The reliability of the Greulich and Pyle atlas when applied to a Southern Turkish population

Güngör, Özge; Çelikoğlu, Mevlüt; Kale, Burak; Gungor, Ahmet Yalcin; Sarı, Zafer

doi:10.4103/1305-7456.156846

Cited by 17 publications

(9 citation statements)

References 16 publications

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“…The subjects were classified into 3 growth periods: the pre-peak, peak, and post-peak growth periods, using handwrist maturation stages as determined by the Greulich-Pyle method 19. The pre-peak growth period was defined as the period when the epiphysis of the proximal phalanx of the index finger was of the same width as the diaphysis (PP2), when the epiphysis of the middle phalanx of the middle finger was of the same width as the diaphysis (Mp3), and by the first mineralization of the ulnar sesamoid bone (S).…”

Section: Methodsmentioning

confidence: 99%

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

Uslu-Akcam

2017

Imaging Sci Dent

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PurposeThis retrospective study aimed to evaluate the nasopharyngeal and oropharyngeal dimensions of individuals with skeletal class II, division 1 and division 2 patterns during the pre-peak, peak, and post-peak growth periods for comparison with a skeletal class I control group.Materials and MethodsTotally 124 lateral cephalograms (47 for skeletal class I; 45 for skeletal class II, division 1; and 32 for skeletal class II, division 2) in pre-peak, peak, and post-peak growth periods were selected from the department archives. Thirteen landmarks, 4 angular and 4 linear measurements, and 4 proportional calculations were obtained. The ANOVA and Duncan test were applied to compare the differences among the study groups during the growth periods.ResultsStatistically significant differences were found between the skeletal class II, division 2 group and other groups for the gonion-gnathion/sella-nasion angle. The sella-nasion-B-point angle was different among the groups, while the A-point-nasion-B-point angle was significantly different for all 3 groups. The nasopharyngeal airway space showed a statistically significant difference among the groups throughout the growth periods. The interaction among the growth periods and study groups was statistically significant regarding the upper oropharyngeal airway space measurement. The lower oropharyngeal airway space measurement showed a statistically significant difference among the groups, with the smallest dimension observed in the skeletal class II, division 2 group.ConclusionThe naso-oropharyngeal airway dimensions showed a statistically significant difference among the class II, division 1; class II, division 2; and class I groups during different growth periods.

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Section: Methodsmentioning

confidence: 99%

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

Uslu-Akcam

2017

Imaging Sci Dent

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“…A further limitation of the study is the failure to calculate the mean absolute and root mean square errors, which might have further confirmed the accuracy of the G&P atlas in relation to each population. However, the mean of each variable (BA and CA) was only available for 13 studies [18, 19, 24, 26–28, 35, 38, 49–53], and for these 13 studies, individual observations were not provided; therefore, the mean error could not be calculated.…”

Section: Discussionmentioning

confidence: 99%

Is the Greulich and Pyle atlas applicable to all ethnicities? A systematic review and meta-analysis

2019

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Objective To determine whether the Greulich and Pyle (G&P) atlas is applicable when applied to populations of different ethnicity. Methods A systematic review of studies published between 1959 and 15th February 2017 identified from the Embase, MEDLINE and Cochrane databases was undertaken. Quality of the studies was assessed using the National Institute for Health and Care Excellence tool. Meta-analysis used mean differences and standard deviations as summary statistics for the difference between bone age (BA) and chronological age (CA). Results A total of 49 studies were included of which 27 (55%) were related to Caucasian populations. Of the 49 eligible studies, 35 were appropriate for further meta-analysis. In African females, meta-analysis showed a significant mean difference between BA and CA of 0.37 years (95% CI 0.04, 0.69). In Asian males, meta-analysis showed significant differences between BA and CA of -1.08, -1.35, -1.07, -0.80 and 0.50 years for chronological ages of 6, 7, 8, 9 and 17 years, respectively. Meta-analysis showed no significant differences between BA and CA in African males, Asian females, Caucasians and Hispanics. Conclusions The G&P standard is imprecise and should be used with caution when applied to Asian male and African female populations, particularly when aiming to determine chronological age for forensic/legal purposes. Key Points • In African females, bone age is significantly advanced when compared to the G&P standard. • In Asian males, bone age is significantly delayed between 6 and 9 years old inclusive and significantly advanced at 17 years old when compared to the G&P standard. • The G&P atlas should be used with caution when applied to Asian and African populations, particularly when aiming to determine chronological age for forensic/legal purposes. Electronic supplementary material The online version of this article (10.1007/s00330-018-5792-5) contains supplementary material, which is available to authorized users.

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“…However, other authors recommend that the G&P atlas be used with reservation due to mean BA being retarded in some age groups compared to the reference population [29–32]. Common findings among these studies of the G&P atlas include underestimation of males aged below 13 years and overestimation during adolescence [30–36]. G&P was applicable to females during adolescence while overestimation was reported before the age of 12 years [31, 32].…”

Section: Discussionmentioning

confidence: 99%

“…G&P was applicable to females during adolescence while overestimation was reported before the age of 12 years [31, 32]. Others have recommended that a new standard altogether is required for precise bone age assessment, given the significant advancement of BA due to secular changes in skeletal maturation, which is thought to be due to improved standard of living [28, 30, 35, 36]. For example, Calfee et al reported that G&P overestimated males and females between 12 and 15 years old, for whom BA exceeded CA by at least 2 years [35].…”

Section: Discussionmentioning

confidence: 99%

Applicability of two commonly used bone age assessment methods to twenty-first century UK children

Alshamrani

Offiah

2019

Eur Radiol

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ObjectivesTo assess the effect of secular change on skeletal maturation and thus on the applicability of the Greulich and Pyle (G&P) and Tanner and Whitehouse (TW3) methods.MethodsBoneXpert was used to assess bone age from 392 hand trauma radiographs (206 males, 257 left). The paired sample t test was performed to assess the difference between mean bone age (BA) and mean chronological age (CA). ANOVA was used to assess the differences between groups based on socioeconomic status (taken from the Index of Multiple Deprivation).ResultsCA ranged from 2 to 15 years for females and 2.5 to 15 years for males. Numbers of children living in low, average and high socioeconomic areas were 216 (55%), 74 (19%) and 102 (26%) respectively. We found no statistically significant difference between BA and CA when using G&P. However, using TW3, CA was underestimated in females beyond the age of 3 years, with significant differences between BA and CA (− 0.43 years, SD 1.05, p = < 0.001) but not in males (0.01 years, SD 0.97, p = 0.76). Of the difference in females, 17.8% was accounted for by socioeconomic status.ConclusionNo significant difference exists between BoneXpert-derived BA and CA when using the G&P atlas in our study population. There was a statistically significant underestimation of BoneXpert-derived BA compared with CA in females when using TW3, particularly in those from low and average socioeconomic backgrounds. Secular change has not led to significant advancement in skeletal maturation within our study population.Key Points • The Greulich and Pyle method can be applied to the present-day United Kingdom (UK) population. • The Tanner and Whitehouse (TW3) method consistently underestimates the age of twenty-first century UK females by an average of 5 months. • Secular change has not advanced skeletal maturity of present-day UK children compared with those of the mid-twentieth century. Electronic supplementary materialThe online version of this article (10.1007/s00330-019-06300-x) contains supplementary material, which is available to authorized users.

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The reliability of the Greulich and Pyle atlas when applied to a Southern Turkish population

Cited by 17 publications

References 16 publications

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

Pharyngeal airway dimensions in skeletal class II: A cephalometric growth study

Is the Greulich and Pyle atlas applicable to all ethnicities? A systematic review and meta-analysis

Applicability of two commonly used bone age assessment methods to twenty-first century UK children

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