title: Comparative study between the hand-wrist method and cervical vertebral maturation method for evaluation skeletal maturity in cleft patients.
abstract: OBJECTIVE
  To test the measure of agreement between use of the Skeletal Maturation Index (SMI) method of Fishman using hand-wrist radiographs and the Cervical Vertebral Maturation Index (CVMI) method for assessing skeletal maturity of the cleft patients.
  
  
  METHODS
  Hand-wrist and lateral cephalometric radiographs of 60 cleft subjects (35 females and 25 males, age range: 7-16 years) were used. Skeletal age was assessed using an adjustment to the SMI method of Fishman to compare with the CVMI method of Hassel and Farman. Agreement between skeletal age assessed by both methods and the intra- and inter-examiner reliability of both methods were tested by weighted kappa analysis.
  
  
  RESULTS
  There was good agreement between the two methods with a kappa value of 0.80 (95% CI = 0.66-0.88, p-value <0.001). Reliability of intra- and inter-examiner of both methods was very good with kappa value ranging from 0.91 to 0.99.
  
  
  CONCLUSIONS
  The CVMI method can be used as an alternative to the SMI method in skeletal age assessment in cleft patients with the benefit of no need of an additional radiograph and avoiding extra-radiation exposure. Comparing the two methods, the present study found better agreement from peak of adolescence onwards.
authors.affiliation: Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Thailand. monman@kku.ac.th
authors.forename: Montian
authors.initials: M
authors.lastname: Manosudprasit
authors.affiliation: Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Thailand.
authors.forename: Tasanee
authors.initials: T
authors.lastname: Wangsrimongkol
authors.affiliation: Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Thailand.
authors.forename: Poonsak
authors.initials: P
authors.lastname: Pisek
authors.affiliation: Department of Orthodontics, Faculty of Dentistry, Khon Kaen University, Thailand.
authors.forename: Melissa
authors.initials: M
authors.lastname: Chantaramungkorn
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton; D000367:Age Factors; D001846:Bone Development / Q000502:physiology*; D002508:Cephalometry; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000254:growth & development*; D002648:Child; D002971:Cleft Lip / Q000150:complications / Q000000981:diagnostic imaging*; D002972:Cleft Palate / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D050276:Hand Bones / Q000000981:diagnostic imaging / Q000254:growth & development*; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D013785:Thailand