Diagnostic methods for assessing maxillary skeletal and dental transverse deficiencies: A systematic review

Abstract

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.

Dentofacial transverse development in Koreans according to skeletal maturation: A cross-sectional study

“…Current studies are investigating cone-beam computed tomography (CBCT) images for diagnostic superiority over the conventional 2D imaging using posteroanterior radiographs. 30 However, the use of CBCT as a standard diagnostic tool for growing patients may face ethical challenges associated with unnecessary radiation exposure. Furthermore, the cross-sectional design of our study and the assessment of subjects in a one-time frame inevitably included individual growth variations that should be considered during interpretation of descriptive data and comparisons between consecutive SMI stages.…”

ENPP1 and ESR1 genotypes associated with subclassifications of craniofacial asymmetry and severity of temporomandibular disorders

“…42 Cone-beam computed tomography (CBCT) images are considered more reliable for diagnosis of asymmetry, but there is insufficient evidence to conclude that CBCT is superior to PA celphalgrams for detecting transverse facial differences. 43 We routinely use PA cephalograms in surgical treatment planning of patients and attempt to minimize head rotation around the vertical Z-axis where the majority of projection error occurs 44 . A second potential error is landmark identification due to unclear radiographic representation of anatomical locations.…”

Cephalometric and Pharyngometric Evaluation in Snoring Children with Sleep-Disordered Breathing and Adenotonsillar Hypertrophy Under an Orthodontic or Orthopedic Treatment

“…Dental examination: Maxillary arch constriction was defined by the presence of two or more maxillary posterior teeth in an edge-to-edge cuspal relationship with their antagonists or crossbite and based on the Korkhaus index for maxillar arch constriction. 24 Class II malocclusion was present when the inferior molar was positioned posterior to the upper molar cuspid reference. 25 Cephalometric evaluation: All assessments were performed by the same operator who was blinded to the study in the Department of Radiology of HC-FMUSP.…”