Association Between Teeth Development in Panoramic Radiograph and Skeletal Maturity in Lateral Cephalogram

Using a reliable indicator to identify different phases of skeletal maturation is an important issue in orthodontic diagnosis and treatment planning. The aim of this study was to evaluate the correlation between stages of tooth calcification and cervical vertebral maturation in Iranian individuals. 216 digital panoramic and lateral cephalometry of healthy patients, 99 males and 117 females (aged 8 to 16 years) seeking orthodontic treatment included in the study. To determine dental maturational stage, calcification of the mandibular canine, the first and second premolars and the second molar were assessed according to the method suggested by Demirjian et al. To evaluate the stage of skeletal maturation, cervical vertebral morphologic changes were assessed on lateral cephalometric radiographs according to the method suggested by Baccetti et al. All radiographs were evaluated by two observers and inter- and intra-examiner reliability were examined. Spearman’s correlations coefficients were calculated to establish the association between cervical vertebral maturation and teeth calcification. P-values less than 0.001 were considered statistically significant. All correlation values obtained were statistically significant (P < 0.001). Correlations between dental development and skeletal maturity stage due to CVM method ranged from 0.76 to 0.77 (P < 0.001) for females and 0.63 to 0.71 (P < 0.001) for males. The second molar (0.77) and second premolar (0.71) presented the highest correlation for female and male subjects, respectively. The relationship between calcification of tooth and maturation of cervical bones was significant. This suggested that tooth calcification stages from panoramic radiographs might be clinically useful as a maturity indicator.