Comparative determination of skeletal maturity by hand–wrist radiograph, cephalometric radiograph and cone beam computed tomography
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The purpose of this study is to assess the stages of skeletal maturity in cone beam computed tomography (CBCT), hand–wrist radiography (HWR) and cephalometric radiography (CR) techniques of orthodontic patients, and associate skeletal maturity stages with chronological age, in a Turkish subpopulation.
Hand–wrist radiographs, cephalometric radiographs and CBCT of 105 patients were evaluated. For evaluation of HWR, the “Hand Bone Age A Digital Atlas of Skeletal Maturity” of Vicente Gilsanz and Osman Ratib (2005) was used. Skeletal maturation in the cephalometric radiographs and sagittal sections of cervical vertebrae obtained by CBCT were evaluated with Hassel and Farman’s method (1995). All results were re-evaluated 3 weeks later to assess intra-observer reliability.
Intra-observer reliability coefficients of the skeletal maturity stages in HWR, CR, and CBCT were 0.912, 0.595, 0.756 respectively (p < 0.05). Spearman’s correlation coefficient value between skeletal developmental stages in in HWR, CR, and CBCT was found to be 0.785, 0.875, and 0.791, respectively (p < 0.05).
Results of this study reveal that the determination of the skeletal development status with analysis of cervical vertebrae using cephalometric radiographs and CBCT is as reliable method as the evaluation of the hand–wrist radiographs and is compatible with chronological age in a subgroup of the Turkish population. When assessing the skeletal development stages of patients, both CBCT and CR can be used validly, so no extra hand–wrist radiography is required. This information is important for the prevention of increased radiation doses in patients.
KeywordsCephalometric radiograph Chronological age Cone beam computed tomography Hand–wrist radiograph Skeletal age Skeletal maturation
Compliance with ethical standards
Conflict of interest
All authors declare that they have no conflict of interest.
All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions.
Informed consent was obtained from all patients for being included in the study.
- 2.Green LJ. The interrelationship among height, weight and chronological, dental and skeletal ages. Angle Orthod. 1961;31:189–93.Google Scholar
- 24.Byun BR, Kim YI, Yamaguchi T, Maki K, Ko CC, Hwang DS, Son WS. Quantitative skeletal maturation estimation using cone-beam computed tomography-generated cervical vertebral images: a pilot study in 5-to 18-year-old Japanese children. Clin Oral Investig. 2015;19(8):2133–40.CrossRefPubMedGoogle Scholar
- 26.Gilsanz V, Ratib O. Hand bone age: a digital atlas of skeletal maturity. Berlin, Heidelberg, New York: Springer Science & Business Media; 2005. p. 2–17.Google Scholar
- 29.Simmons K, Greulich WW. Chronological versus skeletal age, an evaluation of craniofacial growth. Angle Orthod. 1979;49(3):181–9.Google Scholar
- 32.Tanner JM, Healy MRJ, Goldstein H, Cameron N. Assessment of skeletal maturity and prediction of adult height (TW3). 3rd edn. London: W.B Saunders; 2001. p. 243–54.Google Scholar
- 34.Kama JD, Gündüz AS, Darı O, Özer T. Erkek Bireylerde Servikal Vertebra Kemik Yaşının Kronolojik ve İskelet Yaş ile Karşılaştırılması. Dicle Tıp Dergisi. 2006;33(1):36–41.Google Scholar