Assessment of bone age by cervical vertebral dimensions in lateral cephalometric radiographs

Aim and Objectives: For determining the skeletal/bone age from hand-wrist radiographs, Greulich and Pyle's Atlas and Tanner–Whitehouse 3 (TW3) methods are considered as reliable methods, but there are concerns of extra radiation dose. The cervical vertebral bone age (CVBA) by measurements of the vertebral body of third (C3) and fourth (C4) is a relatively new method of objectively evaluating the skeletal maturation. The aim of this study was to estimate bone age by measuring 3rd and 4th cervical vertebral (C3, C4) dimensions. Materials and Methods: Lateral cephalometric and hand-wrist radiographs of 40 male and 46 female subjects (08–16 years of age) who had attended Government Dental College Srinagar for treatment were taken and measurements of C3 and C4 was done by using NNT Dicom version 7.0.0.0 software. Hand-wrist bone age was determined using Pyle and Greulich Atlas. Stepwise multiple regression analysis demonstrated the correlation between the measurements. Results: Anterior height of the third cervical vertebrae (AH3) in males had the strongest correlation with hand-wrist bone age (r=1.o, p<0>3 was 10.733. The highest correlation coefficient in females was observed between H3 and the estimated bone age from Greulich's Atlas (r=0.896, p<0>3 was 10.43. The bone age was calculated by multiple regression model: Bone age in males = 0.809×AH3+ 2.896. Adjusted R2 was 0.153 (p<0 xss=removed>3+ 2.752. Adjusted R2 was 0.245 (p<0> Conclusions: Lateral cephalometric radiographs might be an alternative to the hand-wrist radiography for bone age estimation. Therefore, analysis of cervical vertebrae by replacing hand-wrist method additional radiograph could be avoided.