title: Is Greulich and Pyle standards of skeletal maturation applicable for age estimation in South Indian Andhra children?
abstract: BACKGROUND
  Now-a-day age determination has gained importance for various forensic and legal reasons. Skeletal age (SA) of a test population can be estimated by comparing with established standards of Greulich and Pyle (G-P). As this atlas has been prepared using data from upper-class children born between 1917 and 1942 in the USA and the applicability of these standards to contemporary populations has yet to be tested on Andhra children living in India. Hence, this study was aimed to assess the reliability of bone age calculated by G-P atlas in estimation of age in selected population.
  
  
  METHODS
  A total of 660 children (330 girls, 330 boys) between ages 9 and 20 years were randomly selected from outpatient Department of Oral Medicine in GITAM Dental College, Andhra Pradesh. Digital hand-wrist radiographs were obtained and assessed for SA using G-P atlas and the difference between estimated SA and chronological age (CA) were compared with paired t-test and Wilcoxon signed rank test.
  
  
  RESULTS
  G-P method underestimated the SA by 0.23 ± 1.53 years for boys and overestimated SA by 0.02 ± 2 years in girls and mild underestimation was noted in the total sample of about 0.1 ± 1.78 years. Spearman rank test showed significant correlation between SA and CA (r = 0.86; P < 0.001).
  
  
  CONCLUSIONS
  This study concluded that G-P standards were reliable in assessing age in South Indian Andhra children of age 9-20 years with unknown CA.
authors.affiliation: Department of Oral Medicine and Radiology, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Rezwana Begum
authors.initials: RB
authors.lastname: Mohammed
authors.affiliation: Department of Periodontics, GITAM Dental College and Hospital, Visakhapatnam, Andhra Pradesh, India.
authors.forename: Dola Srinivasa
authors.initials: DS
authors.lastname: Rao
authors.affiliation: Department of Periodontics, Bhabha College of Dental Sciences, Bhopal, Madhya Pradesh, India.
authors.forename: Alampur Srinivas
authors.initials: AS
authors.lastname: Goud
authors.affiliation: Department of Oral Medicine and Radiology, Government Dental College, Hyderabad, Telangana, India.
authors.forename: S
authors.initials: S
authors.lastname: Sailaja
authors.affiliation: Department of Orthodontics and Dentofacial Orthopaedics, RKDF Dental College and Research Centre, Bhopal, Madhya Pradesh, India.
authors.forename: Anshuj Ajay Rao
authors.initials: AA
authors.lastname: Thetay
authors.affiliation: Department of Endodontics and Conservative Dentistry, Indira Gandhi Institute of Dental Sciences, Ernakulam, Kerala, India.
authors.forename: Meera
authors.initials: M
authors.lastname: Gopalakrishnan
keywords: Age estimation; Greulich and Pyle atlas; digital radiography; forensic radiology; skeletal age