J Korean Acad Pediatr Dent 35(2) 2008 도사이상관성이낮다고보고하였다. 국내에서는차와서 13), 오와양 14), 이와이 15), 정과양 16) 이치아석회화과정과골성숙도에관한연구를보고하였다. 부정교합의형태에따른골성숙도의연구로는김과정 17) 의보

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1 대한소아치과학회지 35(2) 2008 Ⅲ 급부정교합어린이의수완부골성숙과하악제 3 대구치발육에대한연구 강근영 양규호 최남기 김선미 전남대학교치의학전문대학원소아치과학교실, 치의학연구소및 2 단계 BK21 사업단 국문초록 본연구는 Ⅰ급부정교합과 Ⅲ급부정교합어린이의수완부골성숙단계와하악제3대구치발육을비교 평가하고자하였다. 이를위해전남대학교병원소아치과에내원한환자들로 8세부터 15세사이의 Angle Ⅰ급부정교합을지닌남자 149명, 여자 155명그리고 Angle Ⅲ급부정교합을지닌남자 153명, 여자 155명, 총 612명을대상으로하였으며골성숙단계평가를위해수완부사진을이용한 Fishman의방법을사용하였고하악제3대구치의발육단계를평가하기위해 Orthopantomogram을이용한 Gat 등의 New Six-Developmental-Stage 방법으로판독하여다음과같은결과를얻었다. 1. 골성숙단계는 Ⅰ급부정교합과 Ⅲ급부정교합군모두전반적으로여자가남자보다빠르나 (p<0.05) 하악제3대구치의석회화단계는성별차이가없었다. 2. 남녀별골성숙단계와하악제3대구치의석회화단계는 Ⅰ급과 Ⅲ급부정교합군간에서유의한차이가없었다. 3. Ⅰ급부정교합과 Ⅲ급부정교합군의수완부골성숙단계와하악제3대구치석회화단계사이의상관관계는두군모두높은상관성을보였다 (p<0.01). 4. Ⅰ급부정교합과 Ⅲ급부정교합군의하악제3대구치석회화단계와연령사이의상관관계는두군모두높은상관성을보였다 (p<0.01). 이상의결과로수완부골성숙도와하악제3대구치발육은 1급부정교합과 Ⅲ급부정교합군간에차이가없었다. 주요어 : Ⅲ 급부정교합, 수완부골성숙단계, 하악제 3 대구치발육 Ⅰ. 서론 성장과발육을평가하기위한방법으로는신장이나체중에의한신체적성숙도, 이차성징의출현에의한성적성숙도, 치아의맹출시기와맹출순서및치아의발육정도에의한치아의성숙도, 여러부위에존재하는골의골화정도에의한골성숙도등이있다 1-6). 교신저자 : 양규호 광주광역시동구학동 8 번지전남대학교병원소아치과학교실 Tel: hellopedo@hanmail.net 골성숙도는근래에널리사용되는성숙지표로서수완부방사선사진이가장일반적으로이용되고있다. Fishman 7,8) 은수완부의각골에서의성숙도를일정한순서에의해관찰하는 SMI(Skeletal Maturation Indicators) 방법을제시하였다. 치아의성숙도를평가하는방법에는치아맹출도에따른방법과치아석회화과정에따라평가하는방법이있으며치아석회화과정은환경적영향을덜받기때문에치아성숙도를평가하는데널리이용하고있다 9-11). 골성숙단계와치아석회화도사이의연구로 Sierra 5) 는치아석회화과정과골성숙도사이의상관성이높음을보고하였고 Demisch와 Wartman 10), Engström 등 11) 은하악제3대구치의석회화과정과골성숙도사이에상관성이있다고하였으며, 반면 Lewis와 Garn 12) 은하악제3대구치의석회화과정과골성숙 235

2 J Korean Acad Pediatr Dent 35(2) 2008 도사이상관성이낮다고보고하였다. 국내에서는차와서 13), 오와양 14), 이와이 15), 정과양 16) 이치아석회화과정과골성숙도에관한연구를보고하였다. 부정교합의형태에따른골성숙도의연구로는김과정 17) 의보고가있으며부정교합과하악치아발달에관한연구는이와이 18) 에의해보고된바있다. 하악제3대구치의치아석회화정도와관련된골성숙도는이전연구에서많은편차를보이며연구대상에서제외되는경우가많았는데본연구에서는이전연구의편차를좀더보완하고세분화하기위해남녀각각에서 Ⅰ급부정교합군과 Ⅲ급부정교합군에대한수완부골성숙도와하악제3대구치발육상태를평가하고그상관성을살펴보고자한다. Ⅱ. 연구대상및방법 부정교합을지닌남자 153명, 여자 155명, 총 612명을대상으로하였다 (Table 1). 연구의정확성을기하기위하여치아발육에영향을미칠전신질환이나치아의상실이있는경우, 치과보철물이나수복물이있는치아, 교정치료의경험이있는경우, 방사선사진이희미하여판독이어려운경우등은대상에서제외하였다. 2. 연구방법 (1) 수완부골성숙단계의평가좌측수완부골방사선사진을이용하여 Fishman 8) 의골성숙평가방법 (Skeletal maturation assessment: SMA) 에따라제1,3,5 수지및요골 (radius) 에서 11개의골성숙지수 (Skeletal maturity indicator: SMI) 를구하였다 (Fig. 1, 2). 1. 연구대상본연구는 1991년 5월에서 2005년 1월전남대학교병원소아치과에내원한환자들로 8세부터 15세사이의 Angle Ⅰ급부정교합을지닌남자 149명, 여자 155명그리고 Angle Ⅲ급 (2) 치아석회화도평가 Orthopantomogram을이용하여하악좌측제3대구치의석회화단계를 Gat 등 19) 의 New Six-Developmental-Stage 방법으로판독하였으며형성단계에대한평가기준은다음과같다 (Fig. 3). Table 1. Distribution of subjects Angle Classification Age Sum M Class Ⅰ (14.8) (12.1) (12.1) (13.4) (14.1) (14.8) (10.1) (8.7) (100) F (12.3) (14.2) (14.2) (13.5) (13.5) (11.6) (11.6) (9.0) (100) M Class Ⅲ (13.7) (16.3) (14.4) (13.7) (12.4) (11.8) (10.5) (7.2) (100) F (13.5) (14.2) (12.3) (12.9) (14.8) (12.9) (10.3) (9.0) (100) ( ): % A B C D A. Epiphysis equal in width to disphysis B. Appearance of adductor sesamoid of the thumb C. Capping of epiphysis D. Fusion of epiphysis Fig. 1. Radiographic identification of skeletal maturity indicators. 236

3 대한소아치과학회지 35(2) 2008 Width of epiphysis as wide as diaphysis 1. Third finger-proximal phalanx 2. Third finger-middle phalanx 3. Fifth finger-middle phalanx Ossification 4. Adductor sesamoid of thumb Capping of epiphysis 5. Third finger-distal phalanx 6. Third finger-middle phalanx 7. Fifth finger-middle phalanx Fusion of epiphysis and diaphysis 8. Third finger-distal phalanx 9. Third finger-proximal phalanx 10. Third finger-middle phalanx 11. Radius Fig. 2. Eleven skeletal maturity indicators(smis). Stage 0=no evidence of bud development Stage 1=radiolucent bud, no calcification Stage 2=calcification starts to half crown Stage 3=calcification of half crown to full crown Stage 4=root formation starts to half root length Stage 5=half root length to full length, open apex Stage 6=apices closed Fig. 3. Stages of tooth formation used to assess development of the third molar. Each figure signifies the end of the stage. (3) Error of method 수완부골성숙단계와치아석회화도평가일주일후측정에사용된파노라마방사선사진중 30개를각각무작위로선택하여다시측정후처음계측치와비교하여측정상의오류를검증하였다. 일치도는 kappa 계수를구한결과 92% 와 94% 를보여높은재현성을나타냈다. 3. 통계처리통계처리는 SAS 8.2 program을이용하여수완부골성숙단계및하악제3대구치석회화단계의평균연령을 Ⅰ급부정교합군과 Ⅲ급부정교합군, 남녀로구분하여구하였으며, 각데이터의정규성을 Kolmogorov-Smirnov test로검증하였다. 정규분포를따르는데이터에대하여모수적방법인 Independent two sample t-test를적용하였으며따르지않는경우비모수적방법인 Wilcoxon rank sum test를사용하였다. 또한하악제3대구치의석회화단계와수완부골성숙단계사이의관계및연령과의관계를알아보기위해비모수방법인 Spearmann 상관계수를구했다. Ⅲ. 연구성적 1. 수완부골성숙단계와하악제3대구치의석회화단계별평균연령 Ⅰ급부정교합과 Ⅲ급부정교합군남녀의수완부골성숙단계와하악제3대구치의석회화단계별연령및각군내에서남녀간의차이그리고각군간의남녀에대한차이를구하였다 (Table 2-5). Ⅰ급부정교합과 Ⅲ급부정교합군의수완부골성숙단계별평균연령은남녀사이거의모든단계에서유의한차이가발견되었으나 (p<0.05) 하악제3대구치의석회화단계는별다른차이가없는것으로나타났다 (p>0.05) (Table 2, 3). 남녀별로구분하여 Ⅰ급부정교합군과 Ⅲ급부정교합군의수완부골성숙단계와하악제3대구치의석회화단계별평균연령은차이가없는것으로나타났다 (p>0.05) (Table 4, 5). 237

4 J Korean Acad Pediatr Dent 35(2) 2008 Table 2. Differences of ages according to skeletal maturity stages(smi) by gender SMI ClassⅠ occlusion ClassⅢ occlusion Male Female p-value Male Female p-value ± ±0.71 * 9.46± ±0.33 * ± ±0.77 * 10.62± ±0.51 * ± ±1.05 * 11.66± ±0.7 * ± ±0.54 * 12.94± ±1.14 * ± ±0.50 * 13.77± ±0.95 * ± ±0.48 * (12.72±0.77) 11.22±1.20 * ± ±1.02 * (14.14±0.88) 11.70±0.94 * ± ±1.12 * 14.63± ±0.80 * ± ±1.20 NS 15.25± ±1.24 * ± ±0.69 NS 14.41± ±1.13 NS ± ±0.28 NS 15.92± ±0.20 * * P<0.05 NS ; non- significance ( ) : Wilcoxon rank sum test was used Table 3. Differences of ages according to calcification stages of the third molar by gender Stage ClassⅠ occlusion ClassⅢ occlusion Male Female p-value Male Female p-value ± ±0.74 NS 9.95± ±0.78 * ± ±1059 NS 10.92± ±1.63 NS ± ±1.63 NS 12.82± ±1.60 NS ± ±1.46 NS 14.43±0.76 (14.55±1.00) NS * P<0.05 NS ; non- significance Table 4. Differences of ages according to skeletal maturity stages(smi) by class Ⅰ and Ⅲ malocclusion group ASMI Male Female ClassⅠ ClassⅢ p-value ClassⅠ ClassⅢ p-value ± ±0.87 NS 8.74± ±0.33 NS ± ±0.80 * 9.06± ±0.51 NS ± ±0.86 NS 9.78± ±0.7 NS ± ±0.54 * 10.38± ±1.14 NS ± ±0.98 NS 11.22± ±0.95 NS ± ±0.77 NS 11.55± ±1.20 NS ± ±0.88 NS 12.27± ±0.94 NS ± ±0.72 NS 12.89± ±0.80 NS ± ±0 NS 13.79± ±1.24 NS ± ±0.56 NS 14.60± ±1.13 * ± ±0 NS 15.33± ±0.20 NS * P<0.05 NS ; non- significance Table 5. Differences of ages according to calcification stages of the third molar by class Ⅰ and Ⅲ malocclusion group Stage Male Female ClassⅠ ClassⅢ p-value ClassⅠ ClassⅢ p-value ± ±1.16 NS 9.41± ±0.78 NS ± ±1.64 NS 11.11± ±1.63 NS ± ±1.66 NS 12.55± ±1.60 NS ± ±0.76 NS 14.21±1.46 (14.55±1.00) NS * P<0.05 NS ; non- significance 238

5 대한소아치과학회지 35(2) 2008 Table 6. Correlation coefficients(r) between skeletal maturation stage of hand-wrist and calcification stage of lower left manibular third molar in class Ⅰ and Ⅲ malocclusion group Group r P ClassⅠ-Male ** ClassⅠ-Female ** ClassⅢ-Male ** ClassⅢ-Female ** ** p<0.01 Table 7. Correlation coefficients(r) between chronological age and calcification stage of lower left manibular third molar in class Ⅰ and Ⅲ malocclusion group Group r P ClassⅠ-Male ** ClassⅠ-Female ** ClassⅢ-Male ** ClassⅢ-Female ** ** p< 수완부골성숙도와하악제3대구치의석회화도의상관관계수완부골성숙도와하악제3대구치의석회화단계사이의관계를알아보기위해 Ⅰ급부정교합군과 Ⅲ급부정교합군을남녀별로분석한결과다소높은상관성을나타냈다 (p<0.01) (Table 6). 3. 연령과하악제3대구치의석회화도의상관관계연령과하악제3대구치의석회화단계사이의관계를알아보기위해 Ⅰ급부정교합과 Ⅲ급부정교합군을남녀별로분석한결과다소높은상관성을나타냈다 (p<0.01)(table 7). Ⅳ. 총괄및고찰성장과발육, 특히악안면복합체에대한성장과발육에대해이해하는것은악안면부조화에대한조기인식, 그리고치료시기의결정및치료계획수립에매우중요하다. 골성숙도는성장기아동의신체발달척도로가장많이이용되는데이는골성숙도가연령이나신장, 혹은체중등에비하여성장과정의요소들과더욱밀접한관계를보여주기때문이다. 골성숙도에대한평가는수완부가가장많이이용되고있으며 20) 그이유는수완부골에서는출생과더불어화골현상이계속진행되고수완부를구성하는골들은각기화골현상의개시기와정도및양상이다르므로성숙도평가에유용하기때문이다 21). Fishman의 SMI 방법은모지척측종자골의출현을중심으로하여일정한순서에의해관찰하므로, 임상적으로간편하게사용할수있다. 치아성숙도는과거교정학분야에서연령과더불어가장먼저이용된척도로 1771년 Hunter 22) 가최초로치아발육에대한연구를시작하였으며, Spier 23) 가신장의성장과치아의맹출을관련지어연구한이래다양한신체성숙지표들과치아성숙도와의상호관계에대해연구가이루어져왔다. 대부분이치아맹출도를이용한방법으로환경의영향을많이받지만 24) 치아석회화과정은연속되는일련의성숙과정으로환경의영향이미 미하여치아성숙도표현에더욱적합한척도로사용된다 25-27). 치아석회화과정의평가시제3대구치의경우는단계를세분화시키면판독의어려움이있으며 28) 치아형성평가를위한통계적분석을향상시키기위해저자는 Gat 등 19) 에의한6단계방법으로평가하였다. 본연구에서의 Ⅰ급부정교합과 Ⅲ급부정교합군각각에대한남녀의골성숙평균연령은전반적으로두군모두에서여자가남자보다더빠른골성숙진행단계를보였으며 Ⅰ급부정교합의 SMI-9,10,11단계와 Ⅲ급부정교합의 SMI-10단계는유의한차이가인정되지않았다. 이는여자가남자보다골성숙연령이빠르다는 Björk와 Helm 29), Fishman 8) 의보고나박과서 30), 오와양 15), 이와이 16), 정과양 17) 의연구결과와일치한다. 그러나유의한차가인정되지않은경우나단계가증가함에도불구하고연령의감소가있는경우가있었는데이는조사대상의수가너무작았다든지또는누년적인연구가되지못하고횡적인연구가시행된데에원인이있다고생각된다. 하악제3대구치의석회화단계는 Ⅲ급부정교합군의 1단계를제외하고모두남녀간차이를보이지않았으며 Sarnat 등 31) 에의한이스라엘어린이의제3대구치발육단계나 Gravely 32) 의제3대구치발육에대한방사선학적조사에서성과관련이없다는결과와일치한다. 성별에관계없이 Ⅰ급부정교합과 Ⅲ급부정교합군간수완부골성숙단계의평균연령이나하악제3대구치의평균연령은전반적으로차이가없는것으로나타났으며이는김과정 18) 에의한연구에서는Ⅰ급부정교합과 Ⅲ급부정교합군의골성숙도에유의한차이가없다고하여, 본연구의결과와일치한다. 골성숙단계와치아석회화도사이의연구로 Sierra 5) 는치아석회화과정과골성숙도사이의상관성이높음을보고하였고한국인아동을대상으로한양 33) 의연구역시같은결과를보여주고있으나 Tanner 등 34), Acheson과 Dupertuis 35) 의연구에서는상관성이낮은것으로보고하였다. 하악제3대구치와관련하여 Demisch와 Wartman 10), Engström 등 11) 은하악제3 대구치의석회화과정과골성숙도사이에상관성이있다고하였으며, 반면 Lewis와 Garn 13) 은하악제3대구치의석회화과정과골성숙도사이상관성이낮다고보고하였다. 본연구에서 239

6 J Korean Acad Pediatr Dent 35(2) 2008 는수완부골성숙도와하악제3대구치석회화도의상관계수가 Ⅰ급부정교합과 Ⅲ급부정교합군모두높게나와상관성이높다고보고한 Demisch와 Wartman 10), Engström 등 11) 의결과와일치한다. 부가적으로하악제3대구치석회화단계와나이와의상관성조사결과연령과도유의성있는결과를보여주고있다. 이상의본연구를종합해볼때, Ⅰ급부정교합과 Ⅲ급부정교합군사이의수완부골성숙도와하악제3대구치석회화도는별다른차이를보이지않았으며수완부골성숙도는여성의평균연령이남성보다높은반면하악제3대구치석회화도는성별차이를보이지않았다. 또한하악제3대구치발달과골격성숙, 나이사이에서강한상관성이발견되었다. Moorees 등 36) 은치아의발육도를평가할때조사되는대상을, 속해있는인구집단의표준화된집단에서선정해야하며한장의방사선사진으로판단을하는것보다조사되는치아의누년적인방사선사진을가지고서판단하는것이정확하다고하였다. 그러나본연구에서는다수를연구대상에포함시키기위해횡적인방법으로연구가이루어졌으며좀더세밀한연구를위해서는종적인연구가필요하리라사료된다. Ⅴ. 결론본연구는전남대학교병원소아치과에내원한환자들로 8세부터 15세사이의 Angle Ⅰ급부정교합을지닌남자 149명, 여자 155명그리고 Angle Ⅲ급부정교합을지닌남자 153명, 여자 155명, 총 612명을대상으로하였으며골성숙단계평가를위해수완부사진을이용한 Fishman의방법을사용하고하악제3대구치의발육단계를평가하기위해 Orthopantomogram을이용하여 Gat 등에의한 6단계방법으로판독하였다. 연구의정확성을기하기위하여치아발육에영향을미칠전신질환이나치아의상실이있는경우, 치과보철물수복물이있는치아, 교정치료의경험이있는경우, 방사선사진이희미하여판독이어려운경우등은대상에서제외하였으며다음과같은결과를얻었다. 1. 골성숙단계는 Ⅰ급부정교합과 Ⅲ급부정교합군모두전반적으로여자가남자보다빠르나 (p<0.05) 하악제3대구치의석회화단계는성별차이가없었다. 2. 남녀별골성숙단계와하악제3대구치의석회화단계는 Ⅰ급과 Ⅲ급부정교합군간에서유의한차이가없었다. 3. Ⅰ급부정교합과 Ⅲ급부정교합군의수완부골성숙단계와하악제3대구치석회화단계사이의상관관계는두군모두높은상관성을보였다 (p<0.01). 4. Ⅰ급부정교합과 Ⅲ급부정교합군의하악제3대구치석회화단계와연령사이의상관관계는두군모두높은상관성을보였다 (p<0.01). 이상의결과로수완부골성숙도와하악제3대구치발육은 1 급부정교합과 Ⅲ급부정교합군간에차이가없었다. 참고문헌 1. Baume RM, Buschang PH, Weinstein S : Stature, head height, and growth of the vertical face. Am J Orthod, 83: , Hagg U, Taranger J : Maturation indicators and the pubertal growth spurt. Am J Orthod, 82: , Grave KC, Brown T : Skeletal ossification and the adolescent growth spurt. Am J Orthod, 69: , Demirijian A, Buschang PH, Tanguay R, et al. : Interrelationships among measures of somatic, skeletal, and sexual maturity. Am J Orthod, 88: , Sierra AM : Assessment of dental and skeletal maturity. Angle Orthod, 57: , Brown T : Skeletal maturity and facial growth assessment. Orthod J, 2:80-87, Fishman LS : Chronological versus skeletal age : an evaluation of craniofacial growth. Angle Orthod, 41: , Fishman IS : Radiographic evaluation of skeletal maturation : A clinically oriented method based on hand wrist films. Angle Orthod, 52:88-112, Chertkow S, Fatti PL : The relationship between tooth mineralization and early radiographic evidence of adductor sesamoid calcification. Angle Orthod, 49: , Demisch A, Wartmann P : Calcification of the mandibular third molar & its relation to skeletal and chronological age. Child Develop, 27:459, Engström C, Engström H, Soren S : Lower third molar development in relation to skeletal maturinty and chronologic age. Angle Orthod, 53:97-106, Lewis AB, Garn SH : Relationship between tooth formation and other maturational factors. Angle Orthod, 30:70-77, 차경석, 서정훈 : 정상교합자의치아석회화과정과사춘기서장에관한연구. 서울치대논문집, 11(2): , 오희수, 양규호 : 정상교합자의사춘기성장과수완부골성숙단계, 치아석회화도및악골성장에관한연구. 대한소아치과학회지, 19: , 이미라, 이상호 : 한국인사춘기성성장기에서의수완부골성숙도와치아발육에관한연구. 대한소아치과학회지, 240

7 대한소아치과학회지 35(2) : , 정병초, 양규호 : 정상교합자와 Ⅲ급부정교합자의수완부골성숙단계와치아석회회도에대한연구. 대한소아치과학회지, 23: , 김석훈, 정규림 : 정상교합자와부정교합자의골성숙도차이에관한연구. 대한소아치과학회지, 20: , 이상협, 이병태 : Angle씨 Ⅲ급부정교합군과 Angle씨 Ⅰ 급사이의하악치아발달에관한연구. 대한치과교정학회지, 20:55-563, Gat H, Sarnat H, Bjorvatn K, et al. : Dental age evaluation : a new 6-developmental stage method. Clin Prev Dent, 6:18-22, Leite HR, O Reilly MJ, Close JM : Skeletal age assessment using the first, second, and third fingers of the hand. Am J Orthod. 92: , Liliequst B, Lundberg M : Skeletal and tooth development : a methodological investigation. Acta Radio, 11:97-112, Hunter J : Treatise on natural history and disease of human teeth. London :1771, cited from JADA, , Spier L : Physiological age : the relation of dentition to body growth. Dent Cosmos, 60: , Nolla CM : Development of the permanent teeth. J Dent Child, 27: , Green, LJ : The interrelationships among hight, weight and chronological, dental and skeletal ages, Angle Orthod, 31: , Chertkow S : Tooth mineralization as an indicator of pubertal growth spurt, Am J Orthod, 77:79-91, Demirjian A, Goldstein H : New systems for dental maturity based on seven and four teeth, Annals of human biology, 3: , 차대식, 차경석 : 치아석회화과정과골성숙단계의상호연관성에관한연구. 대한치과교정학회지, 24: , Björk A, Helm S : Prediction of the age of maximum pubertal growth in body height, Angle Orthod, 37: , 박진성, 서정훈 : 정상교합자의사춘기성장과수완부골성숙단계에관한연구, 대한치과교정학회지, 15: Sarnat H, Kaffe I, Porat J, et al. : Developmental Stages of the third molar in Israeli children. Pediatric Dent, 25: , Gravely J : A radiographic survey of third molar development. British Dental Journal, 2: , 양규호 : 한국인아동의사춘기성장과수완부골성숙단계, 치아석회화도에관한연구. 대한소아치과학회지, 19:16-29, Tanner JM, Whitehouse RH, Heally MJR, et al. : Assessment of skeletal maturity and prediction of adult height(tw2 method), Academic Press, London, cited from Fishman L S, The Angle Orthodontist, 52:88-112, Acheson RM, Dupertuis : The Oxford method of assessing skeletal maturation, Clin Orthod, 10:19-39, Moorees CFA, Fanning EA, Hunt EE : Age variation of formation stage for ten permanent teeth. J Dent Res, 42: ,

8 J Korean Acad Pediatr Dent 35(2) 2008 Abstract SKELETAL MATURITY AND MANDIBULAR THIRD MOLAR DEVELOPMENT IN CLASS Ⅲ MALOCCLUSION Keun-Young Kang, Kyu-Ho Yang Nam-Ki Choi, Seon-Mi Kim Department of Pediatric Dentistry, School of Dentistry, Chonnam National University and Dental Research Institute, The second stage of BK21 The purpose of this study was to investigate the relationship of the skeletal maturity of hand-wrist and the development of mandibular third molar in subjects with class Ⅰ and class Ⅲ malocclusion. The subjects used in this study were 304 children(149 boys, 155 girls) with class Ⅰ malocclusions and 308 children(153 boys, 155 girls) with class Ⅲ malocclusions, ranged from 8 to 15 years of age. Hand-wrist radiographs and panoramic radiographs were used to evaluate the stage of skeletal maturity and teeth development. Fishman s method for the skeletal maturity stages of the hand-wrist and new six-developmental-stage method for the calcification stages of mandibular third molars were analyzed. The results were as follows : 1. In subjects with class Ⅰ and class Ⅲ malocclusion, skeletal maturity of the hand-wrist occured earlier in females than in males(p<0.05), while the calcification stages of mandibular third molars were no significant gender differences. 2. There were no significant differences between the groups, when comparing the skeletal maturity stages of the hand-wrist and the calcification stages of mandibular third molars between subjects with the class Ⅰ and the class Ⅲ malocclusion. 3. The correlation coefficients between the calcification stages of mandibular third molars and the skeletal maturity stages of the hand-wrist in subjects with class Ⅰ and class Ⅲ malocclusion showed a high interrelationship(p<0.01). 4. The correlation coefficients between the calcification stages of mandibular third molars and chronological age in subjects with class Ⅰ and class Ⅲ malocclusion showed a high interrelationship (p<0.01). As a result, there were no significant differences between class Ⅰ and class Ⅲ malocclusion group for skeletal maturity of the hand-wrist and third molar development. Key words : Class Ⅲ malocclusion, Skeletal maturity of hand-wrist, Development of mandibular third molar 242

J Korean Acad Pediatr Dent 43(1) 2016 ISSN (print) ISSN (online) Evaluation of the Dev

J Korean Acad Pediatr Dent 43(1) 2016 ISSN (print) ISSN (online) Evaluation of the Dev http://dx.doi.org/10.5933/jkapd.2016.43.1.1 ISSN (print) 1226-8496 ISSN (online) 2288-3819 Evaluation of the Developmental Age of Permanent Teeth by the Nolla Method Minkyung Shin 1, Jeseon Song 1, Jaeho