Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.

The aim of this study was to systematically review the existing scientific literature and evidence about (a) the validation of masseter muscle ultrasonography for accurate assessment of muscle thickness and (b) the reproducibility of masseter muscle thickness measures. An electronic literature search was conducted using determined keywords on specific databases. Preliminary search revealed 298 articles listed in Medline, Scopus and Web of Science. 60 duplicates were rejected, leaving 238 articles for review. After reading titles and abstracts, 31 articles remained. 23 articles were assessed for eligibility. These articles were categorized as follows: thickness, cross-section, volume and the length of the masseter muscle measured by ultrasonography. It is possible to verify the thickness of the masseter muscle in males and females in relaxation (10-15 and 9-13 mm, respectively) and contraction (14-19 and 12-15 mm, respectively). A similar tendency can also be evidenced in other measurements. Many studies evaluate masseter muscle dimensions to relate it to cephalometric analysis as such to evaluate morphological variations. It can be concluded that ultrasound is a reliable clinical tool for masseter muscle measurements, yet there is a need for standardization of methods and parameters to be recorded.

PurposeThe aim this study was to compare the accuracy of orthodontists and dentomaxillofacial radiologists in identifying 17 commonly used cephalometric landmarks, and to determine the extent of variability associated with each of those landmarks.Materials and MethodsTwenty digital lateral cephalometric radiographs were evaluated by two groups of dental specialists, and 17 cephalometric landmarks were identified. The x and y coordinates of each landmark were recorded. The mean value for each landmark was considered the best estimate and used as the standard. Variation in measurements of the distance between landmarks and measurements of the angles associated with certain landmarks was also assessed by a subset of two observers, and intraobserver and interobserver agreement were evaluated.ResultsIntraclass correlation coefficients were excellent for intraobserver agreement, but only good for interobserver agreement. The least reliable landmark for orthodontists was the gnathion (Gn) point (standard deviation [SD], 5.92 mm), while the orbitale (Or) was the least reliable landmark (SD, 4.41 mm) for dentomaxillofacial radiologists. Furthermore, the condylion (Co)-Gn plane was the least consistent (SD, 4.43 mm).ConclusionWe established that some landmarks were not as reproducible as others, both horizontally and vertically. The most consistently identified landmark in both groups was the lower incisor border, while the least reliable points were Co, Gn, Or, and the anterior nasal spine. Overall, a lower level of reproducibility in the identification of cephalometric landmarks was observed among orthodontists.

The results of our study suggest that the majority of Portuguese orthodontists judge that LCR is important to producing a treatment plan. Despite that, it does not seem to have an influence on orthodontic treatment planning.

No abstract

SkullAccuracy Reliability a b s t r a c t Objectives: To evaluate the accuracy of two-dimensional (2D) cephalometric analysis when compared to "gold standard" measurements on skulls. Also to appraise the reliability of 10 linear measurements commonly used in 2D lateral cephalometric analysis.Methods: Twenty dry human skulls and its digital lateral cephalometric images of were taken.The skulls were positioned in an aluminum filter box to mimic soft tissue attenuation.Ten linear measurements were performed both in skulls and radiographs by 2 observers (experienced dentomaxillofacial radiologists). The same procedure was repeated twice, with 1 month interval, to allow calculation of the intra-and inter-observer variability.Results: Statistically significant differences were found between cephalometric and direct craniometric measurements. In general, measurements were on average lower in skulls with exception of three that were on average significantly higher (Co-Gn, Go-Me, Co-ANS). When a bilateral landmark was included, measurements were significantly higher. Furthermore, no significant differences were observed between measurements by the two observers (p < 0.05).Conclusion: Radiographic linear measurements systematically overestimated the direct linear measurements performed on the skulls. However, differences found were most often <1 mm, which is generally within one standard deviation of "normal" values in conventional cephalometric analysis. It is assumed that such differences are often clinically acceptable, yet further studies are encouraged to evaluate the impact on cephalometry-based therapy planning. 136 r e v p o r t e s t o m a t o l m e d d e n t c i r m a x i l o f a c . 2 0 1 4;5 5(3):135-141 Fiabilidade da análise cefalométrica em 2D em ortodontia Palavras-chave: Cefalometria Ortodontia Radiografia Crânio Precisão Fiabilidade r e s u m oObjectivos: Para avaliar a precisão da análise cefalométrica bidimensional (2D) quando comparada com as mediç ões de "padrão ouro" em crânios. Também para avaliar a fiabilidade de dez mediç ões lineares, normalmente usadas na análise cefalométrica lateral 2D.Métodos: Vinte crânios humanos secos e foram tiradas fotografias da sua cefalometria lateral digital. Os crânios foram colocados numa caixa do filtro de alumínio para simular a atenuação de tecidos moles. Foram realizadas dez mediç ões lineares em ambos os crânios e radiografias por 2 observadores (radiologistas dento-maxilo-faciais experientes). O mesmo procedimento foi repetido duas vezes, com 1 mês de intervalo, para permitir o cálculo da variabilidade inter e intraobservadores.Resultados: Foram encontradas diferenças estatisticamente significativas entre as mediç ões cefalométrica e directa craniométrica. Em geral, as mediç ões foram, em média, inferiores em crânios, com a excepção de três que foram, em média, significativamente superiores (Co-Gn, Go-Me, Co-ANS). Quando foi incluído um marco bilateral, as mediç ões foram significativamente superiores. Além disso, não foram encontradas diferenças significativ...

<p>Central giant cell granulomas (CGCG) are benign intraosseous proliferative lesions. Usually located are at the anterior region of the maxilla or mandible, although are more frequently found in the mandible. Etiopathogenesis of these lesions has remained unknown, however, some consider them as reparative response rather than neoplastic condition. Clinically CGCG present as asymptomatic, with expansive swelling causing deviation or proliferation of cortical bone. This condition is usually unifocal. Surgical removal is often the preferred treatment. Although nonsurgical treatment methods, such as intralesional corticosteroid injections, systemic calcitonin and interferon have been reported. This article describes the radiographic features of a large CGCG in the anterior mandibular region seen in a 9 year-old patient. Treatment of this lesion included resection of the anterior region of the mandible and replacement by tibia with bone growth factors.</p><p> </p><p><strong>Keywords</strong>: Central giant cell granuloma; reparative granulomas; mandible; jaws.</p><p><strong> </strong></p>

The objective this study was to determine mean values of masseter muscle thickness in male and female, at rest and contraction, in healthy individuals.At first, 102 questionnaires were distributed between students. Thirty patients were selected, 15 male and 15 female, according to the inclusion criteria, excluding all individuals with symptoms of temporo-mandibular dysfunction or syndromes with craniofacial disorders. Masseter muscle thickness was determined bilaterally, at rest and contraction. As a reference point for the measurement of thickness (axial plane), the posterior prolongation of the labial commissure was used. Normality values of the masseter muscle in females were 11.75 ± 1,14 mm in contraction and 10.19 ± 1.04 mm in relaxation; and in the male were 13.95 ± 1.62 mm in contraction and 11.64 mm ± 1.68 mm in relaxation.The results obtained are in agreement with those described in the literature. Demonstrating the accuracy and reproductibility of the ultrasound if a protocol is applied, mainly aimed at controlling the pressure applied by the transducer.