title: Phases of the dentition for the assessment of skeletal maturity: a diagnostic performance study.
abstract: BACKGROUND
  The aim of this study was to analyze the relationship between the circumpubertal phases of the dentition (early mixed, intermediate mixed, late mixed, early permanent) and skeletal maturity as assessed by means of the cervical vertebral maturation (CVM) method.
  
  
  METHODS
  The sample of 1000 subjects included 250 (125 boys, 125 girls) in each of the 4 dentition phases. Individual skeletal maturity was determined by using the CVM method. The relationship between the skeletal maturity (stages in CVM) and the phases of the dentition was evaluated statistically by means of indicators of diagnostic test performance.
  
  
  RESULTS
  Prepubertal stage 1 (CS1) was the variable diagnosed in the early mixed and intermediate mixed dentitions; pubertal stage 3 (CS3) was the variable diagnosed in the late mixed and early permanent dentitions.
  
  
  CONCLUSIONS
  The early mixed dentition phase showed a strong diagnostic value for the identification of prepubertal skeletal maturity (CS1), whereas the intermediate mixed dentition phase had a low diagnostic value for the same prepubertal stage. Neither the late mixed dentition nor the early permanent dentition appeared to be a valid indicator for the onset of the pubertal growth spurt.
authors.affiliation: Department of Orthodontics, University of Florence, Florence, Italy. l.franchi@odonto.unifi.it
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Franchi
authors.forename: Tiziano
authors.initials: T
authors.lastname: Baccetti
authors.forename: Laura
authors.initials: L
authors.lastname: De Toffol
authors.forename: Antonella
authors.initials: A
authors.lastname: Polimeni
authors.forename: Paola
authors.initials: P
authors.lastname: Cozza
mesh_terms: D000365:Age Determination by Skeleton; D000366:Age Determination by Teeth; D002574:Cervical Vertebrae / Q000254:growth & development; D002648:Child; D003430:Cross-Sectional Studies; D003818:Dentition, Mixed; D019229:Dentition, Permanent; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D011627:Puberty / Q000502:physiology; D012680:Sensitivity and Specificity