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World Journal of Dentistry


Objective: The purpose of the study was to verify the relationship between mandibular canine calcification and skeletal maturity, and mandibular canine calcification could be used as a first-level diagnostic tool to estimate the timing of the pubertal growth spurt.

Materials and methods: Data were obtained from hand-wrist radiographs and intraoral periapical radiographs of left mandibular canine. Totally, 221 boys and 191 girls, the age ranging from 7 to 15 years, were selected to depict varying stages of growth. Kappa and t test statistics were applied. Skeletal age was determined as described by Greulich and Pyle, and the maturational patterns of the indicators were evaluated using the 11-grade system of Fishman. The stages from E to H as described by Demirjian’s stages of dental calcification were taken in this study instead of A to H.

Results: The epiphyseal widening for boys at 8.1 years and girls at 7.7 years, the ossification of the adductor sesamoid for boys at 12.2 years and for girls at 11.6 years, capping of epiphysis for boys at 11 years and for girls at 10 years, fusion of epiphysis in distal and middle phalanx in the third finger for boys at 13.8 years and for girls at 12.7 years, and fusion of epiphysis in the radius for boys at 14.4 years and for girls at 13 years were seen.
The relationship between the various stages of calcification of mandibular canine with skeletal age are as follows:
Boys: Stage E at 6.4, stage F at 8.9 years, stage G at 10.9, and stage H at 14 years
Girls: Stage E at 6.1, stage F at 8.2 years, stage G at 10.46, and stage H at 12.94 years.
The results showed stages E and F were coincident with the epiphyseal widening in the third finger proximal and middle phalanx and middle phalanx of the fifth finger. Stage G was coincident with the ossification of adductor sesamoid, capping of third finger middle phalanx, distal phalanx, and fifth finger middle phalanx, indicating its association with the accelerative phase of growth. Stage H was coincident with a fusion of proximal, middle, distal phalanx of the third finger, and fusion of radius, indicating its association with the decelerative phase of growth. Stage G was an ideal time for any orthodontic treatment, particularly functional appliances.

Conclusion: Based on the findings of this study, a close association existed between mandibular canine calcification stages and skeletal maturity indicators.

Keywords: Diagnostic tool, Mandibular canine calcification, Pubertal growth spurt, Skeletal maturity indicator.

How to cite this article: Vijayalakshmi K, Sathiasekar GS. Mandibular Canine Calcification as Skeletal Maturity Indicator. World J Dent 2017;8(2):119-128.

Source of support: Nil

Conflict of interest: None

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