Evaluation of dental and skeletal maturity using digital panoramic radiographs and digital cephalograms

Background: Assessing the maturational status and pubertal growth spurt of a patient has considerable influence on diagnosis, treatment planning, and the outcome of orthodontic treatment. Objectives: To assess the usefulness of panoramic radiographs as a tool to estimate the growth and to ascertain the importance of tooth calcification stages as an indicator of maturity by using digital panoramic radiographs. Methods: We compared the dental maturity assessed by calcification of mandibular canine, first premolar, second premolar, and second molars using digital panoramic radiographs and skeletal maturity assessed by cervical vertebral maturation stages using lateral cephalograms and hand-wrist radiographs. Skeletal maturity was assessed using a cervical vertebrae maturation technique; hand-wrist maturity was evaluated using Fishman skeletal maturity indicators. Dental maturity was estimated according to guidelines of Demirjian. Spearman rank-order correlation coefficients were used to determine the correlation between tooth calcification stages and skeletal maturity assessed on panoramic radiographs, lateral cephalograms, and hand-wrist radiographs of 60 patient participants, including 45 boys and 15 girls. Results: The panoramic radiograph is a reliable tool with which to estimate of growth and development of boys. Conclusion: The relationship between tooth calcification stages and the skeletal maturity indicators in boys allows clinicians to identify the stage of the pubertal growth from panoramic radiographs. It is appropriate to put these skeletal and dental maturation relationships into daily orthodontic diagnostic practice.