Diagnostic validity of different cephalometric analyses for assessment of the sagittal skeletal pattern

Abstract

Introduction: Numerous cephalometric analyses have been proposed to diagnose the sagittal discrepancy of the craniofacial structures. Objective: This study aimed at evaluating the reliability and validity of different skeletal analyses for the identification of sagittal skeletal pattern. Methods: A total of 146 subjects (males = 77; females = 69; mean age = 23.6 ± 4.6 years) were included. The ANB angle, Wits appraisal, Beta angle, AB plane angle, Downs angle of convexity and W angle were used to assess the anteroposterior skeletal pattern on lateral cephalograms. The sample was classified into Class I, II and III groups as determined by the diagnostic results of majority of the parameters. The validity and reliability of the aforementioned analyses were determined using Kappa statistics, sensitivity and positive predictive value (PPV). Results: A substantial agreement was present between ANB angle and the diagnosis made by the final group (k = 0.802). In the Class I group, Downs angle of convexity showed the highest sensitivity (0.968), whereas ANB showed the highest PPV (0.910). In the Class II group, ANB angle showed the highest sensitivity (0.928) and PPV (0.951). In the Class III group, the ANB angle, the Wits appraisal and the Beta angle showed the highest sensitivity (0.902), whereas the Downs angle of convexity and the ANB angle showed the highest PPV (1.00). Conclusion: The ANB angle was found to be the most valid and reliable indicator in all sagittal groups. Downs angle of convexity, Wits appraisal and Beta angle may be used as valid indicators to assess the Class III sagittal pattern.

Evaluation of Various Sagittal Cephalometric Measurements in Skeletal Class I Individuals with Different Vertical Facial Growth Types

“…In addition, Sundareswaran and Kumar's study evaluating the differences in the Beta angle between different malocclusion groups also reported that the Beta angle had higher values in HA cases, a finding that supports the results of our study (24). Similar to previous studies (9,21), it was determined that there are significant negative correlations between the ANB angle and Beta, W and Yen angles in both the total sample and each vertical face type. In a study conducted by Alhammadi et al, the Beta angle does not differ in individuals with Class I malocclusion and different vertical facial types (12).…”

“…Previous studies conducted among various populations examined the relationships between the Wits measurement and the ANB, Beta, Yen and W angles, but did so using only sagittal evaluations (9)(10)(11)(12)(13)(14). No study has shown the relationship between these angles according to different growth types of the face in the vertical dimension.…”

“…They are therefore more sensitive to the changes in the vertical dimension of the jaws used in a McNamara cephalometric evaluation (7). On the other hand, the use of the Beta angle, Yen angle and W angle, which are considered alternatives to the aforementioned measurements, has increased in recent years (4)(5)(6)(9)(10)(11)(12)(13)(14). However, it has long been known that orthodontic malocclusions arising from the difference in the lower and upper jaw positions occur effectively in all three planes (15).…”

Evaluation of Diagnostic Agreement Among Cephalometric Measurements for Determining Incisor Position and Inclination

“…Thus, their conclusions may not be representative. A study by Ahmed et al (2018) assessed the strength of agreement among cephalometric measurements for determining the maxillo-mandibular sagittal relationship. They used a similar methodology than used in the present GÓMEZ-MEDINA, I. P.; AGUILAR-PÉREZ, D. A.; COLOMÉ-RUÍZ, G. E.; ZÚÑIGA-HERRERA, I. D.; ESCOFFIÉ-RAMÍREZ, M.; HERRERA-ATOCHE, J. R.; RODRÍGUEZ-CHÁVEZ, J. A.…”

Accuracy of different cephalometric analyses in the diagnosis of class III malocclusion in Saudi and Yemeni population

“…A study conducted by Ahmed et al . [ 21 ] in 2018 concluded that in the class III group, the ANB angle, Wits appraisal, and Beta angle can be used to accurately assess the sagittal growth pattern of the individual. In the present study, PPV was used to confirm if a particular cephalometric analysis can accurately identify the class III malocclusion.…”