Predictive Value of Dental Maturity for a Positive Gonadotropin-Releasing Hormone Stimulation Test Result in Girls with Precocious Puberty

Dental maturity is associated with skeletal maturity, which is advanced in girls with central precocious puberty (CPP). We investigated the performance of dental maturity as a screening method for CPP using mandibular second premolar and molar calcification stages, assessed the associated anthropometric and laboratory factors, and evaluated pubertal response predictors using the gonadotropin-releasing hormone stimulation test (GnRHST) in prepubertal and pubertal girls. A prospective case-control study was conducted in girls, aged 7.0–8.9 years, classified into pubertal (peak luteinizing hormone [LH] after GnRHST ≥ 5 IU/L), prepubertal (peak LH < 5 IU/L), and control groups. Auxological and biochemical tests, panoramic radiographs, and GnRHSTs in participants with breast development were conducted. Dental maturity was assessed using the Demirjian index (DI). We included 103 girls (pubertal, 40; prepubertal, 19; control, 44). Chronological age (CA) was not significantly different between groups. Bone age (BA) and BA advancement was higher in the pubertal and prepubertal groups. Increased DI values at the mandibular second premolar and molar were significantly associated with CA, BA, BA advancement, height standard deviation score (SDS), peak LH after GnRHST, and insulin-like growth factor-I (IGF-I) (all P < 0.05). Moreover, odds ratio (OR) of the mandibular second premolar and molar (a DI value of ≥ E) for predicting a positive response to GnRHST was 8.7 (95% confidence intervals [CI], 2.9–26.1) and 5.2 (95% CI, 2.2–12.7), respectively. Dental maturity was a strong predictor for diagnosing CPP. Determining dental maturity in girls with suspected precocious puberty might help determine the performance of GnRHSTs.

Correlations between dental and skeletal maturity / 대한치과교정학회지

To investigate the developmental stages of dental and skeletal maturation by ages and the correlations among dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist, the author used the cephalograms, orthopantomograms, and hand-and-wrist radiograms of 1055 patients (male 458, female 597) aged 7 to 29 years old. In the cephalograms, the skeletal maturity stages of each bone were mainly assessed by Hassel and Farman's cervical vertebrae maturation indicators (CVMI) method. In the orthopantomograms, the dental maturity stages of each tooth were mainly assessed by Nolla's tooth calcification stages method. In the hand-and-wrist radiograms, the skeletal maturity stages of each bone were mainly assessed by Fishman's skeletal maturity indicators (SMI) method. The results were as follows. 1. There was a high correlation among dental maturity, skeletal maturity of cervical vertbrae, and that of hand-and-wrist in the both sexes (p0.8) between skeletal maturity of hand-and-wrist and maturity of upper and lower canine, first premolar, and second premolar. 4. There was high a correlation(r=0.8) between skeletal maturity of cervical vertebrae and maturity of upper canine. 5. By the age, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist were obtained in the both sexes. In summary, dental maturity, skeletal maturity of cervical vertebrae, and that of hand-and-wrist are of sufficient diagnostic worth as an index to predict adolescent growth

Study on estimating skeletal maturity of hand-wrist using multiple regression model / 대한치과교정학회지

The evaluation of growth potency can be done with many physiologic indicators. It has well known that skeletal maturity has a close relation with both sexual maturity and somatic maturity, but the correlation between skeletal maturity and dental maturity was believed to be less certain. But, recent studies show that specific teeth. including lower canines, present close correlations with skeletal maturity, So, in this study, we studide hand-wrist X-ray films and orthopantomagrams of 387 Korean boys and girls aged from 7 to 15; the purpose was to determine skeletal and dental maturity, and to find out a new method to estimate individual skeletal maturity using multiple-regression model, without the help of hand-wrist X-ray film. As a result of this study, followings were observed. 1. The following multiple-regression model can estimate skeletal maturity index (SMI) with 84% accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. SMI = 0.60 x chronolngic age - 1.67 x sex** + 0.88 x lower canine* - 0.55 x lower 2nd molar* - 10.3 * : mean age corresponding each developing atage, ** : male = 1, female = 0 2. The followering multiple-regression model can estimate skeletal age with 87% of accuracy, and regression coefficient of chronologic age, sex and lower canine show statistical significance. Skeletal age = 0.75 x chronolngic age - 0.55 x sex** + 0.71 x lower canine* - 0.09 x lower 2nd molar* - 5.77 * : mean age corresponding each developing atage, ** : male = 1, femal = 0