Introduction: Evaluation of skeletal maturity and dental age with the aid of lateral cephalogram and panoramic radiograph plays a crucial role in orthodontic treatment planning, timing, and diagnosis in correction of malocclusions. Successful treatment of skeletal disharmonies may be achieved by growth modification in patients who have a certain amount of growth remaining as during the pubertal spurt.
Aim: The purpose of this study was to evaluate the correlation and efficacy of using the calcification stages of mandibular permanent left canine (tooth 33) to predict the skeletal maturity in Bulgarian subjects.
Materials and Methods: A total of 388 digital x-rays were evaluated. They belonged to 194 children in maturational stages CVM II, CVM III, and CVM IV. Developmental stages of tooth 33 were assessed by the Demirjian et al. (1973) method (3) and cervical vertebral maturation (CVM) stages by the Baccetti et al. method.
Results: For both genders a strong correlation was found between the mineralisation stages of the mandibular left canine and skeletal age defined by the Baccetti method et al. for girls (r = 0.637; Р < 0.05) and for boys (r = 0.605; Р < 0.05). For males in the CVM II stage, 76.3% of the studied mandibular canines were immature with developmental stage G being dominant (Р = 0.05). In stage CVM III the number of teeth with complete root development significantly increased to 72.2% (Р = 0.002). In stage CVM IV 100% of the left mandibular canines were evaluated to be in stage H. For girls in the CVM II stage, 80.8% of the studied mandibular canines were with open apical foramen with developmental stage G being dominant (Р = 0.304). In stage CVM III the number of teeth with complete root development rose significantly, reaching a share of 85.7% among the studied subjects (Р < 0.0001). In stage CVM IV 100% of the left mandibular canines were evaluated to be in stage H.
Conclusion: A highly significant correlation found between mandibular left canine calcification stages and cervical vertebral maturation stages eases the skeletal maturity evaluation with the aid of a single panoramic radiograph. In stage CVM II, observed at least a year before the pubertal growth spurt, with great growth potential ahead and orthodontic treatment approaches, maturational stage G of the mandibular left canine could be used as predictor of pubertal peak for boys and stages F and G for girls.
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