Middle phalanx maturation of the third finger (MPM) method in the evaluation of skeletal age in a growing orthodontic patient.

A 12-year-old boy consulted with a severe skeletal class II malocclusion, proclination of the upper incisors with diastemas in the upper arch, 11mm of overjet, a Bolton discrepancy, deep bite and a severe curve of Spee. Treatment included evaluation of the skeletal age using the middle phalanx maturation of the third finger (MPM) method in order to assess the pubertal growth spurt. When this period was reached, a Herbst was applied for 8 months; then fixed orthodontic treatment was delivered for 16 months. At the end of orthodontic treatment, restorative therapy was given to improve the shape of the upper incisors. Retention was provided with a Boston splint in the upper arch and a spring retainer in the lower arch. Precise evaluation of a patient's skeletal age can shorten orthodontic treatment and enhance compliance.