{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T01:19:29Z","timestamp":1787620769850,"version":"build-2736575974"},"reference-count":20,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Developing methods that minimize radiation exposure in skeletal age assessment for orthodontic planning and growth monitoring in pediatric populations is a priority. This study aimed to evaluate the diagnostic efficacy of ultrasonography as a non-ionizing alternative in bone age estimation and to analyze the correlation between ultrasonographic skeletal maturation and chronological age.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this cross-sectional study, the left hand-wrist region of 131 individuals aged 8-18\u2009years was evaluated simultaneously using digital radiography and ultrasonography. Skeletal maturation was analyzed based on the epiphysis-diaphysis relationship of the phalanges and radius, the presence of sesamoid bone, and bone age estimation based on the Greulich-Pyle atlas. In addition, the ossification ratios (o\/O) of the distal radius and ulna were calculated. Friedman, Wilcoxon signed-rank, McNemar tests, and regression analyses were used to compare the data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A strong correlation was found between chronological age, ultrasonographic age, and radiographic age. Statistically significant differences were found between ultrasonography and radiography measurements in all middle phalanges (MP2-MP5), the distal phalanx of the fourth finger (DP4), the distal and proximal phalanges of the first finger (DP1, PP1), proximal phalanges of the second finger (PP2) and the radius (P\u2009&amp;lt;\u2009.05). A high correlation (r\u2009=\u20090.862) was observed between the 2 methods used to detect sesamoid bones. A strong positive correlation (rs \u2248 0.70) was observed between chronological age and ultrasonographic ossification rates; the explanatory power of radius and ulna measurements on age was 54%.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Ultrasonography shows a strong correlation with both chronological and radiographic age and demonstrates high efficacy in detecting sesamoid bones and monitoring ossification rates. Statistically significant differences have been found between radiographic examination and ultrasonography in evaluating the epiphysis-diaphysis relationship of the phalanges.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Advances in knowledge<\/jats:title>\n                    <jats:p>This research demonstrates that ultrasonography is a reliable, non-ionizing method for skeletal age assessment and shows significant diagnostic consistency across anatomical regions, similar to that of conventional radiography. Furthermore, it supports the clinical utility of ultrasonography as a reliable, radiation-free method and contributes to ongoing efforts to establish standardized, noninvasive assessment methods.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/dmfr\/twag058","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T12:52:56Z","timestamp":1786020776000},"source":"Crossref","is-referenced-by-count":0,"title":["Ultrasonographic assessment of pubertal maturation: a reliable and radiation-free model for bone age estimation"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1767-1383","authenticated-orcid":false,"given":"G\u00fcls\u00fcn","family":"Akay","sequence":"first","affiliation":[{"name":"Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University , Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00c7a\u011fr\u0131","family":"Erdo\u011fdu","sequence":"additional","affiliation":[{"name":"Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University , Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuray","family":"Ba\u011fc\u0131","sequence":"additional","affiliation":[{"name":"Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University , Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u00d6zge","family":"Karada\u011f Ata\u015f","sequence":"additional","affiliation":[{"name":"Department of Statistics, Faculty of Science, Hacettepe University , Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kahraman","family":"G\u00fcng\u00f6r","sequence":"additional","affiliation":[{"name":"Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Gazi University , Ankara, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"2026082420462728500_twag058-B1","doi-asserted-by":"publisher","first-page":"20170398","DOI":"10.1259\/dmfr.20170398","article-title":"Ultrasonography in determining pubertal growth and bone age","volume":"47","author":"Torenek A\u011f\u0131rman","year":"2018","journal-title":"Dentomaxillofac Radiol"},{"key":"2026082420462728500_twag058-B2","doi-asserted-by":"publisher","first-page":"1985","DOI":"10.3390\/children9121985","article-title":"Ultrasound imaging-based methods for assessing biological maturity during adolescence and possible application in youth sport: a scoping review","volume":"9","author":"R\u00fceger","year":"2022","journal-title":"Children (Basel)"},{"key":"2026082420462728500_twag058-B3","doi-asserted-by":"publisher","first-page":"e20171486","DOI":"10.1542\/peds.2017-1486","article-title":"Bone age: a handy tool for pediatric providers","volume":"140","author":"Creo","year":"2017","journal-title":"Pediatrics"},{"key":"2026082420462728500_twag058-B4","doi-asserted-by":"publisher","first-page":"143","DOI":"10.1297\/cpe.24.143","article-title":"Bone age: assessment methods and clinical applications","volume":"24","author":"Satoh","year":"2015","journal-title":"Clin Pediatr Endocrinol"},{"key":"2026082420462728500_twag058-B5","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1080\/00450618.2022.204343","article-title":"Is there any relationship between pubertal growth spurt and dental or bone age estimation methods?","volume":"55","author":"\u0130\u015fbilir","year":"2023","journal-title":"Australian J Foren Scie"},{"key":"2026082420462728500_twag058-B6","doi-asserted-by":"publisher","first-page":"1615923","DOI":"10.3389\/fped.2025.1615923","article-title":"Ultrasound-based bone age assessment in children and adolescents: a mini-review","volume":"13","author":"Zhang","year":"2025","journal-title":"Front Pediatr"},{"key":"2026082420462728500_twag058-B7","doi-asserted-by":"publisher","first-page":"136","DOI":"10.21037\/qims-2025-2009","article-title":"Preliminary study on ultrasound-based quantitative assessment of epiphyseal ossification angle for bone age evaluation in children","volume":"16","author":"Lin","year":"2026","journal-title":"Quant Imaging Med Surg"},{"key":"2026082420462728500_twag058-B8","doi-asserted-by":"publisher","first-page":"2878","DOI":"10.1016\/j.ultrasmedbio.2019.07.681","article-title":"Potential value of conventional ultrasound in estimation of bone age in patients from birth to near adulthood","volume":"45","author":"Wan","year":"2019","journal-title":"Ultrasound Med Biol"},{"key":"2026082420462728500_twag058-B9","doi-asserted-by":"publisher","first-page":"831","DOI":"10.1007\/s00414-013-0871-2","article-title":"Age dependence of epiphyseal ossification of the distal radius in ultrasound diagnostics","volume":"127","author":"Schmidt","year":"2013","journal-title":"Int J Legal Med"},{"key":"2026082420462728500_twag058-B10","doi-asserted-by":"publisher","first-page":"371","DOI":"10.11152\/mu-1604","article-title":"What\u2019s new in musculoskeletal ultrasound in pediatric rheumatology?","volume":"20","author":"Sp\u00e2rchez","year":"2018","journal-title":"Med Ultrason"},{"key":"2026082420462728500_twag058-B11","doi-asserted-by":"publisher","first-page":"1573","DOI":"10.1007\/s00414-021-02521-2","article-title":"Ultrasonographic assessment of ossification of the distal radial epiphysis for estimating forensic age","volume":"135","author":"Ekizoglu","year":"2021","journal-title":"Int J Legal Med"},{"key":"2026082420462728500_twag058-B12","doi-asserted-by":"publisher","first-page":"429","DOI":"10.1007\/s00247-004-1385-3","article-title":"Assessment of skeletal age at the wrist in children with a new ultrasound device","volume":"35","author":"Mentzel","year":"2005","journal-title":"Pediatr Radiol"},{"key":"2026082420462728500_twag058-B13","doi-asserted-by":"publisher","first-page":"134","DOI":"10.7416\/ai.2017.2140","article-title":"Radiological examinations in pediatric age","volume":"29","author":"Siciliano","year":"2017","journal-title":"Ann Ig"},{"key":"2026082420462728500_twag058-B14","doi-asserted-by":"publisher","first-page":"580314","DOI":"10.3389\/fped.2021.580314","article-title":"Evaluation of bone age in children: a mini-review","volume":"9","author":"Cavallo","year":"2021","journal-title":"Front Pediatr"},{"key":"2026082420462728500_twag058-B15","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1002\/ajpa.1330180309","article-title":"Variability in the order of ossification of the bony centers of the hand and wrist","volume":"18","author":"Garn","year":"1960","journal-title":"Am J Phys Anthropol"},{"key":"2026082420462728500_twag058-B16","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1097\/01241398-199301000-00015","article-title":"Skeletal age determination in young children: analysis of three regions of the hand\/wrist film","volume":"13","author":"Carpenter","year":"1993","journal-title":"J Pediatr Orthop"},{"key":"2026082420462728500_twag058-B17","doi-asserted-by":"publisher","first-page":"243","DOI":"10.1016\/j.jpeds.2008.08.018","article-title":"Application of ultrasound for bone age estimation in clinical practice","volume":"154","author":"Khan","year":"2009","journal-title":"J Pediatr"},{"key":"2026082420462728500_twag058-B18","doi-asserted-by":"publisher","first-page":"1351","DOI":"10.1007\/s00256-015-2175-8","article-title":"The utility of ultrasonographic bone age determination in detecting growth disturbances; a comparative study with the conventional radiographic technique","volume":"44","author":"Hajalioghli","year":"2015","journal-title":"Skeletal Radiol"},{"key":"2026082420462728500_twag058-B19","doi-asserted-by":"publisher","first-page":"683","DOI":"10.7863\/jum.2003.22.7.683","article-title":"Accuracy of skeletal age assessment in children from birth to 6 years of age with the ultrasonographic version of the Greulich-Pyle atlas","volume":"22","author":"Bilgili","year":"2003","journal-title":"J Ultrasound Med"},{"key":"2026082420462728500_twag058-B20","doi-asserted-by":"publisher","first-page":"152754","DOI":"10.1016\/j.aanat.2025.152754","article-title":"Prevalence, variability, and clinical anatomy of the sesamoid bones of the hand: a systematic review and meta-analysis","volume":"263","author":"Fibiger","year":"2026","journal-title":"Ann Anat"}],"container-title":["Dentomaxillofacial Radiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dmfr\/advance-article-pdf\/doi\/10.1093\/dmfr\/twag058\/70507065\/twag058.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dmfr\/advance-article-pdf\/doi\/10.1093\/dmfr\/twag058\/70507065\/twag058.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:46:31Z","timestamp":1787618791000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dmfr\/advance-article\/doi\/10.1093\/dmfr\/twag058\/8753155"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,6]]},"references-count":20,"URL":"https:\/\/doi.org\/10.1093\/dmfr\/twag058","relation":{},"ISSN":["0250-832X","1476-542X"],"issn-type":[{"value":"0250-832X","type":"print"},{"value":"1476-542X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,6]]},"article-number":"twag058"}}