Multiple Regression Modeling for Age Estimation by Assessment and Comparison of Spheno-Occipital Synchondrosis Fusion and Cervical Vertebral Maturation Stages

Abstract

Objectives The aim of this study was (1) to evaluate the relationship between spheno-occipital synchondrosis (SOS) fusion stages, cervical vertebral maturation (CVM) stages, and clivus sizes with chronological age on cone-beam computed tomography (CBCT) images, and (2) to compare these methods for accurate age estimation using regression analysis. Materials and Methods The CBCT images of 200 individuals (102 females and 98 males) were included in the study. The SOS fusion stages and CVM stages were evaluated. The width and length of the clivus were measured. The effects of SOS fusion stages, CVM stages, clivus width, and clivus length on age estimation were evaluated by univariate tests and the effects of coexistence with ANCOVA and regression model. Spearman rank correlation analysis was also used to investigate the relationship between the SOS fusion stage, CVM stage, clivus width, and clivus length. Results The SOS stages, CVM stages, and clivus width were not shown statistically significant differences between the sexes (p-values = 0.205, 0.162, and 0.277, respectively), whereas clivus length was significantly longer in males (42.9 ± 4.26 mm) than in females (41.04 ± 3.74 mm). Multiple regression analysis showed 80% success when all parameters (SOS fusion stages, CVM stages, clivus width, and clivus length) were taken into consideration. Conclusion In conclusion, with the use of CVM stages and SOS fusion stages together, an accurate and reliable age estimation can be obtained in forensic medicine.

Characterization of Spheno-occipital Synchondrosis Fusion From Preadolescents to Young Adults Using Age and Cervical Vertebrae Maturation Index

“…Belgin et al 3 reported that the age difference between males and females increased gradually into 3.8 years by increase in the SOS fusion stage. However, in the present study, age differences between males and females showed a pattern of increase during the pubertal growth peak (1.5 y in stage 2, 1.8 y in stage 3, and 1.6 y in stage 4) and a decrease upon completion of the pubertal growth spurt (1.3 y in stage 5), which is similar to the results of the CVMI stage.…”

“…[1][2][3] The beginning of SOS fusion is known to be related to the start of pubertal growth in adolescents, and its late completion of ossification compared to other synchondroses in the cranial base can allow for the estimation of the skeletal maturation status. 1,[3][4][5][6][7][8][9] Because of the inherent limitations of 2-dimensional lateral cephalograms including the superimposition of adjacent structures, 3-dimensional (3D) computed tomography (CT), including multidetector CT (MDCT) or cone-beam CT (CBCT), has been used to classify the SOS fusion stage according to the radiopacity in SOS with 4-, 5-, or 6-stage scoring methods. 2,3,8,[10][11][12][13] Although SOS fusion is known to occur 1-3 years earlier in females than in males, the exact timing and pattern of SOS fusion are still controversial.…”

“…1,[3][4][5][6][7][8][9] Because of the inherent limitations of 2-dimensional lateral cephalograms including the superimposition of adjacent structures, 3-dimensional (3D) computed tomography (CT), including multidetector CT (MDCT) or cone-beam CT (CBCT), has been used to classify the SOS fusion stage according to the radiopacity in SOS with 4-, 5-, or 6-stage scoring methods. 2,3,8,[10][11][12][13] Although SOS fusion is known to occur 1-3 years earlier in females than in males, the exact timing and pattern of SOS fusion are still controversial. 1,2,6,[11][12][13][14][15] It is probably due to a difference in the inclusion and/or exclusion criteria, ethnic background, scoring methods, and individual variation.…”

“…The spheno-occipital synchondrosis (SOS) is a hyaline cartilaginous tissue in the cranial base located between the sphenoid bone and the occipital bone. It is considered a major growth center of the cranial base during the skeletal maturation process 1–3 . The beginning of SOS fusion is known to be related to the start of pubertal growth in adolescents, and its late completion of ossification compared to other synchondroses in the cranial base can allow for the estimation of the skeletal maturation status 1,3–9 …”