Inter-examiner reliability of cervical vertebral maturation staging in different skeletal malocclusions: a retrospective study

Aim: This study aimed to assess the inter-examiner and intra-examiner reliability of cervical vertebrae maturation (CVM) staging in different skeletal malocclusions. Methods:A total of 720 lateral cephalometric radiographs were collected from the clinic of the orthodontic department at Mansoura University. The age of the patients ranges from 8-18. The cephalometric radiographs were traced manually and independently by a consensus of 3 experienced examiners. Cephalograms were classified into six cervical stages for CVM classification according to McNamara's criteria. Images were also categorized into Class I, Class II, and Class III patterns according to the ANB angles. To assess inter-examiner and intra-examiner reliability, 180 cephalograms were manually traced and assessed independently by 2 examiners. Intraclass correlation coefficients and weighted kappa were used to evaluate the reproducibility of the measurements.Results: The interobserver reliability for CVM staging showed a perfect agreement between the two examiners, with a weighted Kappa of 0.93. Moreover, the intraobserver reliability for the CVM method for the 2 examiners was described as perfect agreement (κw = 0.96 and κw = 0.97). Both results were statistically significant (p < .001).Conclusion: The study demonstrated perfect interexaminer and intraexaminer agreement for the CVM staging, hence supporting the method's reliability and therapeutic applicability.