title: Diagnostic performance study on the relationship between the exfoliation of the deciduous second molars and the pubertal growth spurt.
abstract: BACKGROUND
  The aim of this study was to evaluate the possible relationship between the exfoliation of the deciduous second molars (Es) and the onset of the pubertal growth spurt assessed with the cervical vertebral maturation method.
  
  
  METHODS
  The ability to identify the onset of the pubertal growth spurt (cervical stage 3, CS3) was evaluated in a sample of 123 patients with exfoliation of the Es (exfoliation group) with respect to a control group of 250 subjects in the late mixed dentition selected with random criteria. Tests of diagnostic performance were applied.
  
  
  RESULTS
  The comparison of the prevalence rates of CS3 in the exfoliation group vs the control group was not statistically significant. The positive likelihood ratio was smaller than 1, thus indicating lack of diagnostic power of the exfoliation of the deciduous second molars with regard to CS3.
  
  
  CONCLUSIONS
  No significant relationship was found between the moment of exfoliation of the Es and the onset of the pubertal growth spurt.
authors.affiliation: Department of Orthodontics, University of Florence, Florence, Italy.
authors.forename: Nicolò Grezzi Galli
authors.initials: NG
authors.lastname: Tassi
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Franchi
authors.forename: Tiziano
authors.initials: T
authors.lastname: Baccetti
authors.forename: Ersilia
authors.initials: E
authors.lastname: Barbato
mesh_terms: D000365:Age Determination by Skeleton; D000366:Age Determination by Teeth; D002574:Cervical Vertebrae / Q000254:growth & development; D002648:Child; D003818:Dentition, Mixed; D006128:Growth; D006801:Humans; D016013:Likelihood Functions; D008963:Molar / Q000502:physiology*; D011627:Puberty; D012680:Sensitivity and Specificity; D014080:Tooth Exfoliation; D014094:Tooth, Deciduous / Q000502:physiology