Assessment of Residual Skeletal and Dental Growth in Children: A Cross-Sectional Study Using Quantitative Cameriere...

Background/Objectives: Accurate assessment of biological maturation is essential in pediatric dentistry and orthodontics for optimizing treatment timing. Quantitative methods proposed by Cameriere allow continuous estimation of residual skeletal and dental growth; however, the degree of agreement between these maturation processes remains unclear. This study aimed to assess residual skeletal and dental growth in children using quantitative Cameriere methods and to evaluate the agreement between these two maturation indicators. Methods: This cross-sectional observational study included 98 Caucasian subjects (50 males and 48 females) aged 7.0-11.9 years. Residual skeletal growth was assessed on lateral cephalometric radiographs using the fourth cervical vertebra ratio (C4-Vba), while residual dental growth was evaluated on panoramic radiographs using the open apices method. Measurements were performed using the AgEstimation Project software v1.0. Intra- and inter-observer reproducibility were assessed using intraclass correlation coefficients (ICCs). Correlation analysis and Bland-Altman analysis were performed to evaluate the association and agreement between skeletal and dental maturation. Results: Excellent reproducibility was observed for all measurements, with ICC values ranging from 0.93 to 1.00. Residual skeletal growth time (T_skeletal) and residual dental growth time (T_dental) showed a weak positive association (Spearman ρ = 0.18, p = 0.09). Discrepancies exceeding the predefined 1-year threshold between skeletal and dental maturation (|ΔT| > 1 year) were observed in 48.0% of subjects. Skeletal predominance was identified in 46.9% of cases, whereas dental predominance was observed in only 1.0%. Females showed significantly greater residual skeletal and dental growth compared with males (p < 0.001). Conclusions: Skeletal and dental maturation showed limited agreement in children aged 7-11 years, supporting the concept that these processes follow partially independent biological pathways. The integration of quantitative skeletal and dental assessments may improve the evaluation of individual growth potential and support more personalized orthodontic treatment planning.