Diagnostic accuracy of mandibular dental maturation stages for determination of growth spurt compared to the cervical vertebral maturation method: A systematic review and meta-analysis.

OBJECTIVES

To assess the diagnostic accuracy for dental maturation stages of various mandibular teeth in detecting the growth spurt compared to the cervical vertebral maturation (CVM) method.

METHODS

Eligibility criteria: observational studies assessing dental calcification stages of mandibular teeth for predicting pubertal CVM stages (CS3 and CS4), reporting cross-tabulation and involving healthy growing patients.

INFORMATION SOURCES: an unrestricted literature search of five databases was conducted up to February 2, 2024. Risk of bias: the quality assessment of the studies was conducted using the Joanna Briggs Institute (JBI).

SYNTHESIS OF

RESULTS

random-effects meta-analyses using sensitivity, specificity, and diagnostic odds ratio and their 95% confidence intervals (CIs) were performed, followed by subgroup analyses.

RESULTS

Included studies: eighteen observational studies involving 3965 participants (38.91% male) were included.

SYNTHESIS OF

RESULTS

the diagnostic odds ratios (DORs) of tooth calcification stages were low, indicating that tooth mineralization provides no useful diagnostic information. Only in stage G of the second molar (DOR: 1.47 [95% CI: 0.49-4.41]) and stage C of the third molar (DOR: 1.7 [95% CI: 0.1-28.9]), the values were slightly higher than one, but they were statistically insignificant.

DISCUSSION: Limitations of evidence: most of the studies published on this subject lack cross-tabulation, which prevents the calculation of diagnostic parameters and limits generalizability. The use of CVM as a gold standard can be suboptimal due to several limitations, including inferior inter-observer reliability, unreliability as an indicator of the pubertal growth peak, and retention of pubertal stages in one-fifth of individuals for over 20 years.

INTERPRETATION: Tooth calcification stages are not a reliable indicator for predicting the pubertal growth spurt.

REGISTRATION: PROSPERO (CRD420250654430).