The relation between dental age and cervical vertebral maturation in orthodontic patients aged 8 to 16 years: A cross-sectional study

Individual dental and skeletal age assessment according to Demirjian and Baccetti: Updated norm values for Central-European patients

PURPOSE

Chronological age often differs from dental and skeletal age. With orthopantomograms and lateral cephalograms, dental and skeletal development can be determined according to the methods published by Demirjian et al. and Baccetti et al. However, gender and skeletal class as possible confounders were frequently not considered and available norm values are not up-to-date. This retrospective cross-sectional study thus aimed to evaluate effects of skeletal class and gender on dental and skeletal age of growing patients and to generate updated norm values for contemporary Central-European patients.

METHODS

A total of 551 patients were included in the dental and 733 in the skeletal age assessment, respectively. Dental analysis was based on tooth mineralisation stages in orthopantomograms (Demirjian) and skeletal age was defined by cervical vertebrae maturation stages (CVMS) in lateral cephalograms (Baccetti). Skeletal class was determined by the individualised ANB angle of Panagiotidis/Witt. With nonlinear regression analysis a formula for determining dental age was established. Effects of gender and skeletal class were evaluated and updated norm values generated.

RESULTS

Inter- and intrarater reliability tests revealed at least substantial measurement concordance for tooth mineralisation and CVMS. Demirjian stages and CVMS significantly depended on gender with girls developing earlier. Skeletal class significantly affected skeletal age only, but without clinical relevance. Updated norm values for dental age differed significantly from the original values of Demirjian and the values for skeletal age differed from those published by Baccetti.

CONCLUSION

Optimised norms, separated by gender, increase precision in determining individual dental and skeletal age during orthodontic treatment planning. Further studies analysing the effect of skeletal class on dental and skeletal development are needed.

Association between dental and skeletal maturation in Scandinavian children born between 2005 and 2010

OBJECTIVE

The aim of this cross-sectional study was to analyse the association between dental and skeletal maturation in children born between 2005 and 2010.

MATERIALS AND METHODS

Dental and skeletal maturation of 117 ethnic Scandinavian children born between 2005 and 2010 (70 girls, 47 boys, mean age 11.48 years) was analysed. Dental maturation (DM) was assessed on orthopantomographs (OPs) by using Demirjian's and Haavikko's methods while skeletal maturation was assessed on hand-wrist radiographs by use of Helm's method. The correlation between skeletal and DM was analysed using Spearman's rho (Rs). Additionally, the most frequent DM stage in relation to the skeletal maturation stage was analysed by logistic regression adjusted for age and sex.

RESULTS

The correlation between dental and skeletal maturation was significant for all teeth (Rs = 0.071-0.562; p < .000-p = .035) except for the first incisor and the first molar. Logistic regression analysis showed that when the mandibular and maxillary canines are ¾ mineralized, this is significantly associated with the beginning of the adolescent period before peak height velocity (PHV) (PP2= p < .005-< .05). Likewise, when the mandibular second premolars are ¾ mineralized, this is significantly associated with the maturation stage PP2= or S (PP2= p < .05, S: p < .005-< .05), both of which are before PHV at the beginning of the adolescent period.

LIMITATIONS

Limited sample size and the X-rays were taken before orthodontic treatment, which may have introduced a selection bias.

CONCLUSIONS

When the root of the canines or second premolars is ¾ mineralized, it may indicate the beginning of the adolescent period with increased skeletal growth intensity.

Is there a correlation between dental and cervical vertebrae maturation stages in growing subjects? A systematic review with meta-analysis

OBJECTIVE

To assess the evidence on the relationship between dental and cervical vertebrae maturation.

MATERIALS AND METHODS

Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence.

RESULTS

Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine (n = 7318; r = 0.692; 95% CI: 0.656-0.724), first premolar (n = 6194; r = 0.689; 95% CI: 0.649-0.725), second premolar (n = 6194; r = 0.695; 95% CI: 0.659-0.729), and second molar (n = 7905; r = 0.698; 95% CI: 0.652-0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity.

CONCLUSIONS

The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality.

CLINICAL RELEVANCE

Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs.

Radiographic Correlation of Skeletal Maturation Using the Stages of Dental Calcification in a Peruvian Population

OBJECTIVE

To identify the correlation between the Baccetti method of SM (skeletal maturation) and the stages of DC (dental calcification) using the Demirjian method in the Orthodontics Service of the Universidad Peruana Cayetano Heredia (UPCH) in Lima-Peru. Materials and Methods. The sample was obtained from panoramic and lateral radiographs of 200 subjects (116 women and 84 men) with ages between 9 and 17 years. Canine, premolar, and molar teeth calcification was evaluated using the Demirjian method while SM was evaluated by the cervical vertebrae with the Baccetti method. Spearman's correlation coefficient was used to assess the relationship between the maturation of these cervical vertebrae and DC.

RESULTS

There is a high correlation between the Baccetti method of maturation of the cervical vertebrae and the stages of DC ranging from r = 0.635 to 0.774 for men and from r = 0.677 to 0.784 for women (p < 0.001), the second lower molar being the one with the highest correlation (r = 0.774 in men) and the second lower premolar (r = 0.784 in women).

CONCLUSIONS

Stages of DC could be used as a reliable indicator of SM.