Is there a correlation between dental and cervical vertebrae maturation stages in growing subjects? A systematic review with meta-analysis

Objective To assess the evidence on the relationship between dental and cervical vertebrae maturation. Materials and methods Searches were performed (up to December 2021) in seven databases, as well as in gray literature. Studies that included growing subjects, which evaluated the correlation between the stages of tooth formation and the maturation of cervical vertebrae, were eligible. The methodological quality of the selected reports was assessed using the JBI checklist for cross-sectional studies. Random-effects meta-analyses were implemented to calculate the pooled correlation coefficients between the maturation stages of cervical vertebrae and each tooth type. The GRADE approach was followed to assess the certainty of evidence. Results Seventy-seven studies were selected. Most of them had limitations related to sampling and reliability of the methods to evaluate maturation. The syntheses evidenced positive correlations between the maturation of cervical vertebrae and the formation/calcification stages of the following lower teeth: canine ( n = 7318; r = 0.692; 95% CI: 0.656–0.724), first premolar ( n = 6194; r = 0.689; 95% CI: 0.649–0.725), second premolar ( n = 6194; r = 0.695; 95% CI: 0.659–0.729), and second molar ( n = 7905; r = 0.698; 95% CI: 0.652–0.739). All estimates were affected by the risk of bias and the presence of unexplained statistical heterogeneity. Conclusions The evidence points to an apparent positive correlation between dental and cervical vertebrae maturation. These results need to be carefully evaluated as the body of evidence is of very low quality. Clinical relevance Dental maturation might be a potential indicator of skeletal craniofacial growth status. A routine dental x-ray could be sufficient, reducing radiation exposure by requesting additional radiographs.