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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. 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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