Second molar calcification stages to evaluate skeletal maturation: A cross-sectional radiographic study

Objectives: The aim of this cross-sectional radiographic study was to investigate the relationship between mandibular second molar calcification stages and cervical vertebrae maturity indicators, and further to evaluate whether the second molar calcification stages can be used as a reliable diagnostic tool to assess skeletal maturity and optimal treatment timing. Materials and Methods: Samples were derived from panoramic radiographs and lateral cephalograms of 101 subjects (47 males 54 females) with ages ranging from 10 to 18years. Estimates of dental maturity (Demirjian index, D.I) and skeletal maturity (cervical vertebrae maturation indicators, CVMI) were made. The modified version of the CVMI method by Macnamara and Baccetti was used. Results: A highly significant association (P < 0.001) was found between DI and CVMI. DI stage E corresponds to stage 2 of CVMI (pre-peak of pubertal growth spurt)DI stage F corresponded to stage 3 of CVMI (peak of pubertal and mandibular growth)DI stage G corresponded to stages 4 and 5 of CVMI (peak in mandibular growth has occurred within 1 or 2 years before this stage)DI stage H was associated with stage 6 of CVMI (end of pubertal growth spurt). Conclusion: A highly positive correlation exists between DI of mandibular second molars and CVMI. Stage F of Demirjian index, with the root length equal to or greater than the crown height corresponds to stage 3 of CVMI indicating the start of peak in mandibular growth which would be appropriate time to plan for functional appliances. Therefore, mandibular second molar calcification stages are reliable skeletal maturity indicator, which can be used to predict the growth status in determining the optimal treatment timing