الفهرس 
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Abstract
The present study was undertaken to assess the pubertal growth spurt in a
group of Marsa Matrouh school female adolescents, using the developmental stages of the middle phalanx of the middle finger (MP3) as a skeletal maturation index and its correlation with adductor sesamoid ossification stages (AS).
This study was conducted as a part of research project between Ministry of
Health and Faculty of Dentistry, Cairo University represented by Orthodontic
Department. This present study was conducted in Marsa Matrouh governorate.
A total sample of 742 adolescent females were included in the research. Their
circumpubertal ages ranged from 8 to 14 years. Middle phalanx of the middle finger (MP3) of each subject was radiographed. In 141 subjects from the total sample, the adductor sesamoid were digitally radiographed. Each film was interpreted to define its MP3 developmental stage or its adductor sesamoid ossification stage, then the
data were collected and statistically analyzed.
Based on the findings of this study, the following conclusions could be drawn:
1. The mean skeletal maturity age of MP3-G stage (that represent the onset of
the peak of pubertal growth spurt) in Marsa Matrouh adolescent females was
found to be 11.08 ± 0.86 years.
2. The mean skeletal maturity age of AS3 (that represent the peak of pubertal
growth spurt) in Marsa Matrouh adolescent females was found to be 11.44 ±1.18 years.
3. A Positive correlation was observed between the MP3 stages and adductor
sesamoid stages.
4. The growth modulation treatment by functional orthodontic appliances should
carried out for Egyptian female adolescent within range of 9.33 years to 12.01 years, that represents the active period of pubertal growth between the onset of the pre-peak (MP3-F) and the end of the peak (MP3-H) stages respectively.
Clinical implications:
According to Rajagobal and Kansal 3 findings that a high correlation was found between modified MP3 and CVMI and the conclusion of Baccetti et al 29 who
correlate the peak of maxillary and mandibular growth to certain stages of CVMI, the following clinical implications could be given:
A. Management of mandibular deficiency anteroposteriorly or vertically is
recommended to be performed at MP3-G stage at mean age 11.08 ± 0.86
years.
B. Management of maxillary deficiency anteroposteriorly or transversely is
recommended to be performed at MP3 stage (F or FG) at mean age range 9.33
±0.90 to 10.19 ±0.97 years old. i.e. earlier than mandibular deficiency.