title: Diagnostic performance of combined canine and second molar maturity for identification of growth phase.
abstract: BACKGROUND
  The objective of this research is to analyze the diagnostic performance of the circumpubertal dental maturation stages of the mandibular canine and second molar, as individual teeth and in combination, for the identification of growth phase.
  
  
  METHODS
  A total of 300 healthy subjects, 192 females and 108 males, were enrolled in the study (mean age, 11.4±2.4 years; range, 6.8 to 17.1 years). Dental maturity was assessed through the calcification stages from panoramic radiographs of the mandibular canine and second molar. Determination of growth phase (as pre-pubertal, pubertal, and post-pubertal) was carried out according to the cervical vertebral maturation method. The diagnostic performances of the dental maturation stages, as both individual teeth and in combination, for the identification of the growth phase were evaluated using positive likelihood ratios (LHRs), with a threshold of ≥10 for satisfactory performance.
  
  
  RESULTS
  For the individual dental maturation stages, most of these positive LHRs were ≤1.6, with values≥10 seen only for the identification of the pre-pubertal growth phase for canine stage F and second molar stages D and E, and for the post-pubertal growth phase for second molar stage H. All of the combined dental maturation stages yielded positive LHRs up to 2.6.
  
  
  CONCLUSIONS
  Dental maturation of either individual or combined teeth has little role in the identification of the pubertal growth spurt and should not be used to assess timing for treatments that are required to be performed at this growth phase.
authors: Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy. G.Perinetti@fmc.units.it.
authors: Giuseppe
authors: G
authors: Perinetti
authors: Roberto
authors: R
authors: Di Lenarda
authors: Luca
authors: L
authors: Contardo
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods / Q000706:statistics & numerical data; D000366:Age Determination by Teeth / Q000379:methods*; D002508:Cephalometry / Q000379:methods / Q000706:statistics & numerical data; D002574:Cervical Vertebrae / Q000254:growth & development; D002648:Child; D003481:Cuspid / Q000000981:diagnostic imaging / Q000254:growth & development*; D003786:Dental Pulp Cavity / Q000254:growth & development; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008334:Mandible / Q000000981:diagnostic imaging; D008963:Molar / Q000000981:diagnostic imaging / Q000254:growth & development*; D009805:Odontogenesis / Q000502:physiology; D011627:Puberty / Q000502:physiology; D011862:Radiography, Panoramic / Q000379:methods; D019227:Tooth Apex / Q000254:growth & development; D014074:Tooth Calcification / Q000502:physiology; D019228:Tooth Crown / Q000254:growth & development; D014092:Tooth Root / Q000254:growth & development