title: Reliability of skeletal maturity analysis using the cervical vertebrae maturation method on dedicated software.
abstract: OBJECTIVE
  The aim of this study was to assess the feasibility of skeletal maturation analysis using the Cervical Vertebrae Maturation (CVM) method by means of dedicated software, developed in collaboration with Outside Format (Paullo-Milan), as compared with manual analysis.
  
  
  METHODS
  From a sample of patients aged 7-21 years, we gathered 100 lateral cephalograms, 20 for each of the five CVM stages. For each cephalogram, we traced cervical vertebrae C2, C3 and C4 by hand using a lead pencil and an acetate sheet and dedicated software. All the tracings were made by an experienced operator (a dentofacial orthopedics resident) and by an inexperienced operator (a student in dental surgery). Each operator recorded the time needed to make each tracing in order to demonstrate differences in the times taken.
  
  
  RESULTS
  Concordance between the manual analysis and the analysis performed using the dedicated software was 94% for the resident and 93% for the student. Interobserver concordance was 99%. The hand-tracing was quicker than that performed by means of the software (28 seconds more on average).
  
  
  CONCLUSIONS
  The cervical vertebrae analysis software offers excellent clinical performance, even if the method takes longer than the manual technique.
authors.affiliation: Via Emilia Est 181, 41121 Modena, Italy. Electronic address: savy_pada@yahoo.it.
authors.forename: Saverio
authors.initials: S
authors.lastname: Padalino
authors.affiliation: Department of Orthodontics, University of Pavia, Piazzale Golgi, 27100 Pavia, Italy.
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Sfondrini
authors.affiliation: Via Gressoney 11, 11026 Pont-Saint-Martin (AO), Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Chenuil
authors.affiliation: Clinical Epidemiology and Biometrics, Fondazione IRCCS Policlinico San Matteo, Piazzale Golgi 2, 27100 Pavia, Italy.
authors.forename: Luigia
authors.initials: L
authors.lastname: Scudeller
authors.affiliation: Department of Orthodontics, University of Pavia, Piazzale Golgi, 27100 Pavia, Italy.
authors.forename: Paola
authors.initials: P
authors.lastname: Gandini
mesh_terms: D000293:Adolescent; D000365:Age Determination by Skeleton / Q000706:statistics & numerical data*; D002508:Cephalometry / Q000706:statistics & numerical data; D002574:Cervical Vertebrae / Q000254:growth & development*; D002648:Child; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data; D008297:Male; D015588:Observer Variation; D015203:Reproducibility of Results; D012984:Software; D013997:Time Factors; D055815:Young Adult
keywords: CVM method; Cervical vertebrae; Manual analysis; Skeletal maturity; Software