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

Table 8

Main cross-sectional studies on the dental emergence and dental maturation method according to Demirjian et al. [40] and hand and wrist or cervical vertebral maturation in untreated subjects without major malocclusion.

Study	Sample size and sex distribution/age range	Dental maturation assessment	Skeletal maturation assessment	Statistical analysis	Main results	Clinical implications according to the authors
Tassi et al. 2007 [100]	428 (a)	Exfoliation of the deciduous second molars	CVM, 6-stage method according to Baccetti et al. [20]	Sensitivity, specificity, PPV, positive LHR	No significant relationship between the moment of exfoliation of deciduous second molars and the onset of the pubertal growth spurt	Not recommended for treatment planning
Franchi et al. 2008 [101]	500 F, 500 M/≈6–14 yrs	Early mixed, mixed, late mixed, and permanent	CVM, 6-stage method according to Baccetti et al. [20]	Sensitivity, specificity, PPV, positive LHR	Mixed dentition and early permanent dentition are not valid indicators for the onset of the pubertal growth spurt	Not recommended for treatment planning
Perinetti et al. 2012 [57]	208 F, 146 M/6.8–17.1 yrs	Mandibular teeth	CVM, 6-stage method according to Baccetti et al. [20]	Sensitivity, specificity, PPV, NPV, accuracy, positive LHR	Dental maturation assessment is reliable in the identification of prepubertal and postpubertal growth phases	Not recommended for treatment planning
Perillo et al. 2013 [28]	192 F, 108 M/6.8–17.1 yrs	Mandibular canine and second molar	CVM, 6-stage method according to Baccetti et al. [20]	Sensitivity, specificity, PPV, NPV, accuracy, positive LHR	Combined canine and second molar maturation has little role in the identification of the pubertal growth spurt	Not recommended for treatment planning
Surendran and Thomas 2014 [112]	71 F, 79 M/8–16 yrs	Mandibular teeth	MP3, 6-stage method according to Rajagopal and Kansal [36]	Positive LHR	Dental maturation assessment is reliable in the identification of prepubertal and postpubertal growth phases	Recommended only for planning treatments that need to be performed in prepubertal patients
Cericato et al. 2016 [110]	314 F, 262 M/7–18 yrs	Mandibular teeth	CVM, 6-stage method according to Hassel and Farman [33] and Baccetti et al. [20]	Positive LHR	Dental maturation assessment is reliable in the identification of prepubertal growth phases	Not reported

Only studies reporting diagnostic performance are represented. No longitudinal study has been reported to date. CVM, cervical vertebral maturation; PPV, positive predictive value; LHR, likelihood ratio; NPV, negative predictive value; a, other information not provided.