Abstract
The research aims to verify the concordance between the skeletal maturity index (SMI) measured on the hand and wrist X-rays using Fishman method and the cervical vertebral maturation stage (CVMS), measured on the lateral cephalometric X-rays using Baccetti method. The concordance of the two indexes (SMI and CVMS) has been statistically verified with the help of the Cohen’s kappa coefficient, by relating them to the growth stages, within a longitudinal study done upon a group of 38 patients, 22 female and 16 male, aged between 8–18 y, the analyzed investigations being done in series, along the orthodontic treatment. The research showed a strong correlation between the SMI and CVMS indexes within the analyzed group, confirmed by the obtained values (k = 0.84 for female and k = 0.85 for male).
Highlights
The individual growth variations, observed at patients with the same chronological age, for both sexes, within the same family and even at dizygotic twins, led to the developing of the concept of biological age, which defines the path followed until reaching the individual maturity
To assess the intra-operator repeatability, the collected data was checked by using the Cohen Kappa coefficient and the results obtained by the two measurements, done successively, one month apart by the same examiner under identical conditions, showed a perfect or almost perfect concordance (k = 0.972 for the skeletal maturity index SMI and k = 0.955 for the cervical vertebral maturation stage CVMS), which allowed the data to be used within the study
Within the group of females, out of 59 evaluations, in 53 cases we found a perfect concordance; in other words, within the group of females, in 53 cases out of the 59 analyzed evaluations the SMI and CVMS indexes showed the same pubertal stage
Summary
The individual growth variations, observed at patients with the same chronological age, for both sexes, within the same family and even at dizygotic twins, led to the developing of the concept of biological age, which defines the path followed until reaching the individual maturity.Out of all the indicators of the biological age, the skeletal age is considered by most authors as having the best accuracy. On the other hand, estimating the skeletal age by using the development of the cervical vertebrae is a rather recent method, compared to the use of the hand and wrist X-rays. This method gained many supporters, the motive of its popularity being the fact that the interpretation is being done on the lateral cephalogram, a routine investigation within the orthodontic treatment, requiring no additional exposure of the patients to any other X-rays [6,7]. Due to the popularization of the evaluation methods of the skeletal age through the analysis of the cervical vertebrae on the lateral cephalograms, the doctors’ interest in the analysis of the cervical region on lateral X-rays increased. Given the context of the existing correlation between malocclusion development at the level of the dento-maxillary apparatus and the development of the cervical vertebrae, there rises the legitimate question whether the CVMS indexes keep their validity during the orthodontic treatments that aim to correct the dentomaxillary anomalies
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