Original article
Phases of the dentition for the assessment of skeletal maturity: A diagnostic performance study

https://doi.org/10.1016/j.ajodo.2006.02.040Get rights and content

Introduction: The aim of this study was to analyze the relationship between the circumpubertal phases of the dentition (early mixed, intermediate mixed, late mixed, early permanent) and skeletal maturity as assessed by means of the cervical vertebral maturation (CVM) method. Methods: The sample of 1000 subjects included 250 (125 boys, 125 girls) in each of the 4 dentition phases. Individual skeletal maturity was determined by using the CVM method. The relationship between the skeletal maturity (stages in CVM) and the phases of the dentition was evaluated statistically by means of indicators of diagnostic test performance. Results: Prepubertal stage 1 (CS1) was the variable diagnosed in the early mixed and intermediate mixed dentitions; pubertal stage 3 (CS3) was the variable diagnosed in the late mixed and early permanent dentitions. Conclusions: The early mixed dentition phase showed a strong diagnostic value for the identification of prepubertal skeletal maturity (CS1), whereas the intermediate mixed dentition phase had a low diagnostic value for the same prepubertal stage. Neither the late mixed dentition nor the early permanent dentition appeared to be a valid indicator for the onset of the pubertal growth spurt.

Section snippets

Material and methods

This large cross-sectional investigation included 1000 subjects (500 boys, 500 girls) from a parent sample of 1600 subjects from the departments of orthodontics of the universities of Florence and Rome “Tor Vergata.” The exclusion criteria consisted of full deciduous dentition, adult permanent dentition, craniofacial anomalies, cleft lip and palate, extensive caries, early loss of deciduous teeth due to trauma or caries, supernumerary teeth, tooth agenesis, and other tooth anomalies. Dental

Results

The prevalence of the CVM stages in the various phases of the dentition is given in Table I.

The diagnostic tests with the corresponding 95% confidence intervals are shown in Table II. The early mixed dentition phase showed high values in the diagnostic tests for the prepubertal CS1 in skeletal maturation (positive predictive value and positive likelihood ratio), whereas the intermediate mixed dentition phase had low diagnostic scores for that stage. This outcome indicates that a subject who

Discussion

Little is known about the relationship between the onset of puberty and dental maturation. Some studies showed that correlations between tooth mineralization and other parameters of physical development are generally low, whereas there is little more than slight covariation between tooth eruption and the adolescent growth spurt.23, 24, 25, 26, 27, 28, 29 Since no previous data are available with regard to the correspondence between dentition phases and skeletal maturation, we analyzed the

Conclusions

This study on the diagnostic performance of the phases of the dentition as indicators of individual skeletal maturity showed that the early mixed dentition phase shows strong diagnostic value for the identification of prepubertal skeletal maturity (CS1), whereas the intermediate mixed dentition phase has poor diagnostic value for that stage. Neither the late mixed dentition nor the early permanent dentition is a valid indicator for the onset of the pubertal growth spurt (CS3).

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