## 4 Discussion  
Following the analysis, within the group of females, out of 59 evaluations, in 53 cases we found a perfect concordance; in other words, within the group of females, in 53 cases out of the 59 analyzed evaluations the SMI and CVMS indexes showed the same pubertal stage. For the males, out of the 44 evaluations, 39 were in perfect concordance. The obtained values confirm the validity of the evaluated hypothesis, the data showing a better concordance in the case of testing the hypothesis on subjects with serial investigations than in the case of the subjects from the transversal study, this being probably due to the fact that the analyzed investigations belong to the same patient in the case of the longitudinal study. In the group of females, most discrepancies, two of each, were found at the beginning and the end of the pubertal period. The discrepancy between the pubertal and pre-pubertal stages may come from the estimation on the hand X-ray of the SMI 5 stage (indicating the pubertal stage), while the lateral cephalospor corresponds to the CVMS 1 or 2 stage (pre-pubertal stage). The discrepancy between the pubertal and post-pubertal stages is linked to the coexistence of the CVMS 4 stage (indicating the post-pubertal stage) on the lateral cephalogram with a SMI 7 stage (pubertal stage) estimated on the hand X-ray. In the case of the males, the main discrepancy appeared at the beginning of the pubertal stage. This originates in the co-existence of the CVMS 3 stage (indicating the pubertal stage) on the lateral cephalogram with the SMI 4 stage (pre-pubertal stage) on the hand and wrist X-ray. Out of the five discrepancies found, in four of them there was a co-existence of stages CVMS 3 and SMI 4. This fact strengthens the observation made in the transversal study as well, which states that for male, in some cases, the SMI 4 stage may correspond also to the period of maximum pubertal growth and not only to the pre-pubertal period. This fact is also confirmed by the study of [PERSON] and [PERSON], 1976, who found a correspondence between the period of maximum pubertal growth and the SMI 4 and 5 stages [1]. For both the female and the male, the discrepancies noticed were observed nearby the pubertal stage in the intermediary phases of the growth stages, when passing from the pre-pubertal stage to the pubertal stage and from the pubertal stage to the post-pubertal one. The main limitation of the study comes from the small number of participants, justified by the aim of reducing the radiation dosage to which the patient is exposed. When forming the group, a good homogeneity was sought in regards to the repartition of the SMI and CVMS stages. The study verifies the correspondence of the skeletal maturity index SMI and cervical vertebral maturation stage CVMS, by referring to the stages of the pubertal age, based upon the data quoted in the specialty literature. It would have been useful to have had a clinical evaluation of the stages of the pubertal age for the subjects in the group and to refer the SMI and CVMS indexes to these stages. The great variability of the chronologic age at which the stages of SMI and CVMS are reached as well as the recorded individual variability for reaching the pubertal period stages call for prudency in the interpretation of the results obtained.