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Thank you for using Document Supply Services! a Kings College London Information Resources - ILL ol 26-29 Drury Lane LONDON WC2B 5RL United Kingdom 2 $483 Copyright Statement usm Laieselpayourdeshdocsupplyhelp termine tnt ‘The British Library, Document Supply, Boston Spa, Wetherby, United Kingdom, LS23 7BQ www.bl.ukGrowth, 1915, 39, 483-462 INTERRELATIONSHIPS OF DENTAL MATURITY, SKELETAL MATURITY, HEIGHT AND WEIGHT FROM AGE 4 TO 14 YEARS Donat L, ANDERSON, Gordon W. THOMPSON AND FRANK Popovic Faculty of Dentsiry, University of Toronto (Received, July 8, 1975, Accepted, Sept. 2, 1975) ‘The correlations of dental mineralization stages, skeletal mineralization, Dodysheight and weight were determined for each year between age 4 and 14 for 121 boys and 111 girls of the serial experimental group of the Burlington Growth Centre. Dental development related more strongly to morphological evelopment than {0 skeletal development in both sexes, and skeletal age was ‘more strongly related to morphological age than to dental stage. The reation- ship of individual teeth to skeletal age, height and weight were diferent but ‘consistent in a sex-specific pattern. In males, both skeletal mineralization and ‘dental mineralization, particularly of the fist’ molars, were more closely related te bch Hn to weit. Ja the femal skal ad etal minertbain, of the seco ‘were more closely related to weight from age ‘than to height. ‘These relationships. were signifant in both pre-adolescent and adolescent years. In both these periods skeletal age and body size related most Strongly to'late stages of tooth formation, Hence, from an early age, the stages of dental, skeletal and morphological maturation’ were significantly interrelated in a pattern that was specie for Individual teth and for sex Torx Worss: Maturity correlations, longitudinal study, children, toth, bone, body size Many studies have demonstrated that body weight is related to puberty. Early maturers weighed more both before and during ado- Tescence (Tanner, 1962; Zacharias and Wurtman, 1969; Anderson et al. 1973). Good nutrition hastens puberty in girls (Lee et al., 1963; Matsumoto et al., 1963; Ramos-Galvan et al., 1963; Guggen et al., 1966), whereas nutritional deficiency delays it (Keys et al., 1950; Revelle, 1974). The best index of nutrition and growth probably is weight because it sums up all increments in size (Stuart and Mere- dith, 1946; Ausubel, 1958; Watson and Lowery, 1967). Malnutrition has'a more serious effect on males than on females (Tanner, 1962, 1973; Widdowson, 1968; Frisancho et al., 1973), and affects the maturation of the skeleton more than the teeth (Stewart, 1963; Garn et al., 1965). Green (1961) found that skeletal and tooth mineralization were more closely related to height and to weight than to each other, and that skeletal maturation was more closely related to body size than 433434 DENTAL, SKELETAL AND BODY MATURITY was dental maturation. Before puberty, the relationships of tooth ma- turity with height and weight were of low magnitude (Garn et al., 1965). During the preadolescent and adolescent years, mineralization of teeth and bones of the hand and wrist, height and weight all indicate stages of accumulated growth. Dental age, skeletal age, and morpho- logical age provide estimates of biological developmental age (‘Tanner, 1962, 1973), but it has never been clearly determined to what extent they agree or differ. Previous investigations of the Burlington serial experimental female sample studied the amount, timing, velocity and relationships of the growth in height, weight and mandibular length during adolescence (Anderson et al, 1975a; Thompson et al., 197Sb); and, in both sexes studied, the timing and velocity of mineralization of the skeleton (Thompson ct al., 1974), and teeth (Thompson et al., 1975a; Ander- son et al., 1975b). The present study investigates the relationship of dental age, skele- tal age and morphological age in each sex from age 4 to 14 years. ‘Meruops ‘The data used in this study were obtained from the annual records at ages 4 to 14 of 121 boys and 111 girls of the serial experimental group of the Burlington Growth Centre (Anderson et al., 197Sa) ‘The mineralization stages of each tooth of one side of the maxilla and mandible were scored according to the method of Moorrees et al. (1963) by one examiner from annual cephalograms (Anderson et al., 1973b). Thirteen bones of the right hand and wrist were scored according to the method of Greulich and Pyle (1959) by one examiner from annual hand and wrist radiographs (‘Thompson ct al., 1973). Height and weight were obtained from annual recordings made at ages 4 to 14 years. For each sex at each age, Pearson's correlation coefficients (Snede- cor and Cochran, 1967) were used to compare the mineralization stages of sixteen teeth, the skeletal mineralization stages, height and weight. On the basis of these correlations, two teeth were selected for use in partial correlation determinations of height, weight, skeletalD. 1, ANDEKSON, 6. W. THOMPSON AND F. POPOVICH 435 stage and tooth stage in which height and weight, in turn, were held constant, Finvines Dental mineralization was significantly related to skeletal minerali- zation, height, and weight (Table 1). Tooth mineralization related more strongly to height and weight than to skeletal mineralization in both sexes. Dental mineralization in the females was less strongly correlated with skeleton mineralization than it was in the males. In the males, tooth stages related more to height than to weight; whereas in the females, the teeth bore the same relationship to height and weight. Except for a very close similarity between corresponding maxillary and mandibular teeth, individual teeth differed in their relationship to skeletal age, height and weight, and these relationships differed with sex. However, in each sex, these tooth differences were consistent with respect to all three variables. In the males, the correlation coefficients were highest for the first molars; in the females, they were highest for the second molars (Table 1). As well, the mandibular first molar was the only tooth in the males for which the relationships were statistically significant (P<0.05) at all the ages during its development. In the females, the second molars were the only teeth that showed significant correlations with height and weight at all ages from 4 to 14 years. For all teeth, the correlation coefficients varied with age, tending to increase year by year to reach a maximum and then decrease. The age of maximum correlation differed for different teeth (Table 1), but for each tooth this ‘peak age’ was similar in respect to skeletal age, height and weight. Some ages were preadolescent, while others were in the adolescent period. Although these ages were spread over sev- eral years, the stages of mineralization at these ages were similar for all teeth except the third molars and were similar in both sexes (Table 1). Temporally, these stages are concurrent with the final phases of root formation. On the basis of these results, we chose the mandibular first and second molars for partial correlation determinations. The correlation between mineralization of the first molar and skeleton in males was greater with height than with weight (Tables 2 and 3). The correlation456D. L. ANDERSON, G. W. THOMPSON AND F. POPOVICH 437 of mineralization of the second molar with weight was slightly greater than with height in both sexes. Controlling for height had a greater effect on the relationship of weight to first molar stage in both sexes and to skeleton stage in males than did control of weight on the relationship of height to these variables (Tables 2 and 3). On the other hand, controlling for weight produced a greater reduction in the correlation of height to second molar stages in both sexes, and to skeletal stage in females than did control of height on the correlations of weight with these variables. For females, controlling weight had a greater effect on the correla- tions of height with mineralization of first and second molars from age 6 onwards than at ages 4 and 5 (Table 2); controlling height had less effect on the relation of weight to skeletal stage from ages 7 to 14 than at ages 4 to 6 (Table 3). Controlling for weight or for height greatly reduced the correlation of skeletal stage with dental stage. In males, the correlation coefficients between skeletal age and height and weight increased with age (Table 3). In females, the skeletal- height relationships increased to 11 years and then decreased, with a marked drop at age 14. The skeletal-weight relationships increased until age 12 and then decreased. Except for a drop at age 14 in the females, the height-weight correlation coefficients were similar in respect to both age and sex (Table 3). Discussion ‘The correlations of the stage of dental maturity to skeletal maturity and morphological maturity were stronger in the present investigation than in those previously reported (Lewis and Garn, 1960; Steel, 1965; Garn et al., 1965). At each of the 11 ages investigated, dental develop- ment was more closely related to morphological development than to skeletal development; and this was most evident in the skeletal-height relationship in the males. These findings are in agreement with those of Green (1961) who studied a smaller cross-sectional group of males. Since dental and skeletal mineralization were less strongly related to each other than to body size, and since control of either height or weight greatly reduced the dental-skeletal correlations; it appears that dental and skeletal maturation are not closely related. In accord withDENTAL, SKELETAL AND BODY MATURITY 438 NOOO =» 100= 4 ‘s00= v :92904 souEDTIIS eee eee fo ee im wee ewe et TF 3 ay er ts as a oC or a a Sor 308 t a or roy aes or at et BE ers 6 B38 we ifr or 8 See uz te op wre 4 se or eG ty ar wr 3 wr BL wee. re 5 a8 ore wae + sewer ae cod arene ee re a HPAL PHL HL IwESIOD NL HEROD TREK HRPTS 7 EAL eeu AIS yA NOWZTWRNTWY VEFHSS OXY SHOT "IDK 40 SNOLEEO; ® aTHVL 1000 W604 500+ 04 OMENS ro “PoE FONE PS 19H PEE MONCTON EH po MOE ‘SerIOWE RVIRMAAYGY 40 NOLWTOIMIWY OF LHOTIA, aNY SHOE GO NONVEAHOD eaTaVLD. 1, ANDERSON, G. W. THOMPSON AND F. POPOVICH 459 Hunt and Gleiser (1955), the dental-skeletal relationship was noted to be stronger in males than in females. In addition, we found that individual teeth differed in strength of correlation with skeletal stages, height and weight; that the sexes differed in which teeth correlated strongly with these variables; and that, in each sex, individual tooth differences were consistent in their relationship to all three variables. In males, the teeth related most strongly to height, and of the teeth, the mandibular first molars were most strongly related to all the variables; whereas in the females, the second molars were the teeth most strongly related to body size. Thus, in the two sexes, adjacent teeth showed considerable difference in the nature and strength of the relationship of dental mineralization to morphological age. In investigations involving dental maturity, it ap- pears that scores of selected individual teeth would be preferable to mean scores of several teeth ‘The teeth showing the greatest sex difference in correlation of dental maturity to skeletal and morphological maturity were the molars; whereas the greatest sex difference in age and velocity of dental mineralization centered on the canines (Thompson et al., 1975a). ‘These sex-dependent, tooth-specific differences in the relationships between tooth formation and bone and body formation may cast light on diseases such as periodontosis—a severe destructive periodontal disease of adolescents. This disease occurs predominantly in females, and, characteristically, involves the permanent first molars and incisors (Baer and Benjamin, 1974). Both dental and skeletal mineralization were more closely related to height in males and to weight in females. The relationship of weight to dental and skeletal maturity appeared to be allometric in males; whereas from age 7 to 14 in females, weight was partially independent of height. Since the relationship between weight and skeletal and dental mineralization became evident at about age seven, this associa- tion precedes the adolescent acceleration in growth. A weakening of the correlation of skeletal age and weight with height at age 14 prob- ably reflects a slowing down or cessation of growth in height of the females. The retention of a strong correlation of weight with skeletal age at chronological age 14 further indicates an independent rela- tionship between weight and maturation in females. The results are in harmony with previous observations (Tanner, 1962; Zacharias460 DENTAL, SKELETAL AND BODY MATURITY and Wurtman, 1969; Anderson ef al., 197Sa) that in females, weight and weight-for-height are related to maturation age before and during adolescence; but also indicate that these relationships are much less important in males. In both sexes, puberty did not appear to influence the relationship of dental maturity to skeletal and morphological maturity, because the correlation coefficients did not increase at pubertal ages. Instead, the coefficients were maximum at the age of the final stages of root formation of most teeth. The rate of mineralization of the teeth also was not accelerated during adolescence (Thompson ef ai., 1975a). On the other hand, the correlation between skeletal age and height and weight appeared to be related to pubertal growth peaks. In the females, the skeletal-height relationship increased until age 11, and the skeletal-weight relationship increased to age 12, and then de- creased. These ages coincide with the ages of maximum increments in adolescent growth in height and weight respectively (Thompson et al., 1975b), Tanner (1962) found that skeletal age was related to age of sexual maturity. ‘The present study did not investigate the timing or velocity of growth at adolescence. The findings indicate that at ages before and during adolescence significant relationships exist between the stage of dental development, the stage of skeletal development, and the degree of growth attained in height and weight. The sexes differ, however, in how synchronous is the maturation of individual teeth, height, skeleton, and weight. ACKNOWLEDGMENT This study was made possible by use of material from the Burling- ton Growth Centre, Faculty of Dentistry, University of Toronto, which was supported by funds provided by Grants (No. 605-7-299 and 605-7-733) National Health Grants (Canada) Programme. The authors wish to thank Mrs. M. Bachtis for assistance in the data analysis, and J. 0. Godden, M.D. for advice during preparation of the manuscript. Revenncrs Cirz> Awonagox, D. L., Tuonersox, GW. & Porovicu, F. 19750, Adolescent variation in weight, hight and mandibular length in 111 females, Humon Biol, in press Awonsos, D. L, Tuowpsox, G. W., & Porovicn, F, 1973b, Age of attainment of ‘mineralization stages of the permanent dentition, J. Forensic Sel. in press1D. L, ANDERSON, G, W. THOMPSON AND F. POPOVICH 461 Avant, D,P. 195, Theory and Problems of Chik! Devopment Grane and Satin, ‘New York Bars, P. N,,& Brsyiaens, §, D. 1974, Periodontal Disease in Children and Adolescents J. B. 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Sth ed ‘Year Book Publishers, Chicago, p. 84462 DENTAL, SKELETAL AND BODY MATURITY Winnowsox, BM. 1968. The place of experimental animals in the study of human ‘malnutrition, In; Calorie deficiencies and protein deficiencies, Eds. R. A. MeCance and E. M. Widdowson. MIT. Press, Cambridge. ‘Zactuamus, L., & Wortaiax, RJ. 1960. Age at menarche: Genetic and environmental influences, New Eng. J. Med. 280, 868-875DOCUMENT SUPPLY Boston Spa, Wetherby West Yorkshire L523 78Q www. bl.uk Please note the following: Y This is the best copy available “LA, This article has a very tight binding —— Some pages within the original article are advertisements and have therefore not been sent Advertisement pages: ... Some pages within the original are blank and have therefore not been sent Blank pages: The article you require is on different pages to those that you quoted