Comparison of three methods to assess individual skeletal maturity

Area of Science:

• Orthodontics and Dentofacial Orthopedics
• Pediatric Dentistry
• Radiology

Background:

• Understanding facial growth and development is crucial for timing orthodontic treatments in pediatric patients.
• Accurate assessment of skeletal maturity guides intervention timing for optimal treatment outcomes.
• Several methods exist to determine skeletal maturity, but their reliability needs evaluation.

Purpose of the Study:

• To assess the reproducibility and repeatability of three skeletal maturity assessment methods.
• To evaluate the concordance between the hand-wrist, cervical vertebral maturation (CVM), and medial phalanges of the third finger (MP3) methods.
• To determine the clinical utility of different skeletal maturity indicators.

Main Methods:

• 100 growing subjects were analyzed using hand-wrist (WRI), CVM, and MP3 methods.
• Four operators assessed skeletal maturity to evaluate inter-operator reproducibility.
• Repeatability was assessed by operators re-analyzing radiographs after 30 days.
• Concordance among the three methods was evaluated by a single operator.

Main Results:

• All three methods demonstrated high inter-operator reproducibility (weighted kappa: 0.90-0.94).
• High intra-operator repeatability was observed for all methods (weighted kappa: 0.91-0.92).
• Complete agreement among the WRI, CVM, and MP3 methods was found in 70% of cases.

Conclusions:

• The hand-wrist, CVM, and MP3 methods are highly repeatable and reproducible for assessing skeletal maturity.
• The CVM method offers convenience by not requiring an additional radiograph.
• The MP3 method is a practical alternative using standard dental radiography equipment.