Dental calcification stages as determinants of the peak growth period

The objective of this study was to investigate the diagnostic accuracy of dental maturation stages for identifying individual-specific skeletal maturation phases.

Prior to initiating this study, 255 orthodontic patients comprising 145 girls and 110 boys from the Department of Orthodontics, Aristotle University of Thessaloniki, Greece were identified. Lateral cephalometric and panoramic radiographs were evaluated. Dental calcification stages were assessed according to the Demirjian method and skeletal maturation according to the cervical vertebral maturation stage (CVMS) method. Statistical assessments included Spearman Brown formula, descriptive statistics, Spearman's rho correlation coefficient, and positive likelihood ratios (LHRs).

The highest (r = 0.725) correlations were found for second molars and the lowest correlation for canines (r = 0.463, p < 0.001). Positive LHR values exceeding ten were found to identify the pre-peak growth phase in conjunction with the second molar (stage D), second premolar (stage E), and first premolar (stages D and E). Only the second molar (stage F) yielded positive LHR values for identifying the peak growth phase. The positive LHR values for the second molar also facilitated identification of the post-peak growth phase (stage H). Taking the clinical diagnostic efficacy of the second molar into account in identifying these growth phases, we calculated the positive LHRs of the second molar to determine dental maturation stages for diagnosing CVMS II and III. Positive LHR values greater than 10 identified CVMS II (stage D).

Evaluating dental maturation is a useful initial diagnostic step when assessing skeletal growth. The calcification stages of the second molar provide reliable diagnostic information with which to determine the pubertal growth spurt.