The reproducibility of cephalometric measurements: a comparison of analogue and digital methods (original) (raw)
Related papers
International Journal of Morphology, 2020
The incisors are a key factor in dental occlusion and dentofacial aesthetics; therefore, the sagittal position and inclination of the incisors is a key parameter in diagnosis and orthodontic treatment planning. In some cases, the orthodontist will use more than one cephalometric analysis, and thus different results can be obtained. The aim of this study was to establish the diagnostic agreement among the different cephalometric measurements used to determine the anteroposterior position and the inclination of the incisors. Lateral cephalometric radiograms of patients between 18 and 59 years old were measured (n=260). Digital cephalometric measurements were made with Dolphin Imaging software, by a single calibrated operator. Here, a specific cephalometric analysis was designed in the software analysis editor. The results for each variable and each measurement were registered and compared. Fleiss's Kappa statistical tests, Cohen's Kappa, and Kendall's coefficient were used to determine the strength of agreement using the Minitab software. The results showed diagnostic strength agreement between slight and moderate among measurements of the same variable. This indicates that same diagnosis might not be obtained when using different approaches to measure the anteroposterior position and inclination of the incisors. It was concluded that there is a difference in the diagnosis between one measurement and another because the results showed slight or moderate strength of agreement. However, in some cases, better agreement was found when the measurements were compared as a function of the diagnostic response.
Assessing lower incisor inclination change: a comparison of four cephalometric methods
The European Journal of Orthodontics, 2015
Objective: Cephalometric inclination change of the lower incisors during orthodontics is used to assess treatment outcome. The lower border of the mandible is commonly used for measuring inclination change, despite it being subject to remodelling in growing patients. Superimposition of radiographs using Björk's 'stable structures' is intended to exclude these growth changes. We tested whether there is a significant difference for three commonly used methods to assess inclination change induced by orthodontic treatment (Me-Go, Go-Gn, the tangent to the lower border of the mandible) when comparing it to Björk's 'stable structures'. Methods: Björk's superimposition does not allow measuring incisor inclination changes directly; hence, one pre-and mid-treatment cephalogram of 39 growing orthodontic patients were superimposed in this retrospective study. The radiographs were taken at least 1 year apart (120 weeks; SD = 34.4). Patients undergoing growth modification treatment were excluded. Standardized cephalograms were hand traced and changes in lower incisor inclination, using the three mandibular planes, were compared to the changes obtained by anatomical superimposition of Björk's 'stable structures'. Results: Linear regression showed good intra-class correlation (ICC) between all methods. ICC was 0.96 for Me-Go, 0.94 for Go-Gn, and 0.92 for the lower border tangent. ICC for operator reliability was 0.99. Limitations: Measurement errors affect all investigations of both analogue and digital radiographs, but movement artefacts particularly apply to the latter. Cephalometry uses two-dimensional measurements of a three-dimensional subject, which can lead to further inaccuracies. These limitations have to be taken into account when interpreting the results of our investigation. Conclusion: Data obtained from Björk's superimposition did not vary significantly from the other more commonly used techniques (Me-Go, Go-Gn, and the tangent to the lower border of the mandible). Remodelling of the lower border of the mandible was insignificant for the time period investigated.
Is Incisor Location Similar for Study Models and Cephalogram ? ?-A Comparative Study
2014
BACKGROUND: Variations were observed when the same parameter was analyzed in different types of orthodontic diagnostic records affecting our diagnosis and treatment planning. We appraised the linear distance from most prominent point of upper and lower incisors to AB plane from standardized photograph of study models and compare with lateral cephalogram. MATERIALS AND METHODS: A total of 30 standardized photographs of study models and lateral cephalogram were obtained from patients who had full complement of teeth till permanent second molar's and incisors fully erupted. Patients with age group of 15 to 25 years and normal overjet and overbite of 2-4 mm were included. All the standardized photographs were loaded on a computer with Adobe photoshop and dolphin imaging solution 11.5. Incisor positions of upper and lower teeth were analyzed in relation to A-B Plane after calibrating the images. OBSERVATIONS: A mean value of 9.40 ± 2.48mm for position of upper central incisors and 2....
Applied Sciences
Before orthognathic surgery, a thorough diagnosis of the maxillofacial structure is performed for combined orthodontic–surgical treatment planning. One of the tools that are used for this collaboration is the cephalometric radiograph. Cephalometric analysis is a method for measuring the location of specific anatomical landmarks upon a cephalogram. Some of these parameters are more difficult to define accurately in cases of dentofacial deformities. Therefore, the data obtained from different examiners are characterized by high variability. The present study aimed to examine whether there is a significant variation in the physicians’ measurements between orthognathic Class I (normal) cases and the cases of skeletal deformity Class III. The study involved ten physicians with a mean age of 27. All physicians underwent appropriate instruction for reading and analyzing cephalometric radiographs, and all physicians were instructed about their role in the study. Each participant received 10...
International Journal of Applied Dental Sciences, 2020
Introduction: Tweed's cephalometric analysis has its beginning in clinical orthodontics where he found that the cases of malocclusion with pleasing outcome, harmonious profiles and stable occlusion following orthodontic treatment had a common consistent feature of occlusion: their mandibular incisors were upright on their skeletal bases. So the correct position of incisors is essential for achieving stable end results and establish harmony and balance of facial aesthetics. Aims and objectives: The purpose of this study was to evaluate the linear and angular position of mandibular incisors over the basal bone and their relationship with frankfort mandibular plane angle in different skeletal classes. Materials and Methods: A total of 60 lateral cephalograms in the age group of 18-30 years of Class I, Class II, Class III subjects were selected and traced as per inclusion criteria. All the linear and angular measurements were done in each group and their relationship and comparison was done in each group by using ANOVA test and Student's independent t-test. Results: Descriptive statistical analysis was first carried out to find the means of IMPA, FMA angle and lower incisor to A-pog distance. On doing intergroup comparison with ANOVA test and Student's independent t-test, statistically significant difference was found only in IMPA and lower incisor to A-pog line distance between Class I and III groups and Class II and Class III groups. Conclusion: There appears to exist a demonstrable relationship between the axial inclination of the mandibular incisors and the incisor mandibular plane angle, the greater the procumbency of the mandibular incisors, the greater the incisor mandibular plane angle in excess of 90 degree and vice versa. There also appears to exist a relationship between the incisor mandibular plane angle and the contour of the lower third of the face. The lower incisors tend to be more upright in subgroups with prognathic mandible than subgroups with normal or retrognathic mandible.
Comparison between cephalometrics measure using anatomic and metallic porion point
… Journal of Oral …, 2005
The aim of this study was to compare the cephalometric measures involving FMA (Frankfurt Mandibular Plane Angle), FMIA (Frankfurt Mandibular Incisor Angle), and occlusal plane angles (Frankfurt horizontal plane-occlusal plane) for cephalometric tracing by using anatomic and metallic porion points. Cephalometric tracing was performed in thirty head lateral teleradiographs divided into two groups. The anatomic porion point was marked in group 1, whereas metallic porion point was marked regarding the Frankfurt horizontal Plane (FHP). All measures were analysed. The mean values for FMA (32.33 o) and occlusal plane angles (10.77 o) in group 2 were statistically higher than those found in group 1 (FMA-27.57 o); occlusal plane angle-6.23 o). The mean value for FMIA angle (62.73 o) in group 1 was statistically higher when compared to group 2 (57,80°). According to these results, one can conclude that cephalometric tracing of porion points (either anatomic or metallic) alter the values for FMA, FMIA, and occlusal plane angles, thus resulting in different treatment plans.
Linear Mandibular Measurements: Comparison between Orthopantomograms and Lateral Cephalograms
The Cleft Palate-Craniofacial Journal, 2009
Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side ...
Cephalometric graphical evaluation of the exact location of transverse maxillofacial discrepancies
Otorhinolaryngology-Head and Neck Surgery, 2020
Objective: To develop and apply a novel diagnostic graphical model for analyzing frontal cephalometric radiographs to determine the exact location of a maxillofacial asymmetry. Material and methods: Standard frontal cephalometric radiographs of 64 patients with visible craniomandibular asymmetry were taken. Known cephalometric points were used and the midsagittal line was built using the Sassouni method. The evaluation of the grade of severity of the facial asymmetry is based on the research of Buranostidporn et al. To identify the exact location of the maxillofacial asymmetry, more bilateral points than the ones known from the literature are required. In order to determine the symmetry of a facial contour where there are no known bilateral points, we elaborated our own independent graphic model-the Concentric Arcs Method. Results: The analysis of our sample of patients with our own independent Concentric Arcs Method found that 51.5% of them have both mandibular and maxillary asymmetry, whereas 48.5% of the patients have only mandibular asymmetry. We evaluated the grade of severity of the facial asymmetry. We establish the distribution of the studied 64 patients, depending on the three degrees of facial asymmetry. Conclusion: The created graphic method and applied on frontal cephalometric radiographs estimates the exact location of facial asymmetry, facilitates determining whether the reason for these discrepancies is to be found in the maxilla and/or the mandible, and offers a basis for setting limit values of the severity degree of transverse maxillofacial discrepancies.