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Cervical Vertebral and Dental Maturity are Correlated in Turkish Subjects
DIAGNOSIS
ARTICLE ANALYSIS & EVALUATION ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Cervical vertebral and dental maturity in Turkish subjects Basaran G, Ozer T, Hamamci N. Am J Orthod Dentofacial Orthop 2007;131(4):447.e13-20
LEVEL OF EVIDENCE 2
PURPOSE/QUESTION The purpose of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects.
SOURCE OF FUNDING Not reported.
TYPE OF STUDY/DESIGN A retrospective cross-sectional study.
Cervical Vertebral and Dental Maturity are Correlated in Turkish Subjects SUMMARY Subjects Records from patients attending a University Orthodontic Department were reviewed.
Inclusion Criteria Turkish, no systemic disease, no history of orthodontic treatment, available lateral cephalometric and panoramic radiographs of good quality, no dental anomalies. Dental age was calculated from panoramic radiographs of the mandibular teeth on the left side using the method of Demirjiyan.1 This method classifies the dental mineralization stage for each tooth in 1 of 8 stages (stages A-H). Cervical maturation stages were measured on the lateral cephalometric radiographs using the method by Hassel and Farman.2 This method classifies the vertebral morphology of the 4 first cervical vertebrae in 1 of 6 stages (CVS 1-6).
Results More than 2000 files were reviewed. A total of 590 Turkish subjects (295 male and 295 female) were included. Mean age was 12.93 6 1.91 (range 7 years 2 months to 18 years 7 months). Correlation coefficients between cervical maturation stage and dental maturation stage for each of the teeth ranged from 0.421 to 0.911 and were significant at P < .01 (Table II). Several tables present the stages of dental calcification for each tooth for each stage of cervical maturation (separate for males and females) (Tables III-V).
Conclusions The authors conclude that the dental maturation stages can be used as a reliable indicator of facial growth.
COMMENTARY AND ANALYSIS
J Evid Base Dent Pract 2008;8:91-92 1532-3382/$34.00 Ó 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.jebdp.2008.03.006
As the authors of this paper state, the assessment of facial growth is important during orthodontic treatment planning. Since it is difficult to measure the amount or future potential of facial growth (especially when only one observation time point is available), several surrogate measures have been proposed. These surrogate measures relate to events that to a certain extent are correlated with facial growth. They are meant to provide the clinician with an assessment of the facial growth rate as well as its stage of development. The development of the long bones and the dentition are 2 events that are correlated with facial growth. Measurements of the maturation and development of the skeleton and the dentition have both been used as surrogate measures of facial growth.
JOURNAL OF EVIDENCE-BASED DENTAL PRACTICE
Skeletal development is evaluated using the morphological changes of long bones. Traditionally the long bones of the hand and wrist are assessed, but more recently methods using the cervical vertebrae have been developed. This eliminates the need for an additional radiograph. Development of the dentition is usually measured on a panoramic radiograph and several methods have been developed for its assessment. Several studies have investigated the correlation between skeletal and dental development and established their usefulness and limitations as surrogate markers for facial growth. The study by Basaran and coworkers aimed at investigating the correlation between dental age and vertebral maturation in a Turkish population. They found that these 2 measures were highly correlated. From this they conclude that dental maturation can be used as a reliable indicator of facial growth. However, this study did not measure facial growth and did not evaluate the correlation of either surrogate with facial growth. The final conclusion (dental maturation stages can be used
92
as a reliable indicator of facial growth) is not supported by the findings of this study. However, the study found that dental maturation and cervical maturation are correlated in Turkish subjects.
REFERENCES 1. Demirjiyan A, Goldstein H, Tanner JM. A new system for dental age assessment. Hum Biol 1973;43:211-27. 2. Hassel B, Farman A. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995;107:58-66.
REVIEWER Anne-Marie Bollen, DDS, PhD Department of Orthodontics School of Dentistry University of Washington Seattle, Washington [email protected]
June 2008
ARTICLE ANALYSIS & EVALUATION ARTICLE TITLE AND BIBLIOGRAPHIC INFORMATION Cervical vertebral and dental maturity in Turkish subjects Basaran G, Ozer T, Hamamci N. Am J Orthod Dentofacial Orthop 2007;131(4):447.e13-20
LEVEL OF EVIDENCE 2
PURPOSE/QUESTION The purpose of this study was to investigate the relationships between the stages of calcification of teeth and the cervical vertebral maturity stages in Turkish subjects.
SOURCE OF FUNDING Not reported.
TYPE OF STUDY/DESIGN A retrospective cross-sectional study.
Cervical Vertebral and Dental Maturity are Correlated in Turkish Subjects SUMMARY Subjects Records from patients attending a University Orthodontic Department were reviewed.
Inclusion Criteria Turkish, no systemic disease, no history of orthodontic treatment, available lateral cephalometric and panoramic radiographs of good quality, no dental anomalies. Dental age was calculated from panoramic radiographs of the mandibular teeth on the left side using the method of Demirjiyan.1 This method classifies the dental mineralization stage for each tooth in 1 of 8 stages (stages A-H). Cervical maturation stages were measured on the lateral cephalometric radiographs using the method by Hassel and Farman.2 This method classifies the vertebral morphology of the 4 first cervical vertebrae in 1 of 6 stages (CVS 1-6).
Results More than 2000 files were reviewed. A total of 590 Turkish subjects (295 male and 295 female) were included. Mean age was 12.93 6 1.91 (range 7 years 2 months to 18 years 7 months). Correlation coefficients between cervical maturation stage and dental maturation stage for each of the teeth ranged from 0.421 to 0.911 and were significant at P < .01 (Table II). Several tables present the stages of dental calcification for each tooth for each stage of cervical maturation (separate for males and females) (Tables III-V).
Conclusions The authors conclude that the dental maturation stages can be used as a reliable indicator of facial growth.
COMMENTARY AND ANALYSIS
J Evid Base Dent Pract 2008;8:91-92 1532-3382/$34.00 Ó 2008 Elsevier Inc. All rights reserved. doi:10.1016/j.jebdp.2008.03.006
As the authors of this paper state, the assessment of facial growth is important during orthodontic treatment planning. Since it is difficult to measure the amount or future potential of facial growth (especially when only one observation time point is available), several surrogate measures have been proposed. These surrogate measures relate to events that to a certain extent are correlated with facial growth. They are meant to provide the clinician with an assessment of the facial growth rate as well as its stage of development. The development of the long bones and the dentition are 2 events that are correlated with facial growth. Measurements of the maturation and development of the skeleton and the dentition have both been used as surrogate measures of facial growth.
JOURNAL OF EVIDENCE-BASED DENTAL PRACTICE
Skeletal development is evaluated using the morphological changes of long bones. Traditionally the long bones of the hand and wrist are assessed, but more recently methods using the cervical vertebrae have been developed. This eliminates the need for an additional radiograph. Development of the dentition is usually measured on a panoramic radiograph and several methods have been developed for its assessment. Several studies have investigated the correlation between skeletal and dental development and established their usefulness and limitations as surrogate markers for facial growth. The study by Basaran and coworkers aimed at investigating the correlation between dental age and vertebral maturation in a Turkish population. They found that these 2 measures were highly correlated. From this they conclude that dental maturation can be used as a reliable indicator of facial growth. However, this study did not measure facial growth and did not evaluate the correlation of either surrogate with facial growth. The final conclusion (dental maturation stages can be used
92
as a reliable indicator of facial growth) is not supported by the findings of this study. However, the study found that dental maturation and cervical maturation are correlated in Turkish subjects.
REFERENCES 1. Demirjiyan A, Goldstein H, Tanner JM. A new system for dental age assessment. Hum Biol 1973;43:211-27. 2. Hassel B, Farman A. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofacial Orthop 1995;107:58-66.
REVIEWER Anne-Marie Bollen, DDS, PhD Department of Orthodontics School of Dentistry University of Washington Seattle, Washington [email protected]
June 2008