Axial cervical vertebrae-based multivariate regression model for the estimation of skeletal-maturation status.
OBJECTIVE
This study aimed to determine the viability of using axial cervical vertebrae (ACV) as biological indicators of skeletal maturation and to build models that estimate ossification level with improved explanatory power over models based only on chronological age.


METHODS
The study population comprised 74 female and 47 male patients with available hand-wrist radiographs and cone-beam computed tomography images. Generalized Procrustes analysis was used to analyze the shape, size, and form of the ACV regions of interest. The variabilities of these factors were analyzed by principal component analysis. Skeletal maturation was then estimated using a multiple regression model.


RESULTS
Separate models were developed for male and female participants. For the female estimation model, the adjusted R(2) explained 84.8% of the variability of the Sempé maturation level (SML), representing a 7.9% increase in SML explanatory power over that using chronological age alone (76.9%). For the male estimation model, the adjusted R(2) was over 90%, representing a 1.7% increase relative to the reference model.


CONCLUSIONS
The simplest possible ACV morphometric information provided a statistically significant explanation of the portion of skeletal-maturation variability not dependent on chronological age. These results verify that ACV is a strong biological indicator of ossification status.
Department of Orthodontics, School of Dentistry, Dental Research Institute, Pusan National University, Yangsan, South Korea.
Y-M
YM
Yang
J
J
Lee
Y-I
YI
Kim
B-H
BH
Cho
S-B
SB
Park
D000293:Adolescent; D000365:Age Determination by Skeleton / Q000706:statistics & numerical data*; D000367:Age Factors; D059925:Anatomic Landmarks / Q000000981:diagnostic imaging; D001368:Axis, Cervical Vertebra / Q000000981:diagnostic imaging; D002348:Carpal Bones / Q000000981:diagnostic imaging / Q000254:growth & development; D001270:Cervical Atlas / Q000000981:diagnostic imaging; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D054893:Cone-Beam Computed Tomography / Q000379:methods; D005260:Female; D005539:Foramen Magnum / Q000000981:diagnostic imaging; D050276:Hand Bones / Q000000981:diagnostic imaging / Q000254:growth & development; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008297:Male; D015233:Models, Statistical; D010012:Osteogenesis / Q000502:physiology*; D025341:Principal Component Analysis; D012044:Regression Analysis; D012737:Sex Factors
Procrustes analysis; Sempé maturation level; axial cervical vertebra maturation; geometric morphometrics; principal component analysis