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Indian J Dent Res. 2012 Jul-Aug;23(4):447-53. doi: 10.4103/0970-9290.104947.

Digital radiograph of the middle phalanx of the third finger (MP3) region as a tool for skeletal maturity assessment.

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Department of Pedodontics and Preventive Dentistry, Sharad Pawar Dental College and Hospital, Wardha, Maharashtra, India.



To evaluate the reliability of the digital radiograph of the middle phalanx of the third finger (MP3) in skeletal maturity assessment.


Fifty children (24 girls and 26 boys) belonging to the circumpubertal age-group were selected for the study. Two radiographs - lateral cephalogram and digital radiograph of the MP3 region - were taken in each child. Age assessment was based on the changes in shape of the cervical vertebrae and the epiphysis of the middle phalanx of the third finger of the left hand. The radiographs were assessed by three examiners. The inter- and intraexaminer variability were determined by the Wilcoxon rank sign test and the Kruskal-Wallis test and were found to be nonsignificant. Examiner 3 showed the best intraexaminer agreement and was selected to evaluate the radiographs for the entire study.


The correlation determined between the MP3 stages and cervical vertebrae maturity index (CVMI) stages, the peak-wise distribution of the MP3 stages, and the correlation between the MP3 stages and the chronological age were found to be highly significant.


Digital radiograph of the MP3 region is definitely a simple, reliable, cost-effective, and time-saving technique for the assessment of skeletal maturity.

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