ArticleInternational journal of legal medicine2026
Quantitative insights into cranial fusion: fractal dimension analysis of spheno-occipital synchondrosis.
Article in International journal of legal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveChronological age is not always a reliable indicator of skeletal maturity. The Spheno-Occipital Synchondrosis (SOS), a key growth center of the cranial base, has been qualitatively linked to age. This study introduces fractal dimension (FD), a quantitative metric derived from fractal analysis (FA), to assess SOS fusion and its correlation with age using cone beam computed tomography (CBCT) images.
methodsIn this retrospective cross-sectional study, 102 CBCT scans (ages 6-22) were analyzed. SOS fusion stages were classified qualitatively and evaluated quantitatively via FD using ImageJ software. Inter- and intra-observer reliability, correlation between FD and age, and diagnostic performance via ROC analysis were assessed.
resultsFD significantly declined with age (males: r = -0.66; females: r = -0.80; p < 0.001). FD differed significantly across SOS fusion stages and age groups (p < 0.001), with gender-specific patterns in intermediate stages. Regression analysis demonstrated FD as a significant age predictor (R² = 0.44 for males, R² = 0.64 for females). ROC analysis showed excellent-to-outstanding diagnostic accuracy (AUC: 0.815 for males; 0.945 for females) in distinguishing legal age thresholds.
conclusionFractal dimension analysis of the SOS on CBCT offers a reliable, reproducible, and objective method for age estimation. FD provides quantifiable insight into cranial base maturation, supporting its application in orthodontic planning and forensic age assessment.
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