ObjectiveTo evaluate the accuracy and reliability of the diagnostic tools available for assessing maxillary transverse deficiencies.MethodsAn electronic search of three databases was performed from their date of establishment to April 2015, with manual searching of reference lists of relevant articles. Articles were considered for inclusion if they reported the accuracy or reliability of a diagnostic method or evaluation technique for maxillary transverse dimensions in mixed or permanent dentitions. Risk of bias was assessed in the included articles, using the Quality Assessment of Diagnostic Accuracy Studies tool-2.ResultsNine articles were selected. The studies were heterogeneous, with moderate to low methodological quality, and all had a high risk of bias. Four suggested that the use of arch width prediction indices with dental cast measurements is unreliable for use in diagnosis. Frontal cephalograms derived from cone-beam computed tomography (CBCT) images were reportedly more reliable for assessing intermaxillary transverse discrepancies than posteroanterior cephalograms. Two studies proposed new three-dimensional transverse analyses with CBCT images that were reportedly reliable, but have not been validated for clinical sensitivity or specificity. No studies reported sensitivity, specificity, positive or negative predictive values or likelihood ratios, or ROC curves of the methods for the diagnosis of transverse deficiencies.ConclusionsCurrent evidence does not enable solid conclusions to be drawn, owing to a lack of reliable high quality diagnostic studies evaluating maxillary transverse deficiencies. CBCT images are reportedly more reliable for diagnosis, but further validation is required to confirm CBCT's accuracy and diagnostic superiority.

Objective: To provide a synthesis of the published studies evaluating the natural growth and development of the human posterior cranial base (S-Ba). Materials and Methods: The search was performed on MEDLINE, Embase, PubMed, and all EBM Reviews electronic databases. In addition, reference lists of the included studies were handsearched. Articles were included if they analyzed posterior cranial-base growth in humans specifically. Study selection, data extraction, and risk of bias assessment were completed in duplicate. A meta-analysis was not justified. Results: Finally, 23 published studies were selected: 5 cross-sectional and 18 cohort studies. Articles were published between 1955 and 2015, and all were published in English. The sample sizes varied between 20 and 397 individuals and consisted of craniofacial measurements from either living or deceased human skulls. Validity of the measurements was not determined in any of the studies, while six papers reported some form of reliability assessment. All the articles included multiple time points within the same population or data from multiple age groups. Growth of S-Ba was generally agreed to be from spheno-occipital synchondrosis growth. Basion displaced downward and backward and sella turcica moved downward and backward during craniofacial growth. Timing of cessation of S-Ba growth was not conclusive due to limited identified evidence. Conclusions: Current evidence suggests that S-Ba is not totally stable, as its dimensions change throughout craniofacial growth and a minor dimensional change is observed even in late adulthood.

Background:Three-dimensional cephalometric analyses are getting more attraction in orthodontics. The aim of this study was to compare two softwares to evaluate three-dimensional cephalometric analyses of orthodontic treatment outcomes.Materials and Methods:Twenty cone beam computed tomography images were obtained using i-CAT® imaging system from patient's records as part of their regular orthodontic records. The images were analyzed using InVivoDental5.0 (Anatomage Inc.) and 3DCeph™ (University of Illinois at Chicago, Chicago, IL, USA) software. Before and after orthodontic treatments data were analyzed using t-test.Results:Reliability test using interclass correlation coefficient was stronger for InVivoDental5.0 (0.83-0.98) compared with 3DCeph™ (0.51-0.90). Paired t-test comparison of the two softwares shows no statistical significant difference in the measurements made in the two softwares.Conclusions:InVivoDental5.0 measurements are more reproducible and user friendly when compared to 3DCeph™. No statistical difference between the two softwares in linear or angular measurements. 3DCeph™ is more time-consuming in performing three-dimensional analysis compared with InVivoDental5.0.

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