Pasciuti Enzo, Franchi Lorenzo, Baccetti Tiziano, Milani Silvano, Farronato Giampietro
Private practice, Milan, Italy.
J Orofac Orthop. 2013 Sep;74(5):397-408. doi: 10.1007/s00056-013-0164-x. Epub 2013 Aug 23.
The knowledge of facial growth and development is fundamental to determine the optimal timing for different treatment procedures in the growing patient.
To analyze the reproducibility of three methods in assessing individual skeletal maturity, and to evaluate any degree of concordance among them.
In all, 100 growing subjects were enrolled to test three methods: the hand-wrist, cervical vertebral maturation (CVM), and medial phalanges of the third finger method (MP3). Four operators determined the skeletal maturity of the subjects to evaluate the reproducibility of each method. After 30 days the operators repeated the analysis to assess the repeatability of each method. Finally, one operator examined all subjects' radiographs to detect any concordance among the three methods.
The weighted kappa values for inter-operator variability were 0.94, 0.91, and 0.90, for the WRI, CVM, and MP3 methods, respectively. The weighted kappa values for intra-operator variability were 0.92, 0.91, and 0.92, for the WRI, CVM, and MP3 methods, respectively.
The three methods revealed a high degree of repeatability and reproducibility. Complete agreement among the three methods was observed in 70% of the analyzed samples. The CVM method has the advantage of not necessitating an additional radiograph. The MP3 method is a simple and practical alternative as it requires only a standard dental x-ray device.
面部生长发育的知识对于确定生长发育期患者不同治疗程序的最佳时机至关重要。
分析三种评估个体骨骼成熟度方法的可重复性，并评估它们之间的一致性程度。
共纳入100名生长发育期受试者，以测试三种方法：手腕部、颈椎成熟度（CVM）和第三指中节指骨法（MP3）。四名操作人员确定受试者的骨骼成熟度，以评估每种方法的可重复性。30天后，操作人员重复分析以评估每种方法的重复性。最后，一名操作人员检查所有受试者的X光片，以检测三种方法之间的一致性。
手腕部、CVM和MP3方法的操作者间变异性的加权kappa值分别为0.94、0.91和0.90。手腕部、CVM和MP3方法的操作者内变异性的加权kappa值分别为0.92、0.91和0.92。
这三种方法显示出高度的重复性和可重复性。在70%的分析样本中观察到三种方法完全一致。CVM方法的优点是不需要额外的X光片。MP3方法是一种简单实用的替代方法，因为它只需要一台标准的牙科X光设备。
