Download Cervical vertebral maturation: radiologist vs orthodontist

Cervical vertebral maturation: radiologist vs orthodontist
Poster No.:
C-0521
Congress:
ECR 2013
Type:
Scientific Exhibit
Authors:
G. Di Grezia , L. Vecchione , G. Gatta , S. Cappabianca , R.
1
2 1
2
2
2
2
Grassi ; napoli/IT, Naples/IT
Keywords:
Patterns of Care, Physiological studies, Diagnostic procedure,
Conventional radiography, Pediatric, Head and neck
DOI:
10.1594/ecr2013/C-0521
Any information contained in this pdf file is automatically generated from digital material
submitted to EPOS by third parties in the form of scientific presentations. References
to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in
any way constitute or imply ECR's endorsement, sponsorship or recommendation of the
third party, information, product or service. ECR is not responsible for the content of
these pages and does not make any representations regarding the content or accuracy
of material in this file.
As per copyright regulations, any unauthorised use of the material or parts thereof as
well as commercial reproduction or multiple distribution by any traditional or electronically
based reproduction/publication method ist strictly prohibited.
You agree to defend, indemnify, and hold ECR harmless from and against any and all
claims, damages, costs, and expenses, including attorneys' fees, arising from or related
to your use of these pages.
Please note: Links to movies, ppt slideshows and any other multimedia files are not
available in the pdf version of presentations.
www.myESR.org
Page 1 of 6
Purpose
The purpose of this work is the determination of the reproducibility between two differently
specialized observers (i.e. one radiologist and one orthodontist) of cervical vertebrae
maturation-instead of hand wrist radiograph- as an indicator of skeletal maturation stages
in young patients of both genders undergoing orthodontic and dentofacial orthopedic
treatment.
Methods and Materials
Lateral cephalometric radiographs of 30 young subjects of both genders (16 females and
14 males) undergoing orthodontic and dento-facial orthopedic treatment were evalutated.
The patients evalutated were from 8 to 16 years old.
Cervical vertebrae maturation was evaluated with lateral cephalometric radiographs
including in the " six stages" of the method described by doctor Tiziano Baccetti and
collaborators in order to estimate cranio-facial and mandibular growth timing and velocity.
Each radiograph was separately analyzed by two differently specialized evaluators (one
radiologist and one orthodontist), who determined the skeletal maturation stage using the
references established by the authors.
The kappa statistic was used for the assessment of the interobserver agreement when
evaluating each cervical vertebrae morphology question for each subject.
Images for this section:
Page 2 of 6
Fig. 1: Six stages of cervical vertebrae maturation (Baccetti T et al.): CS1:Mandibular
peak will start in 2 years CS2:Mandibular peak will start in 1 year CS3:Mandibular
peak will happen during that year CS4:Mandibular peak has started 1-2 years ago
CS5:Mandibular peak has finished 1 year ago CS6:Mandibular peak has finished 2 years
ago
Fig. 2: Statistical correlation between radiologist and orthodontist as observer of Cervical
Vertebrae Maturation. Number of observed agreements: 93.55% of the observations
Kappa= 0.910 #SE of kappa = 0.062 #95% confidence interval: From 0.788 to 1.031
Page 3 of 6
Results
Agreement between radiologist and orthodontist was reported in 93.55% of cases and
the #number of agreements expected by chance was 8.9 (28.62% of the observations)
Intraobserver agreement was performed, and the degree of agreement was established
using the Kappa coefficient (95% CI). Very good agreement (Kappa: 0.910, SE of kappa
= 0.062 #95% confidence interval: From 0.788 to 1.031) was observed between the
evaluators.
Conclusion
The Baccetti method is generally recognized to be a very valid indicator of the skeletal
growth, providing information for the assessment of timing and velocity of growth
modification of the whole body and especially of cranio-facial and mandibular district
development.
This method presents also a very good agreement even if it's evaluated by different ( such
a radiologist and an orthodontist) observers.
The vantage of this method is to give information, with one only cranial radiographic
procedure, both about the cephalometric points of orthodontic interest both about the
skeletal maturation of the subject examinated.
Thus, it's so possible avoiding the need for other additional radiographic procedures in
the same subject (as, for example, the hand wrist radiograph) with conseguent less xray exposure in growing patients and less economical cost for the whole community.
Images for this section:
Page 4 of 6
Fig. 3: Cephalography showing in the same exam both points of orthodontic interest both
cervical vertebrae maturation.
Page 5 of 6
References
1. Gonzalez B. The cervical vertebrae maturation stage method. Int J Orthod Milwaukee
2012 Fall; 23(3):63-6
2. Shim JJ, Bogowicz P, Heo G, Lagravère MO Interrelationship and limitations of
conventional radiographic assessments of skeletal maturation. Int Orthod 2012 Jun; 10(2)
135-47
3. Baccetti T, Franchi L, McNamara JA An improved version of the cervical vertebral
maturation (CVM) method for the assessment of mandibular growth. Angle Orthod 2002
Aug; 72(4):316-23
Personal Information
Page 6 of 6