Evaluation of skeletal maturation using mandibular third molar development in Indian adolescents

Correlation Between Third Molar Mineralization and Midpalatal Suture Maturity: A Cone Beam Computed Tomography Study

BACKGROUND Midpalatal suture ossification varies in patients of different ages, which can lead to making inaccurate presumptions when considering effective treatment timing based on chronological age. Chronological age provides only general information, whereas dental development correlates with skeletal growth, which suggests that tooth mineralization could be considered to be a precise criterion for determining the midpalatal suture's maturity. The present study was conducted to investigate the association between third-molar mineralization and midpalatal suture's maturation stages using cone-beam computed tomography (CBCT) images. MATERIAL AND METHODS The study involved 97 CBCT images of patients aged 8-37 years with normal growth and development. Subjects with cleft lip and palate, caries treatment, or present cavities in the third molars were not included in the study. The stages of midpalatal suture ossification were evaluated according to the protocol suggested by Angelieri et al, and the third-molar mineralization degree was measured by the Demirjian index. Statistical analysis was performed to evaluate correlations between the variables. RESULTS Patients with advanced third-molar mineralization stages were found to have greater midpalatal suture maturity. A statistically significant positive correlation was found between the stages of third-molar mineralization and midpalatal suture maturation (R=0.814, P<0.01). Third-molar development was also found to be associated with chronological age (R=0.883, P<0.01). CONCLUSIONS A measure of third-molar mineralization does not allow for accurate determination of the midpalatal suture maturation stage.

Is there a correlation between dental and cervical vertebrae maturation stages in growing subjects? A systematic review with meta-analysis

OBJECTIVE

To assess the evidence on the relationship between dental and cervical vertebrae maturation.

MATERIALS AND METHODS

Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence.

RESULTS

Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine (n = 7318; r = 0.692; 95% CI: 0.656-0.724), first premolar (n = 6194; r = 0.689; 95% CI: 0.649-0.725), second premolar (n = 6194; r = 0.695; 95% CI: 0.659-0.729), and second molar (n = 7905; r = 0.698; 95% CI: 0.652-0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity.

CONCLUSIONS

The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality.

CLINICAL RELEVANCE

Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs.

Dental Radiographic/Digital Radiography Technology along with Biological Agents in Human Identification

The heavy casualties associated with mass disasters necessitate substantial resources to be managed. The unexpectedly violent nature of such occurrences usually remains a problematic amount of victims that urgently require to be identified by a reliable and economical method. Conventional identification methods are inefficient in many cases such as plane crashes and fire accidents that have damaged the macrobiometric features such as fingerprints or faces. An appropriate recognition method for such cases should use features more resistant to destruction. Forensic dentistry provides the most appropriate available method for the successful identification of victims using careful techniques and precise data interpretation. Since bones and teeth are the most persistent parts of the demolished bodies in sudden mass disasters, scanning and radiographs are unrepeatable parts of forensic dentistry. Forensic dentistry as a scientific method of human remain identification has been considerably referred to be efficient in disasters. Forensic dentistry can be used for either "sex and age estimation," "Medical biotechnology techniques," or "identification with dental records," etc. The present review is aimed at discussing the development and implementation of forensic dentistry methods for human identification. For this object, the literature from the last decade has been searched for the innovations in forensic dentistry for human identification based on the PubMed database.

Sensitivity and Specificity of Mandibular Third Molar Calcification at Chronological Age and Hand Wrist Maturation Stage to Discriminate Between Female and Male at Pubertal Growth Period

Background:

The mandibular third molar is the last tooth that is not completely developed by the time pubertal growth has been finished. Maturation of the mandibular third molar is one of the physiological maturation indicators that can be used to determine the stage of pubertal growth.

Objective:

The aim of the study was to determine the sensitivity and specificity of mandibular third molar calcification at chronological age and hand wrist maturation stage to discriminate between female and male at pubertal growth period.

Methods:

It is a retrospective study with a cross-sectional approach using panoramic and hand-wrist digital radiographs of 279 females and 144 males, age 8-17 years, with a total of 423 panoramic radiographs and 423 hand-wrist radiographs. Statistical analysis was performed using Excel Mega Stat. ANOVA to analyze the differences between mandibular third molar calcification at chronological age and hand-wrist maturation stage, and t-test was used to analyze the differences between females and males. Spearman rank correlation was used for the analysis of the correlation between mandibular third molar calcification with chronological age and hand-wrist maturation stage; sensitivity and specificity were used to discriminate the pubertal growth period between mandibular third molar calcification and hand-wrist maturation stage.

Results:

There were significant differences found in mandibular third molar crown maturation stage B and C, but no significant difference was observed between mandibular third molar stage A, D, E, F, G and H, between females and males. The highest percentage of mandibular third molar crown formation in females was observed at stage D (6.68%) at MP3u, and in males, it was observed at stage D (8.83%) at SMI-4. The highest percentage of root formation in females was stage E (8.24%) at the SMI-10 stage, and males stage F (4.86%) at MP3u. The correlation was observed between mandibular third molar calcification with hand-wrist, females 0.22 and males 0.43, and chronological age 0.60 for females and 0.69 for males. The highest sensitivity of mandibular third molar calcification of 97.0% was observed in female at SMI-4 of hand-wrist maturation with specificity of 100%, while in male, a sensitivity of 94.5% was observed at SMI-2 stage with a specificity of 99.99%.

Conclusion:

There were significant differences found in mandibular third molar calcification between females and males except for stage B and stage C; weak correlation was observed between mandibular third molar calcification and hand-wrist, and moderate correlation was observed with chronological age. The sensitivity and specificity in females and males indicate that mandibular third molar calcification is only useful for diagnosing the pre-pubertal growth phase.

An analysis of third molar mineralization in Brazilian patients with cleft lip and palate

Purpose: This study investigated the third molar mineralization in patients with cleft lip and palate.Materials and methods: From a total of 253 digital panoramic radiographs from patients with cleft lip and palate within the age range of 7-21 years, 97 radiographs were selected (cleft group). A control group was formed from same sex individuals, without malformation and chronological age matched within 30 days. The analysis of third molar mineralization was carried out by three calibrated examiners using Demirjian's and Nolla's methods. McNemar and Wilcoxon test for paired samples were used for pairwise comparisons between the groups. The Likelihood Ratio test was used to check for an association between the type of cleft and tooth calcification.Results: In both methods, the mineralization means were smaller in the case group than in the control, with significant differences for all third molars (p < .05). The type of cleft affected dental mineralization. There was no significant difference when comparing the left or right sides, but maxillary molars showed earlier mineralization.Conclusions: A significant delay in third molar mineralization was observed in patients with cleft lip and palate according to Demirjian's and Nolla's methods.

Correlation between skeletal maturation and developmental stages of canines and third molars among Saudi subjects

Aims

The present study was designed to evaluate the efficacy of using the developmental stages of the canines and third molars to predict the timing of skeletal maturity in the Saudi population.

Material and methods

The lateral cephalometric radiographs and orthopantograms of 239 Saudi patients, 106 males and 133 females, aged 9 to 21 years, were collected from several dental centers. Orthopantograms were used to assess the developmental stages of the upper and lower canine teeth and third molars using two popular methods: that of Nolla and that of Demirjian. Cervical vertebral maturation (CVM) stage was assessed on the lateral cephalometric images according to the method of Baccetti et al. Trained observers with no knowledge of patient age or gender performed assessments. Data were analyzed with Spearman's rank correlation coefficient at a significance level of P ≤ .05.

Result

Skeletal CVM stages III and IV had a stronger correlation with mandibular left canine developmental stage than with maxillary canine developmental stage in the two methods used (correlation with Nolla stage 10 and Demirjian stage H: root completely formed with apex closed), especially for male patients (r = 0.700, P < .001). In contrast, the maxillary third molars at Nolla stages 5 and 7 (crown completed to 1/3 of the root formed) showed an association with CVM stages III and IV (r = 0.540 for females and r = 0.639 for males, P ≤ .001 for both) and with Demirjian stages D, E, and F. Males had slightly higher correlation values than females (r = 0.578 and 0.5010, respectively; P ≤ .001) at CVM stages III and IV. Interestingly, canine teeth showed a stronger correlation than third molars with skeletal maturation in Saudi children.

Conclusion

Dental developmental stages were highly correlated with CVM stages III and IV among Saudi subjects.