title: Comparison of three methods to assess individual skeletal maturity.
abstract: BACKGROUND
  The knowledge of facial growth and development is fundamental to determine the optimal timing for different treatment procedures in the growing patient.
  
  
  OBJECTIVE
  To analyze the reproducibility of three methods in assessing individual skeletal maturity, and to evaluate any degree of concordance among them.
  
  
  METHODS
  In all, 100 growing subjects were enrolled to test three methods: the hand-wrist, cervical vertebral maturation (CVM), and medial phalanges of the third finger method (MP3). Four operators determined the skeletal maturity of the subjects to evaluate the reproducibility of each method. After 30 days the operators repeated the analysis to assess the repeatability of each method. Finally, one operator examined all subjects' radiographs to detect any concordance among the three methods.
  
  
  RESULTS
  The weighted kappa values for inter-operator variability were 0.94, 0.91, and 0.90, for the WRI, CVM, and MP3 methods, respectively. The weighted kappa values for intra-operator variability were 0.92, 0.91, and 0.92, for the WRI, CVM, and MP3 methods, respectively.
  
  
  CONCLUSIONS
  The three methods revealed a high degree of repeatability and reproducibility. Complete agreement among the three methods was observed in 70% of the analyzed samples. The CVM method has the advantage of not necessitating an additional radiograph. The MP3 method is a simple and practical alternative as it requires only a standard dental x-ray device.
authors: Private practice, Milan, Italy.
authors: Enzo
authors: E
authors: Pasciuti
authors: Lorenzo
authors: L
authors: Franchi
authors: Tiziano
authors: T
authors: Baccetti
authors: Silvano
authors: S
authors: Milani
authors: Giampietro
authors: G
authors: Farronato
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000379:methods* / Q000706:statistics & numerical data*; D000465:Algorithms; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging*; D002648:Child; D005260:Female; D005384:Finger Joint / Q000000981:diagnostic imaging*; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D011857:Radiographic Image Interpretation, Computer-Assisted / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014955:Wrist Joint / Q000000981:diagnostic imaging*
references: Angle Orthod. 1966 Jan;36(1):44-54
references: 5218761
references: Prog Orthod. 2006;7(2):176-88
references: 17143345
references: Leg Med (Tokyo). 2011 May;13(3):120-33
references: 21377398
references: Acta Odontol Scand. 1980;38(3):179-86
references: 6932164
references: Angle Orthod. 1967 Apr;37(2):134-43
references: 4290545
references: J Clin Pediatr Dent. 1999 Fall;24(1):47-52
references: 10709543
references: J Indian Soc Pedod Prev Dent. 2010 Apr-Jun;28(2):95-9
references: 20660975
references: Am J Orthod. 1985 Nov;88(5):433-8
references: 3864376
references: J Clin Pediatr Dent. 2003 Winter;27(2):149-56
references: 12597687
references: Eur J Orthod. 2002 Jun;24(3):303-11
references: 12143094
references: Am J Orthod Dentofacial Orthop. 1998 Oct;114(4):427-9
references: 9790327
references: Am J Orthod Dentofacial Orthop. 2011 Aug;140(2):182-8
references: 21803255
references: Psychol Bull. 1968 Oct;70(4):213-20
references: 19673146
references: J Clin Orthod. 2002 Jul;36(7):398-406
references: 12165981
references: Am J Orthod Dentofacial Orthop. 2008 Aug;134(2):227-37
references: 18675204
references: Am J Orthod. 1980 Jan;77(1):79-91
references: 6928087
references: Am J Orthod Dentofacial Orthop. 2006 Nov;130(5):622-8
references: 17110259
references: Angle Orthod. 2006 Nov;76(6):984-9
references: 17090154
references: Aust Orthod J. 2003 Apr;19(1):25-32
references: 12790353
references: Angle Orthod. 2012 Nov;82(6):1123-31
references: 22417653
references: Angle Orthod. 2008 Jul;78(4):591-6
references: 18302455
references: Angle Orthod. 1988 Apr;58(2):179-84
references: 3164596
references: Prog Orthod. 2012 Sep;13(2):126-31
references: 23021115
references: Acta Odontol Scand. 1980;38(3):187-200
references: 6932165
references: Am J Orthod Dentofacial Orthop. 1995 Jan;107(1):58-66
references: 7817962
references: Angle Orthod. 2006 Jan;76(1):1-5
references: 16448261
references: Am J Orthod Dentofacial Orthop. 2006 Aug;130(2):131.e1-6
references: 16905053