J Orthod. 2021 Jul 15:14653125211028862. doi: 10.1177/14653125211028862. Online ahead of print.
ABSTRACT
OBJECTIVE: To determine the degree to which the anteroposterior (AP) skeletal jaw relation can accurately be determined from a silhouetted clinical profile photograph and whether the level of agreement is influenced by patient vertical proportions.
DESIGN: Cross-sectional study.
SETTING: University Dental Hospital of Manchester, United Kingdom.
PARTICIPANTS: Specialist orthodontists.
METHOD: Eight specialist orthodontists assessed 37 silhouetted profile photographs of individuals aged 11-19 years and determined the class and severity of AP skeletal pattern. These assessments were compared to corresponding lateral cephalometric radiographs, where ANB values, supplemented by an Eastman Correction and a Wits Appraisal, where appropriate, were used for sagittal skeletal classification.
RESULTS: The agreement between silhouette and cephalometric AP determination yielded a weighted kappa score of 0.207 (95% confidence interval [CI] 0.135-0.278), which indicates only a fair level of agreement. The silhouetted sagittal skeletal pattern classification, along with severity, agreed with the lateral cephalometric radiograph in 29% of instances. Class III individuals were identified correctly 19.2% of the time. There was a statistically significant difference in kappa scores between the high angle (K= 0.439; 95% CI 0.310-0.568) and low angle (K = 0.068; 95% CI 0.007-0.130) patients (P < 0.001), as well as the high and average angle (K= 0.151; 95% CI 0.031-0.270) patients (P < 0.05).
CONCLUSION: AP skeletal pattern, as determined from a lateral cephalometric radiograph, has only a fair level of agreement to that from a silhouetted profile photograph. Vertical proportions were shown to have a significant effect on the determination of the sagittal skeletal pattern and class III skeletal patterns were shown to be the most difficult to identify from profile silhouettes.
PMID:34263691 | DOI:10.1177/14653125211028862
