Sagittal Cephalometric Evaluation Without Point Nasion: Sagittal G-Triangle Analysis

Li, Boxiu; Zhang, Zhuomin; Xinping, Lin; Yan, Dong

doi:10.1097/scs.0000000000008290

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…Although unaffected by jaw rotations, it depends on point S, which has been deemed unstable by numerous studies [13]. Li et al (2022) introduced G triangle analysis as a method for evaluating sagittal relationships [18]. In contrast to the ANB angle, this approach does not incorporate the nasion point into the triangle construction.…”

Section: Discussionmentioning

confidence: 99%

A New Approach for the Assessment of True Maxillomandibular Sagittal Relationship: A Zeta Angle

Mohelay,

Dua,

Maqhbool

et al. 2024

Cureus

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Introduction: The assessment of sagittal skeletal dysplasia is crucial for accurate diagnosis and treatment planning, thus necessitating a thorough evaluation. A novel cephalometric parameter, known as the Zeta angle, was proposed in this study for the evaluation of the maxillomandibular relationship in the sagittal plane. Materials and methods: This observational study was carried out using 291 pre-treatment lateral cephalograms of participants aged between 15 and 25 years, categorized into skeletal class I, II, and III relationships based on Wits appraisal, ANB angle, and Beta angle. The individuals reported to the Department of Orthodontics from January 2021 to October 2023, Manav Rachna Dental College, Manav Rachna International Institute of Research and Studies, Faridabad. The Zeta angle was constructed using three skeletal reference points as point Pt (pterygoid), point M (center of premaxilla), and point Pm (suprapogonion) and was measured perpendicular to point M on the Pt-Pm line and the M-Pm line to determine the severity and type of maxillomandibular discrepancy in the sagittal plane. Statistical tests were used to obtain the mean values for the Zeta angle. Analysis of variance (ANOVA), followed by the Bonferroni post-hoc test, was used to assess skeletal differences between the groups. Receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of this angle. Results: The results indicated that a Zeta angle between 57° and 64° had a class I skeletal jaw pattern, a Zeta angle less than 57° indicated a class II skeletal jaw pattern, and a Zeta angle greater than 64° indicated a class III skeletal jaw pattern. ROC curves showed that a Zeta angle less than 57.5° had 80% sensitivity and 82.5% specificity in distinguishing class II from the class I subset. A Zeta angle greater than 64.5° has a sensitivity and specificity of 92.5% in distinguishing class III from the class I subset. Conclusion: The Zeta angle may serve as an additional diagnostic tool for the reliable determination of sagittal jaw relationships due to its establishment based on stable anatomical points, thus remaining unaffected by jaw rotations and orthodontic treatments.

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Section: Discussionmentioning

confidence: 99%

A New Approach for the Assessment of True Maxillomandibular Sagittal Relationship: A Zeta Angle

Mohelay,

Dua,

Maqhbool

et al. 2024

Cureus

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“…Because of the great variability observed in intracranial references, the description of measurements that are not influenced in any way by this variation is essential 13–15. .To do this, conducting diagnostic analyses with the patient in the Natural Head position is fundamental 14,16.…”

mentioning

confidence: 99%

“…11,12 Because of the great variability observed in intracranial references, the description of measurements that are not influenced in any way by this variation is essential. [13][14][15] .To do this, conducting diagnostic analyses with the patient in the Natural Head position is fundamental. 14,16 In such a manner, measurements can be generated related to the true horizontal and vertical planes that, therefore, are not influenced in any way by the variability of the structures of the craniofacial complex, nor by the changes that occur in them with age.…”

mentioning

confidence: 99%

Definition of New Three-Dimensional Cephalometric Analysis of Maxillomandibular Sagittal Relationship for Orthodontics and Orthognathic Surgery: Normative Data Based on 700 CBCT Scans

Ertty¹,

Méndez-Manjón

Haas

et al. 2023

Journal of Craniofacial Surgery

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The objective of the study was to define the norm of new 3-dimensional cephalometric analysis of maxillomandibular sagittal relationship with the patient in Natural Head Position. A cross-sectional study was performed using 700 consecutives cone beam computed tomography datasets of pre-orthodontic patients received for three-dimensional craniofacial analysis. To stablish the clinical norm of the new sagittal reference (linear distance A-B), the correlation with the gold standard (ANB angle) was estimated with the Pearson’s correlation coefficient. Subsequently, the prognostic values of the linear distance A-B was calculated to define the clinical norm. The sample was composed by 463 women (66.1%) and 237 men (33.9%). The mean age was 30 ± 14,5 years old (range 6–71 y old). According to the skeletal class classification (ANB), 46.1% (323) were class I, 42% (294) class II, and 11.9% (83) class III. The regression model found that each additional grade of the ANB angle imply a mean increase of 1.24 mm of the distance A-B (P<0.001). The normative value of the linear distance A-B was obtained through the prognostic values of the distance for the limits of the ANB norm 0 to 4. These values were on the range of 0.52 to 5.48 mm. Therefore, the clinical norm for cephalometric maxillomandibular sagittal relationship using linear distance from point A-B is: 3±2.48 mm. With this new approach, we can define the skeletal sagittal relationship of the patient in natural head position overcoming the limitations of using intracranial or occlusal plane references improving the diagnosis and orthognathic surgical planning process.

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Evaluating the accuracy of automated cephalometric analysis based on artificial intelligence

et al. 2023

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Background The purpose of this study was to evaluate the accuracy of automatic cephalometric landmark localization and measurements using cephalometric analysis via artificial intelligence (AI) compared with computer-assisted manual analysis. Methods Reconstructed lateral cephalograms (RLCs) from cone-beam computed tomography (CBCT) in 85 patients were selected. Computer-assisted manual analysis (Dolphin Imaging 11.9) and AI automatic analysis (Planmeca Romexis 6.2) were used to locate 19 landmarks and obtain 23 measurements. Mean radial error (MRE) and successful detection rate (SDR) values were calculated to assess the accuracy of automatic landmark digitization. Paired t tests and Bland‒Altman plots were used to compare the differences and consistencies in cephalometric measurements between manual and automatic analysis programs. Results The MRE for 19 cephalometric landmarks was 2.07 ± 1.35 mm with the automatic program. The average SDR within 1 mm, 2 mm, 2.5 mm, 3 and 4 mm were 18.82%, 58.58%, 71.70%, 82.04% and 91.39%, respectively. Soft tissue landmarks (1.54 ± 0.85 mm) had the most consistency, while dental landmarks (2.37 ± 1.55 mm) had the most variation. In total, 15 out of 23 measurements were within the clinically acceptable level of accuracy, 2 mm or 2°. The rates of consistency within the 95% limits of agreement were all above 90% for all measurement parameters. Conclusion Automatic analysis software collects cephalometric measurements almost effectively enough to be acceptable in clinical work. Nevertheless, automatic cephalometry is not capable of completely replacing manual tracing. Additional manual supervision and adjustment for automatic programs can increase accuracy and efficiency.

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Sagittal Cephalometric Evaluation Without Point Nasion: Sagittal G-Triangle Analysis

Cited by 3 publications

References 15 publications

A New Approach for the Assessment of True Maxillomandibular Sagittal Relationship: A Zeta Angle

A New Approach for the Assessment of True Maxillomandibular Sagittal Relationship: A Zeta Angle

Definition of New Three-Dimensional Cephalometric Analysis of Maxillomandibular Sagittal Relationship for Orthodontics and Orthognathic Surgery: Normative Data Based on 700 CBCT Scans

Evaluating the accuracy of automated cephalometric analysis based on artificial intelligence

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