Does clinical experience affect the reproducibility of cervical vertebrae maturation method?
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Updated: Apr 18, 2026
Precision Measurements and Parametric Models of Vertebral Endplates
Published on: September 17, 2019
Roberto Rongo1, Rosa Valleta2, Rosaria Bucci3
1a Postdoctoral student, School of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples Federico II, Napes, Italy.
Objective:
To assess interobserver and intraobserver reproducibility of the cervical vertebrae maturation method (CVMM) among three panels of judges with different levels of orthodontic experience (OE).
Materials And Methods:
Fifty individual lateral cephalograms of good quality with complete visualization of cervical vertebrae 1 to 4 were selected. Thirty clinicians, divided according to their OE into three groups (junior group, JU, OE ≤ 1 year; postgraduate group, PG, 2 ≤ OE ≤ 4 years; specialist group, SP, OE ≥ 7 years), evaluated the cephalograms in two sessions (T1 and T2) at 3 weeks apart. Kendall's W and weighted Cohen's kappa (κ) coefficients were performed to assess interobserver and intraobserver agreement. The level of significance was set as P < .05. For both the interobserver and the intraobserver datasets, the percentage of perfect agreement (PPA) and the number of stages apart for each disagreement were calculated.
Results:
Kendall's W at T1 was SP = 0.61, PG = 0.70, and JU = 0.87; at T2 it was SP = 0.78, PG = 0.85, and JU = 0.86. The percentage of total interobserver perfect agreement (Inter-PPA) was 42.3% at T1 and 46.3% at T2. The JU group had the highest Cohen's κ coefficient at 0.78, while the PG and SP had coefficients of 0.64 each. The percentage of total intraobserver perfect agreement (Intra-PPA) was 54.2%.
Conclusions:
The reproducibility of the method was not improved by the level of orthodontic experience. The group with the lowest level of orthodontic experience had the best performance.
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