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Abstract
Introduction The determination of skeletal maturity stages is very important in orthodontic treatment planning, especially skeletal discrepancies in growing individuals. A hand-wrist radiograph is considered the most accurate approach for skeletal maturity detection. Dental calcification stages have been suggested as an alternative diagnostic method to decrease radiation exposure. The recent study is aimed at detecting the efficacy of dental calcification stages in assessing skeletal maturity during the prepubertal and pubertal growth periods. Methods Patients' records were collected from the Aleppo Orthodontic Center. Dental maturity stages were assessed from a panoramic radiograph using the Demirjian method, while skeletal maturity stages were determined using the Björk method. Four permanent left mandibular teeth were included (canine, 1st premolar, 2nd premolar, and 2nd molar) for the study. Results From 517 records, 295 records (145 males and 150 females) were included. The Spearman rank-order correlation coefficients between skeletal maturation and dental maturation were strong and statistically significant (ranging from 0.789 to 0.835). The highest correlation was between skeletal stages and the second molar (r = 0.829 and 0.88 in males and females, respectively). Receiver operating characteristic (ROC ) curve suggested a high validity of the sum of dental stages for the four teeth in identifying MP3= stage (sensitivity was 70%, specificity was 92.77%, and ROC area was 0.81) but not for MP3cap (sensitivity was 50.85%, specificity was 81.36%, and ROC area was 0.66). Conclusions The correlation between the skeletal maturity stages and the dental calcification stages was high. The orthodontist can use the dental stages as a definite diagnostic tool for prepubertal growth period.
Highlights
The determination of skeletal maturity stages is very important in orthodontic treatment planning, especially skeletal discrepancies in growing individuals
Orthodontists should have a good knowledge of assessing skeletal maturation of growing patients as it can directly or indirectly affect the diagnosis, planning, outcome, and retention protocol in orthodontic treatment [3, 4]
Local traditions, gender, and racial dysmorphism limit the use of secondary sexual characteristics for growth assessment in orthodontics [7]
Summary
The determination of skeletal maturity stages is very important in orthodontic treatment planning, especially skeletal discrepancies in growing individuals. The recent study is aimed at detecting the efficacy of dental calcification stages in assessing skeletal maturity during the prepubertal and pubertal growth periods. The correlation between the skeletal maturity stages and the dental calcification stages was high. Most patients seeking orthodontic treatment are young and secular trends have been reported for growth over time, and children are growing much faster and maturing earlier [2]. Orthodontists should have a good knowledge of assessing skeletal maturation of growing patients as it can directly or indirectly affect the diagnosis, planning, outcome, and retention protocol in orthodontic treatment [3, 4]. Growth curves are less predictable due to the secular trends for increased height with time [2]
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