The hand X-ray was once widely used in orthodontics but is now obsolete. For a long time, orthodontists believed that it could be used to predict the expected remaining growth stage of young patients. However, new scientific studies have shown that hand X-rays are not suitable for accurately predicting lower jaw growth or body growth. The information provided by hand X-rays is therefore too inaccurate for planning orthodontic treatments, meaning that the X-ray has no practical value.
The detailed X-ray guidelines of the British Orthodontic Society also deal with hand X-rays with the brief statement that they are not accurate enough to predict the pubertal growth spurt. According to the British guidelines, there is therefore no longer any indication for hand X-rays in orthodontics.
However, the exact opposite statement can be found in a statement issued by the German Society of Orthodontics in 2016. This statement lists all kinds of uses for hand X-rays. Even though this statement appears very scientific with its long list of references, it does not prove the usefulness of hand X-rays. Rather, it seems to be about obtaining a way to bill for services. Simply embarrassing—this statement should be revised urgently!
Against this background, hand X-rays should therefore be avoided today. After all, even billing statistics in Germany show that these X-rays are actually being billed less and less.
Sources:
Verma, Peltomäki, Jäger. Reliability of growth prediction with hand-wrist radiographs. Eur J Orthod 31;2009:438-432).
British Orthodontic Society. Orthodontic Radiographs. Guidelines. London 2015. Link: https://bos.org.uk/wp-content/uploads/2022/03/Orthodontic-Radiographs-2016-2.pdf
German Society of Orthodontics (DGKFO): Proff P, Kirschneck C: Indication for hand skeletal radiographs in orthodontic treatment, Regensburg 2016. Link: https://www.dgkfo-vorstand.de/fileadmin/redaktion/veroeffentlichungen/DGKFO_Stellungnahme_Handskelettaufnahmen_Proff_2016-04.pdf