Diagnostic accuracy of intraoral photographic orthodontic records

Abstract

Objective The aims of this study were (1) to investigate how relevant intraoral photographs are to contemporary orthodontic diagnosis and (2) to assess orthodontists' ability to accurately diagnose angle classification and dental midlines using standardized intraoral photographs. Methods Study participants were orthodontists who completed a survey regarding photography protocols and their use of intraoral photographs for diagnosis. Each participant was randomized to complete 1 visual diagnostic task regarding either angle classification or midlines. Accuracy was compared across groups and camera angulations. Results In all, 80% of 192 respondents reported using photographs and clinic notes to plan orthodontic treatment; 50% also included dental casts. For the angle task, accuracy judging molar and canine classification was 79.9% and 51.3%, respectively with ideal standardized photographs. As camera angulation deviated, accuracy decreased significantly (P < 0.0001). For the midline task, accuracy judging the direction of deviation decreased with a small camera angulation change yet increased with a large change (P < 0.001). Conclusions When using ideal intraoral photographs alone to diagnose angle classification and midline relationships, accuracy is not likely to be greater than 80%. As camera angulation becomes less ideal, by 15 degrees when judging angle classification or 4 degrees when judging midlines, accuracy is likely to significantly decrease. Clinical significance For the clinician who wants to have the most accurate and complete records, our results suggest that intra‐oral photos alone may not be adequate when it comes to judging occlusal relationships such as angle classification and esthetic parameters like midlines. When using ideal intraoral photographs to diagnose angle classification and midline relationships, accuracy is not likely to be greater than 80%. As camera angulation becomes less ideal, by as little as 15 degrees when judging angle classification or 4 degrees when judging midlines, accuracy is likely to decrease significantly. Understanding these limitations will allow clinicians to improve both their clinical photography technique and their diagnostic skills.

Assessment of Handicapping Labio‐Lingual Deviation index scoring methods and their effect on orthodontic treatment coverage by Medicaid

“…Our results support previous studies, which reported that two‐dimensional digital images are an alternative to orthodontic casts for assessing orthodontic treatment needs by the Index of Orthodontic Treatment Need [22]. However, another study reported that intrasoral photos alone might not be adequate for judging occlusal relationships such as angle classification and esthetic parameters like midlines [23].…”

Revised FDI criteria for evaluating direct and indirect dental restorations—recommendations for its clinical use, interpretation, and reporting

“…When color matching has to be evaluated, visual examination is the method of choice. In addition, intraoral photographs can be used but are also difficult to standardize during follow-up examinations [105,106]. In contrast, commercially available color measuring instruments, e.g., reflectance spectrophotometers and colorimeters, have gained acceptance due to their satisfactory accuracy, reliability, and time-efficient use [86,[107][108][109].…”

Comparative evaluation of malocclusions using digital intraoral photography and conventional examination methods: A tele dentistry approach in orthodontics

“…Evidence showed that the possibility of an inaccurate diagnosis of Angle's classification increases seven times when the angle bias is 30 degrees. [20] As the camera perspective changed and ideal photographic conditions were not possible, photographs failed to simulate clinical situations; therefore, the accuracy of Angle's classification diagnosis decreased. However, as the deviation of perspective from the perpendicular degree increased, the apparent lateral distance amplified, and a correct evaluation of the dental arch's space relationship would be more straightforward.…”