Skeletal maturation evaluation using mandibular second molar calcification stages

Department of Orthodontics, PDM Dental College and Research Institute, Sarai Aurangabad, Bahadurgarh, Haryana, India.
The Angle Orthodontist (Impact Factor: 1.23). 09/2011; 82(3):501-6. DOI: 10.2319/051611-334.1
Source: PubMed


To investigate (1) the relationships between the stages of mandibular second molar calcification and skeletal maturity; and (2) whether second molar calcification stages can be used as a reliable diagnostic tool to determine skeletal maturity.
Samples were derived from panoramic radiographs and lateral cephalograms of 300 subjects (137 males and 163 females) with ages ranging from 9 to 18 years, and estimates of dental maturity (Demirjian Index [DI]) and skeletal maturity (cervical vertebrae maturation indicators [CVMI]) were made.
A highly significant association (C*  =  0.854 for males and 0.866 for females) was found between DI and CVMI. DI stage E corresponded to stage 2 of CVMI (pre-peak of pubertal growth spurt) and DI stages F and G corresponded to stages 3 and 4 of CVMI (peak of pubertal growth spurt). DI stage H was associated with stages 5 and 6 of CVMI (end of pubertal growth spurt).
A highly significant association exists between DI and CVMI. Mandibular second molar DI stages are reliable indicators of skeletal maturity.

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    • "he relevance of ethnic and social diversities , one needs only to consider these data in comparison with the elements reported in other examined groups : a ) among the Indian population phase CVM 5 is significantly associated to DM H [ Krailassiri et al . , 2002 ] ; b ) among the Turkish population phase CVM 5 is associated equally to DM G and H [ Kumar et al . , 2012 ] ; c ) among the Polish population phase CVM 5 in females shows a ratio similar to the one described also in our study , but it defines a balance between DM G and H in male individuals [ Ró yło - Kalinowska et al . , 2011 ] ; d ) among the Chinese population male individuals show a predominance of DM G in phase CVM 5 [ Chen et al . , 2"
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    ABSTRACT: Aim: The aim of this study was to investigate the relationship between the stages of calcification of the mandibular second molar and the stages of skeletal maturity among Italian children and young adults. Materials and methods: Cross-sectional descriptive study. The samples were derived from panoramic radiographs and lateral cephalograms of 500 Italian subjects aged from 10 to 20 years. Dental maturity index (DM) was assessed by calcification stages of the mandibular second molars according to the Demirjian method; skeletal maturity was evaluated with cervical vertebrae maturation index (CVM) according to Hassel and Farman. The Pearson r coefficient and Spearman rank correlation coefficient were estimated to determine the relationship between DM and CVM. Results: Skeletal maturation stages occurred earlier in females (about 6 months). A highly significant correlation between CVM and DM (0.78-0.86 cor according to Pearson test and 0.81-0.85 rho according to Spearman test) was found. DM stage E corresponds to phase CVM 1 and 2 (the phase prior to the growth spurt), DM stage F corresponds to the phase of pubertal growth spurt, stages CVM 2 and CVM 3; DM stage G is indicator of the growth spurt underway (CVM 3-4), but it can still be found during CVM 5 in females. Conclusion: The second mandibular molars can be considered reliable indicators for the evaluation of the growth phases. In case of females the end of the growth spurt it is not clearly associated with a dental maturity stage and needs to be stated with further parameters such as CVM.
    Full-text · Article · Dec 2014 · European Journal of Paediatric Dentistry
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    • "Moreover, the findings of our present study could support the hypothesis that dental maturation may not be linked directly to facial or mandibular growth [53]. Again, despite a significant correlation between dental maturation and bone age found in many studies of various populations [54-56], such correlations are generally considered to be moderate at best [57]. This could explain why dental development indicators are not reliable predictors of an individual’s stage of skeletal development. "
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    ABSTRACT: The causes of dental crowding are not fully understood, but it may result from an evolutionary trend towards reduced facial volume, without a proportional reduction in tooth sizes. Most previous studies conducted among modern humans have revealed a very low or non-existent correlation between tooth size and jaw size. Cross-comparison between dental age and facial skeletal age could help to provide better knowledge of the dynamic process of dental crowding. The primary objective of this research was to study the synchronism of dental maturation and skeletal facial growth in a sample of modern children living in France. The secondary objective was to assess the link between dentofacial asynchronism and dental crowding. The random sample comprised 28 subjects (16 girls, 12 boys). Mean chronological age was 13.5 years (+/-2.1; range 9.2--17.6). Mean dental age was 14.2 years (+/-2.8; range 7.5--17) and mean facial skeletal age was 12.8 years (+/-2.6, range 7--22). In the estimations of dental age and facial skeletal age, there was no evidence of systematic bias. There were 10 subjects (9 girls, 1 boy) with asynchronous dentofacial development. Finally, there were 13 subjects (8 girls, 5 boys) with dental crowding. A significant association was found between delayed facial skeletal growth / advanced dental maturation and dental crowding (P = 0.01). Dental maturation and facial growth are not necessarily synchronous. Further understanding of the interactions between dental maturation and facial growth could have crucial implications in biological anthropology, as well as for the clinical practice of orthodontists. From an anthropological perspective, this study suggests that asynchronous dentofacial development could, at least partially, explain the frequency of dental crowding in modern populations.
    Full-text · Article · Nov 2013 · Journal of PHYSIOLOGICAL ANTHROPOLOGY
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    • "As one of these indicators, dental maturity detected through radiographic methods has been shown to be highly related to skeletal maturity [10-14], especially for the mandibular canines [10,12] and the second molars [14]. In spite of these high correlations, the reliability, or diagnostic performance, of dental maturity for use as an assessment of the different growth phases appears to be low, with poor clinical meaning, which is limited mainly to the identification of the pre-pubertal growth phase [15]. "
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    ABSTRACT: 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. A 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. For 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. Dental 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.
    Full-text · Article · May 2013
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