Skeletal age assessment utilizing cervical vertebrae [master of dental science thesis], 2nd ed. Pittsburgh: University of Pittsburgh, School of Dental Medicine; 1972.
Grave K, Townsend G. Cervical vertebra maturation as a predictor of the adolescent growth spurt. Aust Orthod J 2003 April;19(1): 25–32.
Tanner JM, Whitehouse RH, et al. The adolescent growth spurt of boys and girls of the Harpenden growth study. Ann Hum Biol 1976 Mar;3(2):109–126. DOI: 10.1080/03014467600001231.
Patil AA, Revankar AV. Reliability of the frontal sinus index as a maturity indicator. Indian J Dent Res 2013 July–Aug;24(4):523–527. DOI: 10.4103/0970-9290.118372.
Demisch A, Wartmann P. Calcification of the mandibular third molar and its relation to skeletal and chronological age in children. Child Dev 1956 Dec;27(4):459–473. DOI: 10.2307/1125899.
Hagg U, Taranger J. Maturation indicators and pubertal growth spurt. Am J Orthod 1982 Oct;82(4):299–309. DOI: 10.1016/0002-9416(82)90464-X.
Uysal T, Sari Z, et al. Relationships between dental and skeletal maturity in Turkish subjects. Angle Orthod 2004 Oct;74(5):657–664.
Abdel-Kader HM. The reliability of dental X-ray film in assessment of MP3 stages of the pubertal growth spurt. Am J Orthod Dentofacial Orthop 1998 Oct;114(4):427–429. DOI: 10.1016/S0889-5406(98)70188-X.
Rajagopal R, Kansal S. A comparison of modified MP3 stages and the cervical vertebrae as growth indicators. J Clin Orthod 2002 Jul;36(7):398–406.
Madhu S, Hegde AM, et al. The developmental stages of the middle phalanx of the third finger (MP3): A sole indicator in assessing the skeletal maturity. J Clin Pediatr Dent 2003 Winter;27(2):149–156. DOI: 10.17796/jcpd.27.2.qtj75rg3714l5543.
Ozer T, Kama JD, et al. A practical method for determining pubertal growth spurt. Am J Orthod Dentofacial Orthop 2006 Aug;130(2):131e1–131e6. DOI: 10.1016/j.ajodo.2006.01.019.
Hagg U, Taranger J. Skeletal stages of hand and wrist as indicators of the pubertal growth spurt. Acta Odontol Scand 1980;38(3):187–200. DOI: 10.3109/00016358009004719.
Leite RH, O'Reilly MT, et al. Skeletal age assessment using the first, second and third fingers of the hand. Am J Orthod Dentofacial Orthop 1987 Dec;92(6):492–498. DOI: 10.1016/0889-5406(87)90231-9.
Hegde DY, Baliga S, et al. Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment. Indian J Dent Res 2012 Jul–Aug;23(4):447–453. DOI: 10.4103/0970-9290.104947.
Mayoral J, Mayoral G. Orthodontics: Fundamental principles and practice, 6th ed. Barcelona, Spain: Labor SA; 1990.
Gutierrez Muniz JA, Berdasc Gomez A, et al. Crecimiento y Desarrollo. En: Colectivo de Autores. Pediatría. T1. [en línea]. La Habana: Editorial Ciencias Médicas; 2006; pp. 27–58.
Baccetti T, Franchi L, et al. The diagnostic performance of chronologic age in the assessment of skeletal maturity. Prog Orthod 2006 Nov;7(2):176–188.
Bhanat S, Patel D. Dental and skeletal maturity indicators of chronological age: Radiographic evaluation amongst children in Gujarat, India. IOSR J Dent Med Sci 2013 May–Jun;6(4):6–12. DOI: 10.9790/0853-0640612.
Baccetti T, McGill JS, et al. Skeletal effects of early treatment of Class III malocclusion with maxillary expansion and face-mask therapy. Am J Orthod Dentofacial Orthop 1998 Mar;113(3):333–343. DOI: 10.1016/S0889-5406(98)70306-3.
Franchi L, Baccetti T, et al. Shape-coordinate analysis of skeletal changes induced by rapid maxillary expansion and facial mask therapy. Am J Orthod Dentofacial Orthop 1998 Oct;114(4):418–426. DOI: 10.1016/S0889-5406(98)70187-8.
Enlow D, Hans M. Essentials of facial growth. Philadelphia: W.B. Saunders; 1996; pp. 65–72.
Mayarí GT, Lugo RO. A simplified method to determine the potential growth in orthodontics patients. Rev Cubana Estomatol 2010 Apr–Jun; 47(2):134–142.
Negi KS, Sharma VP, et al. Assessment of growth impetus using MP3 maturation and its correlation with CVMI and dental age. J Ind Orthod Soc 2003 Oct–Dec;36(4):204–213.
Dhiman S, Maheshwari S, et al. Assessment of maturity in orthodontics: A review. J Adv Clin Res Insights 2015 Mar–Apr;2(2): 100–103. DOI: 10.15713/ins.jcri.54.