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Introduction: Pubertal growth stages are important periods in orthodontic treatment with functional appliances and orthognathic surgery. Pubertal growth prediction, which determines the amount of growth that has taken place and estimates the remaining growth, can influence diagnosis, treatment goals, treatment plans, and orthodontic treatment outcomes, especially in cases requiring growth intensity or growth completion. Determination of pubertal growth stages is more accurate when performed using physiological maturation indicators than chronological age. There are several maturation indices that can be used to predict the pubertal growth stage, such as hand-wrist maturation, cervical vertebrae maturation index (CVMS), dental calcification, peak height velocity of body height (PHV), and menarche in females. The aim of this study was to identify the differences and correlation between hand-wrist, CVMS maturation stages, peak height velocity (PHV), canine and M2 calcification stages, and menarche age (of female subjects). The study also aimed to describe the pubertal growth curve plot of female and male subjects. Materials and Methods: This is a retrospective study with a cross-sectional approach, which included 279 females and 144 males aged 8-17 years. Subjects had digital lateral cephalograms, hand-wrist, and panoramic radiographs. The hand-wrist maturation stage was analyzed using the Fishman method, CVMS using Baccetti et al.’s method, and the stages of dental maturation were assessed using Demirjian and Goldstein method. PHV was measured from standing height using a wall-mounted plastic stadiometer, while menarche was analyzed through interviews. Statistical analysis by ANOVA, post hoc analysis, and Spearman’s rank correlation coefficient were determined with Excel Mega Stat. Results: There were significant differences between females and males in CVMS and hand-wrist (P< 0.05) except for radius union (Ru). No significant differences in canine and M2 calcification between females and males were observed. PHV females increased by 7.89 cm at 11-12 years, while males increased by 9.9 cm at 13-14 years. Menarche occurred at the age of 12.2 years on average, with the oldest being 14.7 years and the youngest being 9.6 years. The correlation between females’ and males’ hand-wrist and CVMS was very high. The lowest correlation in females was between menarche and CVMS and in males, it was between PHV and canine. Conclusion: Maturation stages of hand-wrist, CVMS, and PHV females were earlier than males. Pubertal growth curves plot of females tended to skew to the left, demonstrating that the time from the beginning to the peak of pubertal growth is shorter than that from the peak to the end of pubertal growth, while pubertal growth curves plot of males tended to skew to the right, demonstrating that the time from the beginning to the peak of pubertal growth is longer than that from the peak to the end of pubertal growth.

Space closure is an interesting aspect of orthodontic treatment related to principles of biomechanics. It should be tailored individually based on patient's diagnosis and treatment plan. Understanding the space closure biomechanics basis leads to achieve the desired treatment objective. Overbite deepening and losing posterior anchorage are the two most common unwanted side effects in space closure. Conventionally, correction of overbite must be done before space closure resulted in longer treatment. Application of proper space closure biomechanics strategies is necessary to achieve the desired treatment outcome. This cases report aimed to show the space closure biomechanics strategies that effectively control the overbite as well as posterior anchorage in deep overbite patients without increasing treatment time. Two patients who presented with class II division 1 malocclusion were treated with fixed orthodontic appliance. The primary strategies included extraction space closure on segmented arch that employed two-step space closure, namely single canine retraction simultaneously with incisors intrusion followed by enmasse retraction of four incisors by using differential moment concept. These strategies successfully closed the space, corrected deep overbite and controlled posterior anchorage simultaneously so that the treatment time was shortened. Biomechanics strategies that utilized were effective to achieve the desired treatment outcome ABSTRAK Strategi biomekanika penutupan ruang pada tumpang gigit dalam. Penutupan ruang dalam perawatan ortodonti merupakan aspek yang menarik berkenaan dengan prinsip-prinsip biomekanika. Dibuat khusus secara individu berdasarkan diagnosis dan rencana perawatan. Pemahaman dasar-dasar biomekanika penutupan ruang akan meningkatkan kemampuan operator untuk mencapai tujuan perawatan yang diinginkan. Efek samping yang paling sering terjadi dalam penutupan ruang adalah bertambah dalamnya tumpang gigit dan hilangnya penjangkaran posterior. Umumnya tumpang gigit dikoreksi sebelum penutupan ruang, sehingga waktu perawatan menjadi lebih lama. Untuk mengatasi masalah-masalah tersebut, diperlukan penerapan strategi biomekanika penutupan ruang yang tepat untuk memperoleh hasil perawatan yang sesuai harapan. Tujuan laporan kasus-kasus ini adalah untuk menunjukkan penerapan strategi biomekanika yang efektif untuk mengontrol tumpang gigit dan penjangkaran posterior pada pasien dengan tumpang gigit dalam, tanpa memperpanjang waktu perawatan. Dilaporkan dua kasus maloklusi kelas II divisi 1 yang dilakukan perawatan alat ortodonti cekat. Strategi utama meliputi penutupan ruang pencabutan di lengkung segmental dalam dua tahapan yaitu retraksi kaninus secara individu dengan intrusi insisivus secara simultan, diikuti dengan retraksi empat insisivus dengan menggunakan konsep momen diferensial. Dengan strategi ini, dapat dilakukan penutupan ruang, perbaikan tumpang gigit dalam, dan pengendalian penjangkaran posterior dalam waktu bersamaan, sehingga diperlukan waktu perawatan yang lebih singkat. Strate...

Background: Treatment of skeletal Class III malocclusion in growing patient with an anterior crossbite and open bite is challenging due to unpredictable results and potentially unfavorable growth. Growth modification in adult patients is not an alternative approach. Objective: Case report of a patient with Class III malocclusion in adult and anterior crossbite and open bite was treated with combine fixed appliances and orthognatic surgery. Treatment procedure: Treatment of anterior cross bite and open bite was completed in two phases. The first phase was to correct the dental alignment align and arch coordination with fixed orthodontic appliance. The second phase was to correct the skeletal discrepancy with orthognatic surgery. Conclusions: Orthognatic surgery is a good approach in treating anterior cross bite and open bite relating to skeletal problems in adult period. Changes in profile and occlusion were very obvious.

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