Assessment of agreement between cervical vertebrae skeletal and dental age estimation with chronological age in an Indonesian population

Age estimation significantly contributes to forensic medicine and law enforcement in Indonesia. However, lateral cephalometric radiographs of cervical vertebrae have not been used to estimate age in the Indonesian population. This study developed a formula to estimate the skeletal age of cervical vertebrae using multiple linear regression analyses, estimating the dental age and evaluating the agreement between cervical vertebrae skeletal-chronological, dental-chronological, and cervical vertebrae skeletal-dental ages. Several anatomical parameters were measured to obtain cervical vertebrae ratios from 100 lateral cephalometric radiographs, and followed by the calculation of dental tooth crown index data from 100 panoramic radiographs of subjects 9–18 years old. The Bland-Altman plot of cervical vertebrae skeletal and dental ages showed a mean difference of-0.094 ± 1.52 years, with upper and lower limits of 2.882 and-3.070 years, respectively. The means of the cervical vertebrae skeletal, dental, and chronological ages were 13.97 (2.67), 14.06 (2.45), and 13.97 (2.97), respectively. The mean differences between cervical vertebrae skeletal-chronological and dental-chronological ages were 0.566 (2.26) and 4.005 (2.07), respectively. Furthermore, a validation trial (group 2, n = 10, three males and seven females) was conducted to test the accuracy of the cervical vertebrae skeletal age estimation formula using consecutive sampling. The age range was 9–11 years. Cervical vertebrae skeletal age showed a better agreement with chronological age than did dental age.