Dental Maturation Assessment

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DISCUSSION

In this study, the usefulness of dental maturation assessment as a diagnostic test using panoramic radiographs as an approach to determine skeletal maturation was explored, with a reliable methodology.

A significant positive correlation between dental and cervical maturity was obtained for both genders. This is consistent with correlations found in several other publications 12,18–21,23,24. As Sukhia and Fida conclude in their 2010 study, having this correlation makes it posible to use dental maturity to assess skeletal maturation 25.

The area under a ROC curve represents accuracy of a diagnostic test and it is defined as the probability of correctly classifying a pair of healthy and sick individuals 26. In this case, areas
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ROC curves show sensibility and specificity of a certain diagnostic tool. The sensitivity of a test is defined as the ability to positively diagnose individuals who actually have a condition or disease, while specificity is the ability to identify as healthy individuals the ones that actually do not have the disease 28. As with any diagnostic test, to achieve greater sensitivity, specificity is decreased, while having a better specificity decreases sensitivity, so the choice of cutoff should consider the clinical application 26. The relevance of skeletal maturity in dentofacial orthopedic treatment planning is widely regognized. Therefore it is clinically beneficial to identify if a Class II individual seeking orthodontic treatment is in a pre growth spurt phase. This is why the cutoff point was set favoringa good sensitivity over specificity, where the subjects who are diagnosed as post growth spurt, are so indeed. This offers relevant information if dentofacial orthopedic procedures are to be carried…show more content…
That means that between dental stages A and E the individual would be in a pre growth spurt phase and during stages F through H in a post growth spurt phase. In practice, once the left mandibular second molar has developed its furcation enough to show the radicular shape and the root length is equal or grater than the crown height, the patient has already surpassed the peak in pubertal growth velocity. This means that the individual is either in the deceleration of growth in the post-peak stage of the pubertal growth spurt, or he/she actually concluded the pubertal growth spurt.

In the table that resumes the assessment of this diagnostic test, the prevalence is the probability to find an individual aged 5 to 15 years old that already has gone through his o her growth spurt, being 11% and 26% respectively. Sensitivity, which is the ability to identify a post pubertal growth spurt individual when having a dental stage F, G or H is 87% for females and 97.1% for males. Specificity, the ability to identify that has not gone through pubertal growth spurt yet when having a dental stage A to E, is 82.9% for females and 72.3% for

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