Classical and modern methods for the assessment of skeletal maturation and pubertal growth spurt

Abstract

The assessment of skeletal age is of utmost importance not only in the field of anthropology, forensic medicine, pediatrics, endocrinology but also in orthodontics and jaw orthopedics. Bone age refers to the individual's biological development which can differ within a relatively wide range for the same chronological age. Therefore, accurate assessment of skeletal maturity and pubertal growth plays an important role in establishing a diagnosis for certain diseases. In addition, it is essential for proper timing and success of treatments in many cases. Currently, there are many methods available to determine skeletal age and pubertal growth spurt. During growth, bones undergo significant changes, the sequence of which is strongly determined. These changes can be measured by various methods including radiological examinations. More specifically, these classical methods are often based on the radiological evaluation of morphological changes in the hand bones and cervical vertebrae. Methods based on dental development also exist to assess the biologic maturity of an individual. However, thanks to three-dimensional imaging techniques and molecular diagnostic methods, even more accurate tests can be performed to determine biological maturity. These modern methods rely on the information obtained from the cone-beam computer tomograph records and on the measurements of biomarkers present in different circulatory or other body fluids. The purpose of this summary is to provide an overview of the various classical and modern methods for the assessment of skeletal age that could aid us in many fields of science. Orv Hetil. 2018; 159(35): 1423-1432.