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Updated: May 18, 2026

Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
Bone age estimation by cervical vertebral dimensions in lateral cephalometry
Masoud Varshosaz1, Sara Ehsani, Mahtab Nouri
1Dentomaxillofacial Radiologist, Dentomaxillofacial Radiology Department, Dental school, Shaheed Beheshti University, M.C. Evin, Tehran, Iran.
Objectives:
A critical issue in contemporary orthodontics is bone age estimation. The most reliable method for skeletal age evaluation is hand-wrist radiography; but it requires further radiation. There is an increasing attention for evaluating cervical vertebrae to reduce the radiation to the patients. The aim of this study was to estimate bone age by measuring 3rd and 4th cervical vertebrae (C3, C4) dimensions.
Materials And Methods:
We conducted a correlational study on 91 Iranian individuals aged 8-18 years. After taking lateral cephalometry and hand-wrist radiographs, C3 and C4 were measured using Vixwin 2000 software. Hand-wrist bone age, determined on Greulich Atlas, was the reference test. Stepwise multiple linear regression model demonstrated the correlation between the two measurements.
Results:
Anterior height of the fourth cervical vertebrae (AH4) had the strongest simple correlation with hand-wrist bone age (r=0.831, P<0.001) and was the only variable that remained in stepwise multivariate regression model. The regression model was: Bone age=0.989×AH4+3.308. Adjusted R2 was 0.686 (p<0.001).
Conclusions:
Lateral cephalometric radiographs are useful for bone age estimation, and might be an alternative for hand-wrist radiography, with the advantage of radiation reduction.
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