title: Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty.
abstract: Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0-8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9-26.1) and 5.2 (95% CI, 2.2-12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs.
authors.affiliation: Department of Oral and Maxillofacial Surgery, Inje University College of Medicine, Ilsan Paik Hospitalal, Goyang, Korea.
authors.forename: Jee Seon
authors.identifier: http://orcid.org/0000-0002-1353-3127
authors.initials: JS
authors.lastname: Baik
authors.affiliation: Department of Oral and Maxillofacial Radiology, Dankook University College of Dentistry, Cheonan, Korea.
authors.forename: Jin Woo
authors.identifier: http://orcid.org/0000-0002-5515-5320
authors.initials: JW
authors.lastname: Choi
authors.affiliation: Department of Pediatrics, Myongji Hospital, Seonam University College of Medicine, Goyang, Korea.
authors.forename: Su Jin
authors.identifier: http://orcid.org/0000-0003-0893-0512
authors.initials: SJ
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Dongguk University Ilsan Hospital, Goyang, Korea.
authors.forename: Ji Hyun
authors.identifier: http://orcid.org/0000-0001-5489-1169
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine, Inje University College of Medicine, Ilsan Paik Hospitalal, Goyang, Korea.
authors.forename: Sollip
authors.identifier: http://orcid.org/0000-0003-0474-5897
authors.initials: S
authors.lastname: Kim
authors.affiliation: Department of Pediatrics, Inje University College of Medicine, Ilsan Paik Hospitalal, Goyang, Korea. pedendo@paik.ac.kr.
authors.forename: Jae Hyun
authors.identifier: http://orcid.org/0000-0002-0203-7443
authors.initials: JH
authors.lastname: Kim
mesh_terms: D000365:Age Determination by Skeleton; D001641:Bicuspid / Q000254:growth & development; D016022:Case-Control Studies; D002648:Child; D005260:Female; D007987:Gonadotropin-Releasing Hormone / Q000032:analysis*; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D007986:Luteinizing Hormone / Q000032:analysis; D008963:Molar / Q000254:growth & development; D016017:Odds Ratio; D011446:Prospective Studies; D011629:Puberty, Precocious / Q000175:diagnosis*; D014070:Tooth / Q000254:growth & development*
chemical_list: D007987:Gonadotropin-Releasing Hormone; D007334:Insulin-Like Growth Factor I; D007986:Luteinizing Hormone
keywords: Dental Maturity; Diagnosis; Girls; Precocious Puberty