The diagnostic performance of dental maturity for identification of the circumpubertal growth phases: a meta-analysis

Abstract

The present meta-analysis initially evaluates the reliability of dental maturation in the identification of the circumpubertal growth phases, essentially for determining treatment timing in orthodontics. A literature survey was performed using the Medline, LILACS and SciELO databases, and the Cochrane Library (2000 to 2011). Studies of the correlation between dental and cervical vertebral maturation methods were considered. The mandibular canine, the first and second premolars, and the second molar were investigated. After the selection, six articles qualified for the final analysis. The overall correlation coefficients were all significant, ranging from 0.57 to 0.73. Five of these studies suggested the use of dental maturation as an indicator of the growth phase. However, the diagnostic performance analysis uncovered limited reliability only for the identification of the pre-pubertal growth phase. The determination of dental maturity for the assessment of treatment timing in orthodontics is not recommended.

Figure 1

Dental maturational stages and CVM stages. Dental maturational stages according to Demirjian et al. [15] (stages D to H, upper) and CVM stages according to Hassel and Farman [13] or Baccetti et al. [3] (stages 1 to 6, lower). For the dental maturational stages, only the canine is shown for clarity. The CS1 and CS2 are pre-pubertal stages, CS3 and CS4 are pubertal stages, and CS5 and CS6 are post-pubertal stages (see text for details of the maturational staging).

Figure 2

Flow diagram of the search strategy.

Figure 3

Forest plots for the correlation coefficients between the dental maturation and the CVM stages. According to the four mandibular teeth and sexes. Blocks, point estimates; lines, 95% confidence intervals.