Durão Ana Reis, Alqerban Ali, Ferreira Afonso Pinhão, Jacobs Reinhilde
a Invited Assistant, Department of Dental Radiology, Faculty of Dental Medicine, University of Porto, Portugal.
Angle Orthod. 2015 Mar;85(2):206-10. doi: 10.2319/011214-41.1. Epub 2014 Sep 5.
To evaluate the impact of additional lateral cephalometric radiography in orthodontic diagnosis and treatment planning.
Forty-three patients seeking orthodontic treatment, and for whom pretreatment diagnostic records were available, were randomly selected. Ten qualified orthodontists were involved in this study. The patients' records included three photographs of the angle trimmed dental casts, digital lateral cephalometric and panoramic radiographs, and standard clinical photographs comprising seven intra- and four extraoral pictures. Records were evaluated in two sessions. At the first session, orthodontists evaluated records without lateral cephalometric radiography (LCR). In the second session, the same information was presented, but with LCR. Between the two sessions the order in which the cases were presented was altered to avoid bias.
The percentage of agreement between sessions was lower for diagnosis than for treatment planning. Concerning skeletal classification, the least experienced orthodontist was the least consistent (28%), while the more experienced orthodontist was the more reliable (67%). In terms of treatment modalities, in general there was an agreement of 64%. The most frequent modifications in treatment modalities were seen in Class II malocclusion patients.
The results of our study suggest that the majority of Portuguese orthodontists judge that LCR is important to producing a treatment plan. Despite that, it does not seem to have an influence on orthodontic treatment planning.
评估额外的头颅侧位X线片在正畸诊断和治疗计划中的影响。
随机选取43例寻求正畸治疗且有治疗前诊断记录的患者。10名合格的正畸医生参与了本研究。患者的记录包括三张修整后的牙模照片、数字化头颅侧位片和全景X线片,以及包含七张口内和四张口外照片的标准临床照片。记录分两个阶段进行评估。在第一阶段,正畸医生在没有头颅侧位X线片(LCR)的情况下评估记录。在第二阶段,提供相同的信息,但有LCR。在两个阶段之间,病例呈现的顺序被改变以避免偏差。
诊断阶段的两次评估之间的一致性百分比低于治疗计划阶段。关于骨骼分类,经验最少的正畸医生一致性最低(28%),而经验更丰富的正畸医生更可靠(67%)。在治疗方式方面,总体上一致性为64%。治疗方式最常见的改变见于安氏II类错颌患者。
我们的研究结果表明,大多数葡萄牙正畸医生认为LCR对制定治疗计划很重要。尽管如此,它似乎对正畸治疗计划没有影响。