Role of lateral cephalograms in assessing severity and difficulty of orthodontic cases

Citation
Ek. Pae et al., Role of lateral cephalograms in assessing severity and difficulty of orthodontic cases, AM J ORTHOD, 120(3), 2001, pp. 254-262
Citations number
17
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Dentistry/Oral Surgery & Medicine
Journal title
AMERICAN JOURNAL OF ORTHODONTICS AND DENTOFACIAL ORTHOPEDICS
ISSN journal
0889-5406 → ACNP
Volume
120
Issue
3
Year of publication
2001
Pages
254 - 262
Database
ISI
SICI code
0889-5406(200109)120:3<254:ROLCIA>2.0.ZU;2-#
Abstract
To assess the role of lateral cephalometric films in the evaluation of orth odontic patients, 16 certified orthodontists examined 80 sets of dental cas ts and lateral cephalograms. The patients included 5 subgroups: Class I wit h mild crowding, Class II Division 2, Class III, open bites, and bimaxillar y protrusion. A 5-point Visual Analogue Scale was used to assess the degree of severity and difficulty of each case, Severity was defined as the degre e of deviation from ideal occlusion, while difficulty was defined as the pr obability of attaining an ideal occlusion when all treatment options were a vailable. The examiner then chose one or more of the following treatment op tions: growth modification, extraction, nonextraction, and surgery. All exa miners scored the degree of severity and difficulty of each case with casts only at Time 1 (T1), then with casts and cephalograms at Time 2 (T2). The observed ratings from the Visual Analogue Scale were scored by using the Ra sch model, which transforms the nonlinear ordinal ratings to a linear inter val scale. Intersubgroup differences and differences between T1 and T2 diff iculty and severity were assessed by using a 5 x 2 repeated measures analys is of variance. A paired t test examined the amount and direction of the di fferences between T1 and T2 of each subgroup. Multiple contingency tables w ere used to compare treatment option changes between all subgroups at each time. Severity and difficulty scores highly correlated. Analysis of varianc e showed significant differences among subgroups for both severity and diff iculty; however, there were significant time differences for severity only. Paired t tests revealed a small increase in severity for the bimaxillary p rotrusive group and small but significant decreases for the subgroups Class II Division 2 and Class III when cephalograms were added. The multiconting ency table analysis demonstrated that a significant number of examiners did change their treatment options at T2 for bimaxillary protrusive, nonextrac tion, and Class II Division 2 patients. It was concluded that lateral cepha lometric films showed a significant influence on a clinician's determinatio n on severity of some types of orthodontic malocclusions.