A practical formula for determining growth

Assessment of maturation stages and the accuracy of age estimation methods in a Turkish population: A comparative study

Purpose

This study assessed the associations between chronological age, dental maturation (DM), cervical vertebrae maturation (CVM), and hand-wrist maturation (HWM) in individuals aged 9-19 years. In addition, this study aimed to derive practical methods to evaluate the skeletal age using DM, CVM, or HWM for orthodontic, medical, and forensic purposes and to compare which of these 3 developmental parameters is more accurate for estimating the age of individuals in a Turkish population.

Materials and Methods

Panoramic, lateral cephalometric, and hand-wrist radiographs of 284 patients aged 9-19 years were used in this study. The DM, CVM, and HWM stages were determined. The Kolmogorov-Smirnov, kappa, Wilcoxon, Kruskal-Wallis, chi-square, and Spearman correlation tests and simple linear regression analysis were used for statistical analysis. The significance level was 0.05.

Results

Statistically significant differences were found between chronological age and DM, chronological age and CVM, and chronological age and HWM in both sexes (P<0.05). DM did not show statistically significant differences according to sex (P>0.05), but CVM and HWM were statistically different between males and females (P<0.05). The DM-estimated age yielded more accurate values than the other methods.

Conclusion

All correlations between skeletal and dental stages were statistically significant. Our results showed that there was no statistically significant difference between chronological age and DM-estimated age. Therefore, it can be concluded that DM stages have the potential to be used for legal purposes.

Skeletal age prediction model from percentage of adult height in children and adolescents

Skeletal age (SA) is considered the gold standard to assess the degree of maturation and has been widely used in sports, education and public health areas; however, it requires sophisticated equipment and well-trained technicians. Therefore, it is important to develop non-invasive methods for its evaluation. The aim was to develop an equation to predict SA using the percentage of adult height. SA was measured by Tanner-Whitehouse-3 method, and the percentage of adult height was estimated by two methodologies: Tanner-Whitehouse-3 method (P-TW3) and Khamis-Roche method (P-KR) using 839 schoolchildren of both sexes. Linear regression was used for predicting SA from P-TW3; then P-TW3 was replaced in the equation for P-KR value. Bland-Altman graphs, interclass correlation coefficient and Kappa index were used as validation tests. Model showed a SA predictive capacity of 93.2% in boys and 96.8% in girls. The average differences between SA measured and SA predicted by P-TW3 was 0.0504 (± 0.664) in boys and 0.0144 (± 0.435) in girls (P = 0.229 and 0.667, respectively). When P-TW3 was replaced for P-KR value in the equation, the average differences were - 0.0532 in boys and 0.0850 in girls (P = 0.509 and 0.167 respectively). The present model, based on the percentage of adult height, showed an adequate estimation of SA in children and adolescents and it can be used in the absence of bone X-ray equipment, in healthy boys aged 9 to 15 and girls 8 to 13.

Discriminatory ability of cervical vertebral maturation stages in predicting attainment of the legal age threshold of 14 years: A pilot study using lateral cephalograms

Purpose

In India, the age of 14 years is the legal age threshold for child labour. Therefore, in suspected instances of child labour, age assessment plays a crucial role in determining whether a violation of the law on the employment of children has occurred. The aim of this retrospective cross-sectional study was to assess the discriminatory ability of stages of cervical vertebral maturation (CVM) in predicting the legal age threshold of 14 years.

Materials and Methods

Routinely taken lateral cephalograms from 408 subjects aged 10 to 18 years were evaluated retrospectively using the CVM stages described by Baccetti et al. Descriptive statistics, accuracy, sensitivity, specificity, positive and negative predictive values, and likelihood ratios were calculated for stages 2, 3, and 4 of CVM.

Results

Real age increased as the CVM stage gradually increased. The results of 2×2 contingency tables showed that CVM stage 4 produced an accuracy of 71% and 73%, a false positive rate of 7% and 18%, and a post-test probability of 59% and 68% for boys and girls, respectively.

Conclusion

Based on these findings, it can be concluded that the stages of CVM are of limited use for predicting the attainment of the legal age threshold of 14 years. Future studies should investigate whether combinations of skeletal and dental methods could achieve better accuracy and post-test probability.