Abstract
BackgroundThe objective of this research is to analyze the diagnostic performance of the circumpubertal dental maturation stages of the mandibular canine and second molar, as individual teeth and in combination, for the identification of growth phase.MethodsA total of 300 healthy subjects, 192 females and 108 males, were enrolled in the study (mean age, 11.4 ± 2.4 years; range, 6.8 to 17.1 years). Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine and second molar. Determination of growth phase (as pre-pubertal, pubertal, and post-pubertal) was carried out according to the cervical vertebral maturation method. The diagnostic performances of the dental maturation stages, as both individual teeth and in combination, for the identification of the growth phase were evaluated using positive likelihood ratios (LHRs), with a threshold of ≥10 for satisfactory performance.ResultsFor the individual dental maturation stages, most of these positive LHRs were ≤1.6, with values ≥10 seen only for the identification of the pre-pubertal growth phase for canine stage F and second molar stages D and E, and for the post-pubertal growth phase for second molar stage H. All of the combined dental maturation stages yielded positive LHRs up to 2.6.ConclusionsDental maturation of either individual or combined teeth has little role in the identification of the pubertal growth spurt and should not be used to assess timing for treatments that are required to be performed at this growth phase.
Highlights
The objective of this research is to analyze the diagnostic performance of the circumpubertal dental maturation stages of the mandibular canine and second molar, as individual teeth and in combination, for the identification of growth phase
* Correspondence: G.Perinetti@fmc.units.it Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy several other radiographical [2,6,7] and biochemical [8,9] indicators of the growth phases have been investigated. As one of these indicators, dental maturity detected through radiographic methods has been shown to be highly related to skeletal maturity [10,11,12,13,14], especially for the mandibular canines [10,12] and the second molars [14]
The canine stages up to stage F and the second molar stages up to stage E were mostly present in the pre-pubertal growth phases; all of the other stages were distributed throughout the three growth phases, with the exception of the second molar stage H which was seen only in the pubertal and post-pubertal growth phases
Summary
The objective of this research is to analyze the diagnostic performance of the circumpubertal dental maturation stages of the mandibular canine and second molar, as individual teeth and in combination, for the identification of growth phase. The correct identification of the different growth phases, i.e., prepubertal, pubertal, and post-pubertal, on an individual basis represents a crucial issue in orthodontic diagnosis and treatment planning [2] For this reason, and because chronological age [3] and tooth emergence [4,5] have been shown to be unreliable indicators of the onset of the pubertal growth spurt, over the last five decades, As one of these indicators, dental maturity detected through radiographic methods has been shown to be highly related to skeletal maturity [10,11,12,13,14], especially for the mandibular canines [10,12] and the second molars [14]. Excluding those stages that are clearly related to the pre-pubertal and post-pubertal growth phases, the combination of the maturational stages of these teeth might improve the diagnostic performance for the identification of the pubertal growth spurt
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