The best time for orthodontic treatment for Polish children based on skeletal age analysis in accordance to refund policy of the Polish National Health Fund (NFZ)

Adv Clin Exp Med. 2018 Oct;27(10):1377-1382. doi: 10.17219/acem/69976.

Abstract

Background: The ability to estimate the growth potential correctly is an important factor in taking effective actions with respect to orthodontic diagnosis, suitable treatment protocol and optimal timing of commencing the therapy.

Objectives: The aim of this study was to compare skeletal maturity between the groups depending on the malocclusion as well as to define the optimal timing for particular orthodontic treatment procedures in children with miscellaneous types of malocclusion and compare it with the duration of treatment proposed by the National Health Fund (NFZ).

Material and methods: The delivery of the objectives of this study has been divided into 4 stages: the selection of the lateral head films (n = 180) of patients with malocclusion without congenital defect - diagnosing an orthodontic defect using Angle's classification, noting the chronological age (7-16 years) at the moment of taking the radiograph; the evaluation of the patients' skeletal maturation stages determined by the cervical vertebrae; comparison of the skeletal maturity between the groups considering the calendar age and the type of malocclusion and analysis of 45 cephalometric RTG projections of patients with different malocclusions.

Results: The average age for children with malocclusion was significantly higher for class III as compared to class II or I in pubertal peak group (CS3 and CS4), and for class III as compared to class I or II after the puberty peak (CS5 and CS6). Our findings of the average age according to Angle's classification revealed significant differences between class II and class III at CS2, CS3, CS4, CS5, between class I and class III at CS3 and CS5, between class I and class II at CS4, between class III and I at CS5, and between all classes at CS6 maturity stage.

Conclusions: Based on our research, it is concluded that the time of the refund of orthodontic treatment in Poland should be extended to 13.6 years of age for class II malocclusion and to 14.7 years of age for class III defects.

Keywords: Angle’s classification; cervical vertebral maturation method; malocclusion; orthodontic treatment; skeletal age.

MeSH terms

  • Adolescent
  • Age Determination by Skeleton / methods*
  • Cephalometry
  • Child
  • Financial Management*
  • Humans
  • Malocclusion*
  • Malocclusion, Angle Class II*
  • Poland
  • Sexual Maturation