Association between skeletal maturation and the developmental stages of the maxillary canine and mandibular second and third molars across different vertical facial patterns
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Updated: Oct 31, 2026

Systematic Assessment of Mammalian Skull Specimens for Dental and Temporomandibular Joint Pathology
Published on: August 22, 2022
Atefe Rekabi1,2, Mehrnaz Moradinejad1,2, Sepideh Bagheri Hossein Abadi1,2
1Oral and Dental Health Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
Background:
Skeletal maturation and dental developmental stages are widely used indicators of biological growth in orthodontics. This study aimed to evaluate the association between skeletal maturation and the developmental stages of the maxillary canine (U3) and mandibular second (L7) and third molars (L8) across different vertical facial patterns (VFPs).
Methods:
This cross-sectional observational study assessed lateral cephalometric and panoramic radiographs of patients referred to Ahvaz Jundishapur University of Medical Sciences in 2023-2024. VFP was classified using three cephalometric parameters (LAFH/TAFH, Jarabak index, and FMA) based on a majority rule. Skeletal maturation was determined using the Baccetti cervical vertebral maturation (CVM) method, and dental development was scored according to the modified Gleiser and Hunt system. Data were analyzed using non-parametric tests and PLUM ordinal regression models.
Results:
The study sample consisted of 226 participants aged 8-19 years (mean age 12.95 ± 2.39 years), including 155 females and 71 males. Skeletal maturation showed significant positive correlations with U3, L7, and L8 developmental stages across all facial patterns (p < 0.001), with L7 showing the highest coefficients. In fully adjusted ordinal regression models, chronological age (CA) was the strongest predictor of U3, L7, and L8 developmental stages (p < 0.001). Skeletal maturity remained independently associated only with L7 development (p = 0.004). VFP showed no independent significant association with dental developmental stages (p > 0.05).
Conclusion:
Skeletal maturation was significantly associated with dental development of U3, L7, and L8, with L7 showing the strongest correspondence. In fully adjusted models, dental maturation showed no independent significant association with VFP, while CA remained the main determinant of dental developmental stage.
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