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Introduction <p>Accurate bone age (BA) assessment is crucial in orthodontics for treatment planning. Current methods have limitations, including subjectivity or the need for additional radiation. A validated quantitative method for BA assessment using cervical vertebrae (CV) in the Mexican pediatric population is lacking.</p> Objective <p>To develop and validate a regression model for BA estimation using CV measurements in Mexican children and adolescents for timing orthodontic interventions and orthognathic surgical procedures.</p> Materials and Methods <p>A cross-sectional study was designed in order to generate a regression model (Group I: 1,000 cephalograms, 500 females, 500 males, 6–18 years) by measuring the height of C3 and C4 (h3, h4). The model was validated (Group II: 100 separate patients, 50 females, 50 males) by comparing Vertebral Bone Age (VBA) with Carpal Bone Age (CBA) assessed by Tanner-Whitehouse 3 (TW3). Intra-examiner reliability tests and statistical analyses were performed, such as Intraclass Correlation Coefficient (ICC), Mann-Whitney U, Pearson Correlation, Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and the Standard Error of the Estimate (SEE).</p> Results <p>ICC was &gt; 0.95. The final model utilized h4: Females: VBA = 2.421 × h4 (R²adj = 0.821; SEE = 1.256 years); Males: VBA = 2.584 + (1.952 × h4) (<i>R²adj</i> = 0.797; SEE = 1.257 years). No significant differences were found between VBA and CBA (<i>p</i> &gt; 0.05). VBA-CBA correlation was strong (Females: <i>r</i> = 0.807; Males: <i>r</i> = 0.816, <i>p</i> &lt; 0.001). MAE: Females = 0.31 ± 1.50 years; Males = 0.18 ± 1.83 years. RMSE: Females = 1.52 years; Males = 1.82 years.</p> Conclusion <p>The novel C4-based model is a valid, objective, practical, and less invasive alternative for BA estimation in the studied Mexican pediatric population.</p>

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A C4-Based Regression Model for Bone Age Estimation in Mexican Children and Adolescents: A Development and Validation Study

  • 期刊论文

  • 发表日期：

    2026年6月22日

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  • Carlos García-Contreras,
  • Roberto Carrillo Fuentevilla,
  • Roberto Carrillo González,
  • Gustavo Israel Martínez-González,
  • Andrea A. García-Contreras,
  • Fernanda Díaz-Casanova,
  • Michel Stéphane Heya

摘要

Introduction

Accurate bone age (BA) assessment is crucial in orthodontics for treatment planning. Current methods have limitations, including subjectivity or the need for additional radiation. A validated quantitative method for BA assessment using cervical vertebrae (CV) in the Mexican pediatric population is lacking.

Objective

To develop and validate a regression model for BA estimation using CV measurements in Mexican children and adolescents for timing orthodontic interventions and orthognathic surgical procedures.

Materials and Methods

A cross-sectional study was designed in order to generate a regression model (Group I: 1,000 cephalograms, 500 females, 500 males, 6–18 years) by measuring the height of C3 and C4 (h3, h4). The model was validated (Group II: 100 separate patients, 50 females, 50 males) by comparing Vertebral Bone Age (VBA) with Carpal Bone Age (CBA) assessed by Tanner-Whitehouse 3 (TW3). Intra-examiner reliability tests and statistical analyses were performed, such as Intraclass Correlation Coefficient (ICC), Mann-Whitney U, Pearson Correlation, Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and the Standard Error of the Estimate (SEE).

Results

ICC was > 0.95. The final model utilized h4: Females: VBA = 2.421 × h4 (R²adj = 0.821; SEE = 1.256 years); Males: VBA = 2.584 + (1.952 × h4) (R²adj = 0.797; SEE = 1.257 years). No significant differences were found between VBA and CBA (p > 0.05). VBA-CBA correlation was strong (Females: r = 0.807; Males: r = 0.816, p < 0.001). MAE: Females = 0.31 ± 1.50 years; Males = 0.18 ± 1.83 years. RMSE: Females = 1.52 years; Males = 1.82 years.

Conclusion

The novel C4-based model is a valid, objective, practical, and less invasive alternative for BA estimation in the studied Mexican pediatric population.