Effect of cephalograms on decisions for early orthodontic treatment

Ritschel, Robert; Bechtold, Till Edward; Berneburg, Mirjam

doi:10.2319/021113-124.1

Cited by 6 publications

(8 citation statements)

References 17 publications

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“…Exclusion of the LCR did not influence the orthodontic treatment decision of extraction, which is rather an irreversible decision. This recognition corresponds with previous studies [ 6 , 11 , 14 , 16 ]. The contribution of the LCR to orthodontic decision making, as one of the essential orthodontic diagnostic materials might be questionable [ 5 , 6 ].…”

Section: Discussionsupporting

confidence: 93%

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Influence of Lateral Cephalometric Radiographs on Orthodontic Treatment Planning of Class II Patients

Stupar¹,

Yetkiner

Wiedemeier

et al. 2018

TODENTJ

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Background:Lateral Cephalometric Radiographs (LCR) are a common decision-making aid in orthodontic treatment planning and are routinely used in clinical practice. The aim of this present study was to test the null hypothesis that LCR evaluation does not alter specific components of orthodontic treatment planning in Class II patients.Materials and Methods:Records of 75 patients, who had been treated at the Department of Orthodontics, Centre of Dental Medicine, University of Zurich comprised the study material. Inclusion criteria were: (1) adolescents between the age of 12-15, (2) permanent dentition with Class II buccal segment relationship (3) absence of craniofacial and dento-alveolar malformations. Fifteen orthodontists from the dental faculties of Istanbul University, Istanbul and Ege University, Izmir filled out Likert-type linear scale questionnaires without knowing that they would repeat the same procedure with and without LCRs at two different time points. Equivalence and clinical relevance were assessed using (%95 CI) Wilcoxon signed rank tests.Results:Extraction decision did not differ between groups (p=0.68). Preference of functional appliance use (p=0.006) and inter-maxillary fixed functional appliance (p=0.043) was different among groups.Conclusion:LCR evaluation has minor influence on treatment planning procedure of Class II patients. It might be beneficial to consider its prescription not in a routine manner but as a supplementary tool considering possible reduction of radiation exposure.

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Section: Discussionsupporting

confidence: 93%

“…LCR seemed to have a higher impact on diagnosis than on treatment planning [ 6 ]. On the contrary, it was reported that clinical examination and dental casts might be sufficiently informative to estimate future skeletal development under certain circumstances [ 6 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Influence of Lateral Cephalometric Radiographs on Orthodontic Treatment Planning of Class II Patients

Stupar¹,

Yetkiner

Wiedemeier

et al. 2018

TODENTJ

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“…The results of this study revealed limited disagreements for treatment modality preferences and no disagreement for extraction decision when the LCRs were omitted. This is in accordance with previous studies questioning the benefit of routine LCR prescription (4)(5)(6)(7). This outcome may lead us to a possible assumption that the routine prescription of the three sets of LCRs may not be due to actual need but as a result of the orthodontist's training.…”

Section: Discussionsupporting

confidence: 74%

“…It provides linear and angular associations for sagittal and vertical levels of facial bone structures but does not comprise the transversal dimension or function -in other words, the third dimension (1,2). This drawback has led to the questioning of routine prescription and interpretation of LCR regarding its influence on specific malocclusions (3)(4)(5)(6)(7).…”

Section: Introductionmentioning

confidence: 99%

Influence of Lateral Cephalometric Radiography on Treatment Planning and Preferences in Skeletal Open-Bite Patients: Do Lateral Cephalograms Influence Treatment Planning?

et al. 2017

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Objective: To investigate the influence of diagnostic data derived from lateral cephalometric radiographs (LCR) on treatment preferences of specialists planning skeletal open-bite treatment.Methods: Diagnostic records of 25 patients who had been treated at the University of Zurich, Department of Orthodontics, between 1988 and 2007 comprised the study material. Inclusion criteria were 1) skeletal open-bite with no marked antero-posterior discrepancy, 2) dental open-bite, and 3) crowding less than 5 mm. Records consisted of extra-intraoral photographs, panoramic-cephalometric X-rays, casts, and results of analyses. Records, with cephalograms of randomly chosen patients removed, were digitally presented to two orthodontists (A and B), and treatment preferences were asked using Likert-type questionnaires. Three months later, the same records were redelivered with missing cephalograms provided and present cephalograms removed with the questionnaire. Data were evaluated for consistency and tendency to extract using Kappa-κ and McNemar tests. Results:Orthodontist B had no poor-agreement scores, whereas orthodontist A presented very-poor agreement for headgear use. Both A (κ=0.833) and B (κ=0.737) had good to very-good agreement in terms of extraction decisions. Neither orthodontist had any significant tendency for extraction/non-extraction therapy (A=0.99; B=0.5). Conclusion:Information deduced from LCRs had limited influence on treatment planning preferences in skeletal/dental open-bite patients with no marked antero-posterior discrepancy and no influence on extraction/non-extraction decision.

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“…On the other hand, the methods that use radiographs have the advantage of measuring unerupted teeth, and provide more accurate results, but the patient is exposed to ionizing radiation, and it requires additional radiographs, which implicates financial costs 12 . Huckaba 9 (1964) developed a method for overcoming the effect of radiographic distortions while measuring the permanent canines and premolars MD width, using an equation relating the measures of erupted teeth to their radiographic images in order to obtain the proportional dimensions of unerupted teeth, as follows:…”

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confidence: 99%

Evaluation of two methods for mixed dentition analysis using the method error

et al. 2014

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The most commonly used tests to assess the mesiodistal width of the unerupted permanent canines and premolars are divided in two groups: those performed directly on plaster models, using mathematical equations that can generate tables, and those using radiographs. Aim: In order to determine the reliability between two of these methodologically different method, this study evaluated the systematic and random errors of the method proposed by Tanaka and Johnston, which is based on the sum of mandibular permanent incisors, and the Huckaba method, which uses radiographs. Methods: In a random sample of 28 plaster models of mandibular dental arches belonging to individuals of both genders, aged six to eleven years old, a single investigator performed the measurement of required space, according to the two methods evaluated. After 15 days, the measurements were repeated, and each of them was performed twice in sequence to calculate the repeatability and reproducibility conditions, and the systematic and random errors for each method. Results: The random error of the method proposed by Huckaba was larger in terms of reproducibility (1.53 mm) and repeatability (0.57 mm) compared with the analysis proposed by Tanaka and Johnston (0.20 mm and 0.12 mm, respectively). Conclusions: The method proposed by Huckaba was proved to be inadequate in relation to reproducibility, with respect to the random error, and should be used with caution to measure the required space in the mandibular arch.

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Effect of cephalograms on decisions for early orthodontic treatment

Cited by 6 publications

References 17 publications

Influence of Lateral Cephalometric Radiographs on Orthodontic Treatment Planning of Class II Patients

Influence of Lateral Cephalometric Radiographs on Orthodontic Treatment Planning of Class II Patients

Influence of Lateral Cephalometric Radiography on Treatment Planning and Preferences in Skeletal Open-Bite Patients: Do Lateral Cephalograms Influence Treatment Planning?

Evaluation of two methods for mixed dentition analysis using the method error

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