The Journal of Contemporary Dental Practice

Register      Login



Volume / Issue

Online First

Related articles

VOLUME 14 , ISSUE 5 ( September-October, 2013 ) > List of Articles


Objective Evaluation of Cervical Vertebral Bone Age— Its Reliability in Comparison with Hand-Wrist Bone Age: By TW3 Method

Vamsi Nilay Reddy, Gojja Sreedevi, CMS Krishna Prasad, Swaroopa Rani Ponnada, K Padma Priya, B Raveendra Naik

Citation Information : Reddy VN, Sreedevi G, Prasad CK, Ponnada SR, Priya KP, Naik BR. Objective Evaluation of Cervical Vertebral Bone Age— Its Reliability in Comparison with Hand-Wrist Bone Age: By TW3 Method. J Contemp Dent Pract 2013; 14 (5):806-813.

DOI: 10.5005/jp-journals-10024-1407

Published Online: 01-10-2013

Copyright Statement:  Copyright © 2013; Jaypee Brothers Medical Publishers (P) Ltd.



The aim of this study was to establish the validity of a new method for evaluating skeletal maturation by assessing the 3rd and 4th cervical vertebrae seen in the cephalometric radiograph.

Materials and methods

This study consisted of a sample of 50 patients in the age group of 8 to 14 years of age. Chronologically, they were divided into six groups, based on the age consisting of a minimum of six to a maximum of 10 subjects. All the patients included in the study were females. The selected subjects were clinically examined and then age and date of birth of the patient in years and months was noted. Then lateral cephalograms and hand-wrist radiographs of the patient were taken on the same day with good clarity and contrast.


The results suggested that cervical vertebral bone age on cephalometric radiographs calculated with this method is as reliable at estimating bone age as is the Tanner-Whitehouse 3 (TW3) method on hand-wrist radiographs. By determining the cervical vertebral bone age, skeletal maturity can be evaluated in a detailed and objective manner with cephalometric radiographs.


The ability to accurately appraise skeletal maturity from cervical vertebral maturation, without the need for additional radiographs, has the potential to improve orthodontic diagnostic and therapeutic decisions. The technique's simplicity and ease of use should encourage this method as a first level diagnostic tool to assess skeletal maturation.

Clinical significance

This study revealed that the timing and sequence of ossification of the bones in hand and wrist and cervical vertebrae were able to relate the skeletal development of the various skeletal maturity indicators to a child's development. This method provided a mean with which one can determine the skeletal maturity of a person and thereby determine whether the possibility of potential growth existed.

How to cite this article

Prasad CMSK, Reddy VN, Sreedevi G, Ponnada SR, Priya KP, Naik BR. Objective Evaluation of Cervical Vertebral Bone Age—Its Reliability in Comparison with Hand-Wrist Bone Age: By TW3 Method. J Contemp Dent Pract 2013;14(5):806-813.

PDF Share
  1. Skeletal maturation in Indonesian and white children assessed with hand-wrist and cervical vertebrae method. Am J Orthod Dentofac Orthop 2008;134:217-226.
  2. Skeletal maturation evaluation using cervical vertebrae. Am J Orthod Dentofac Orthop 1995;107:58-66.
  3. The interrelationships among height, weight, and chronological, dental and skeletal ages. Angle Orthod 1961;31:189-193.
  4. Prediction of the timing of the adolescent growth spurt from ossification events in handwrist films. Br J Orthod 1979;6:145-152.
  5. Use of skeletal maturation based on hand-wrist radiographic analysis as a predictor of facial growth: a systemic review. Angle Orthod 2004;74:118-124.
  6. Radiographic evaluation of skeletal maturation a clinically oriented method based on hand-wrist films. Angle Orthod 1988;52:89-111.
  7. Carpal radiographs in orthodontic treatment. Am J Orthod Dentofac Orthop 1979;75:27-35.
  8. Skeletal ages of the hand and wrist as indicators of the pubertal growth spurt. Acta Odontal Scand 1980;38:187-200.
  9. The cervical vertebrae as maturational indicators. J Clin Ortho 1998;32:270-279.
  10. Skeletal age assessment utilizing cervical vertebrae. Pittsburgh: Masters thesis, University of Pittsburgh; 1972.
  11. A new method of predicting mandibular length increment on the basis of cervical vertebrae. Angle Orthod 2004;74:630-634.
  12. Tooth mineralization as an indicator of the pubertal growth spurt. Am J Orthod Dentofac Orthop 1980;77:79-91.
  13. Cervical vertebral bone age in girls. Am J Orthod Dentofacial Orthop 2002;122:380-385.
  14. Assessment of skeletal maturity and prediction of adult height (TW 3 method). 3rd ed. London: WB Saunders. 2001.p.58-104.
  15. Comparative evaluation of handwrist radiographs with cervical vertebrae for skeletal maturation in 10-12 years old children. J Indian Soc Pedod Prev Dent 2006;24(3):127-135.
  16. Early facial growth accelerations: a longitudinal study. Angle Orthod 1987;57: 50-62.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.