Review Article

Reliability of Growth Indicators and Efficiency of Functional Treatment for Skeletal Class II Malocclusion: Current Evidence and Controversies

Table 7

Description of the stages of the most common dental maturation method according to Demirjian et al. [40].

Stage descriptionAttainment

Stage D. When (1) the crown formation is complete down to the cementoenamel junction; (2) the superior border of the pulp chamber in the single-root teeth has a definite curved form, with it being concave towards the cervical region; the projection of the pulp horns, if present, gives an outline shaped like the top of an
umbrella and (3) the beginning of root formation is seen in the form of a spicule
Canine, premolars, and second molar before the pubertal growth spurt [28, 57, 110, 112]

Stage E. When (1) the walls of the pulp chamber form straight lines, the continuity of which is broken by the presence of the pulp horn, which is larger than in the previous stage and (2) the root length is less than the crown heightMostly, canine and first premolar before the pubertal growth spurt [28, 57, 110, 112]

Stage F. When (1) the walls of the pulp chamber form a more or less isosceles triangle, with the apex ending in a funnel shape and (2) the root length is equal to or greater than the crown heightSometimes, canine before the pubertal growth spurt [28, 57, 112]

Stage G. When the walls of the root canal are parallel and its apical end is still partially openCanine, premolars, and second molar before, during, and after the pubertal growth spurt [28, 57, 110, 112]

Stage H. When (1) the apical end of the root canal is completely closed and (2) the periodontal membrane has a uniform width around the root and the apexSecond molar after the pubertal growth spurt [28, 57, 112]

Only stages D to H are summarised due to their relevance with the circumpubertal growth phase. In molars, the distal root is considered in assessing the stage [40]. Only results from studies reporting diagnostic reliability analysis are shown regarding the moment of attainment of the different stages for mandibular teeth.