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| Title |
Lateral Cephalometric Analysis and Facial Profile Analysis Usually Determine a Different Anterior-Posterior Orthodontic Skeletal Diagnosis |
| Clinical Question |
For patients receiving orthodontic treatment, does lateral cephalometric analysis as compared to facial profile analysis determine the same anterior-posterior orthodontic skeletal diagnosis? |
| Clinical Bottom Line |
For patients receiving orthodontic treatment, lateral cephalometric analysis as compared to facial profile analysis usually determines a different anterior-posterior orthodontic skeletal diagnosis. |
| Best Evidence |
(you may view more info by clicking on the PubMed ID link) |
| PubMed ID |
Author / Year |
Patient Group |
Study type
(level of evidence) |
| #1) 31730759 | Rasmussen/2020 | 51 Adult patients (30 females and 21 males, 21 years or older) | Case series | | Key results | The results of the study show that the same anterior-posterior orthodontic diagnosis was concluded using lateral cephalometric analysis and facial profile analysis 41% of the time in the maxilla and 45% of the time in the mandible. These results demonstrate a lack of agreement between lateral cephalometric analysis and facial profile analysis in determining anterior-posterior orthodontic diagnosis. | | #2) 30394163 | Ploder/2019 | 112 patients (65 females and 47 males, 27.7 ± 9.0 years) | Case series | | Key results | The results of this study demonstrate that the same anterior-posterior orthodontic diagnosis was determined using lateral cephalometric analysis and facial profile analysis 25% of the time in the maxilla and 44% of the time in the mandible. This shows a lack of agreement between lateral cephalometric analysis and facial profile analysis in determining anterior-posterior orthodontic diagnosis. | |
| Evidence Search |
((anterior posterior orthodontic diagnosis) AND (facial analysis)) AND (skeletal analysis) |
Comments on
The Evidence |
Validity:
Both articles studied a clearly focused issue. The samples were collected from clinics where the studies were done, so they may not be representative of the entire population of the United States; however, consecutive patients meeting the inclusion criteria were analyzed and that shows the authors’ intentions to eliminate bias.
The methods and results were clearly presented, with adequate sample sizes and appropriate use of statistical analysis. In both studies, objective measurements were used, and all measurements were performed by one examiner. Intra-examiner reliability was demonstrated; for example, Rasmussen randomly selected 10 samples and performed the measurements again after 2 weeks from the initial measurement; Ploder also repeated each measurement at three different times for 15 randomly selected samples.
Perspective:
Retrospective case series are low in the hierarchy of evidence and further research, preferably randomized controlled trials using a larger sample size are required to identify any correlation, if it exists, between the two different analyses in determining anterior-posterior orthodontic diagnosis. Another potential limitation of both studies was having only one examiner perform the measurements, which could be a source of bias. In future research, it would be recommended to include multiple examiners to perform the measurements. Additionally, using different anatomic landmarks could influence skeletal diagnosis; therefore, using landmarks that predict similar skeletal diagnosis may potentially help to standardize each analysis separately.
|
| Applicability |
Orthodontists use cephalometric analysis on a daily basis and mostly use skeletal landmarks to determine the anterior-posterior orthodontic diagnosis of patients. For a long time, orthodontic treatment planning was based mostly on the skeletal diagnosis determined by cephalometric analysis, which is based on population norms and may not necessarily apply to every individual. In contemporary orthodontics, however, more emphasis is placed on individualizing treatment planning to each patient in order to achieve favorable facial esthetics, balance, and harmony. This type of approach, relying on facial profile analysis, is not as objective when compared to traditionally used skeletal landmarks and is often subject to the clinician’s perspective. Orthodontic diagnosis determined by either analysis can affect the treatment approach and ultimately the outcome of treatment, so it should be more standardized. Since contemporary orthodontics focuses on facial esthetics as a primary outcome and since current literature demonstrates a lack of agreement between lateral cephalometric analysis and facial profile analysis in determining anterior-posterior orthodontic diagnosis, it would be beneficial to have future research focusing more on facial profile analysis and identifying objective landmarks to help standardize anterior-posterior orthodontic diagnosis. |
| Specialty/Discipline |
(Oral Surgery) (Orthodontics) |
| Keywords |
Facial profile analysis, lateral cephalometric analysis, anterior-posterior orthodontic diagnosis
|
| ID# |
3439 |
| Date of submission: |
11/23/2020 |
| E-mail |
heddaya@livemail.uthscsa.edu |
| Author |
Belal Heddaya, DDS |
| Co-author(s) |
Alexis Polczynski, DMD |
| Co-author(s) e-mail |
polczynski@livemail.uthscsa.edu |
| Faculty mentor/Co-author |
Ravikumar Anthony BDS, MDS, MS |
| Faculty mentor/Co-author e-mail |
anthonyr@uthscsa.edu |
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?) |
post a rationale |
| None available | |
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Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs) |
post a comment |
| None available | |
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