Relationship of dental and skeletal radiography maturity indicator

no correlation was observed between skeletal maturity indicators and dental Skeletal maturation staging from radiographic assessment is. Objectives: To assess the usefulness of panoramic radiographs as a tool to estimate the. tooth calcification stages and the skeletal maturity indicators in boys put these skeletal and dental maturation relationships into daily. Citation. B Rai. Relationship of Dental and skeletal Radiograph: Maturity Indicator. The Internet Journal of Biological Anthropology. Volume 2 Number 1.

relationship of dental and skeletal radiography maturity indicator

Racial variations in the relationships between calcification stages of individual teeth and skeletal maturity have been reported [ 57 ]. Most studies of the dentition have used either mandibular canines [ 7 ], or third molars [ 2728 ], for dental age assessment. Dental eruption is a fleeting event that is under strongly influenced by environmental variables. The first disadvantage of eruption-based methods is that its exact timing cannot be determined.

Moreover, it can be affected by local variables such as systemic diseases and nutrition. Therefore, its reliability is questionable [ 11 ]. Skeletal maturity assessment using the CVM method Lamparski showed that cervical vertebrae were as reliable and as valid as hand-wrist radiographs as indicators of skeletal maturation [ 23 ].

Second to sixth cervical vertebrae C2—C6 were used in this study.

relationship of dental and skeletal radiography maturity indicator

The assessment of cervical vertebral maturation method CVM has been intensely investigated in recent years. Most scholars agree that changes in cervical vertebrae correlate with stages of growth and development in adolescents. This can be used to predict pubertal growth spurts, especially the peak of mandibular growth. Like hand-wrist analysis, this cervical staging method has a comparably high reliability and validity.

It has the added advantage in that no additional radiation exposure is required. These three vertebrae are usually visible even when a protective radiation collar is worn. Finally, every stage can be identified on a single cephalogram.

A low, but statistically significant correlation was found between tooth calcification stages of canines and cervical vertebrae maturation stage for boys. Other investigators have suggested that the development of the second premolars and second molars has the highest correlation with skeletal maturation [ 71518 ].

Relationship between dental calcification and skeletal maturation in a Peruvian sample

In the present study, the development of the mandibular canines was significantly correlated with CVM stage in boys. Skeletal maturity assessment using the hand-wrist maturation method Skeletal age assessment The skeletal age for each hand-wrist radiograph was determined according to the method outlined in the atlas of Greulich and Pyle [ 13 ], which is quick and relatively easy to learn.

It is less time consuming in practice than the bone stage and system of Tanner et al. The Greulich and Pyle method seems to be highly practical for clinical use in skeletal age assessment. Radiographic stage assessment Panoramic and lateral radiographs were reviewed by one previously calibrated researcher AC. Intraobserver agreement was calculated using the kappa index from two cervical and dental maturation assessments of ten patients carried out 3 weeks apart.

Statistical analysis The correlation between dental and cervical maturation was assessed by gender using the Spearman's coefficient. For each gender, receiver operating characteristic ROC curves were made after logistic regression to determine predicted probability. Sensibility and specificity were calculated for best cutoff value, looking for the dental stage that better represented the change from pre- to post-pubertal growth spurt probability cut-off.

It was considered that a better sensibility was more useful, patient that will be under discussion later. The diagnostic value of this test was analyzed by calculating prevalence, positive predictive value PPV and negative predictive value NPVand positive and negative likelihood ratios.

Relationship between dental calcification and skeletal maturation in a Peruvian sample

Results Intraobserver agreement was calculated using the kappa statistic. For dental maturation, kappa value was 1. Six hundred and fifty-seven patients were included in the sample. Three hundred and twenty-six patients Descriptive data regarding the cervical maturational status of the sample are presented in [Table 3].

The area under the ROC curves, representing in this study the probability of correctly classifying a pair of individuals in pre- and post-pubertal stages of development, were assessed using stages CVS 1, 2, and 3 as pregrowth spurt and stages CVS 4, 5, and 6 as postgrowth spurt. Our results indicated an area under the ROC curve of 0.

The analyses of cutoffs for sensitivity and specificity for each gender are seen in [Figure 1]. This test has a sensitivity of According to this values of specificity and sensitivity, the presence of dental Stage F represents, for both genders, the best cutoff point for assessing when the postpubertal growth spurt phase starts. Receiver operating characteristic curves showing probability cutoffs for females and males Click here to view Using the dental Stage F as the cutoff point, the PPV was found to be The assessment of this diagnostic test for each gender is summarized in [Table 4].

Positive likelihood ratios for females and males were 5 and 4, respectively, whereas negative likelihood ratios for females and males were 0.

relationship of dental and skeletal radiography maturity indicator

Dental maturation as a diagnostic test for each gender Discussion In this study, dental maturation assessment was analyzed as a diagnostic test of skeletal maturation. The vertebrae were wedge shaped, and the superior vertebral borders were tapered from posterior to anterior.

The second stage is called acceleration. Concavities were developing in the inferior borders of C2 and C3. The inferior border of C4 was flat. The bodies of C3 and C4 were nearly rectangular in shape.

Distinct concavities were seen in the inferior borders of C2 and C3.

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A concavity was beginning to develop in the inferior border of C4. The bodies of C3 and C4 were rectangular in shape. Distinct concavities were seen in the inferior borders of C2, C3 and C4. The vertebral bodies of C3 and C4 were becoming more square in shape. The fifth stage is called maturation. More accentuated concavities were seen in the inferior borders of C2, C3 and C4.

The bodies of C3 and C4 were nearly square to square in shape. This stage is called completion corresponds to completion of growth. Little or no adolescent growth could be expected. Deep concavities were seen in inferior border of C2, C3 and C4. The bodies of C3 and C4 were square or were greater in vertical dimension than in horizontal dimension. All of the assessments were made simultaneously on an illuminated viewing box in dark room. The interpretations of hand wrist, panorgamic and cephalometric radiographs were discussed until agreement was reached.

Exact chronological ages were verified by reference to the patient's birth date. Results Figure 1 Table 1: Mean and standard deviation of chronological and skeletal age by Fishman method Hand wrist radiographs and by Hasssel and Farman method Cephalogram. Figure 2 Table 2: Figure 3 Table 3: Figure 4 Table 4: Figure 5 Table 5: Figure 6 Table 6: