Ulkur Feyza, Ozdemir Fulya, Germec-Cakan Derya, Kaspar E Cigdem
Lecturer, Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
Associate professor, Department of Orthodontics, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey.
Am J Orthod Dentofacial Orthop. 2016 Aug;150(2):324-31. doi: 10.1016/j.ajodo.2016.01.016.
It is important to reduce the method errors when evaluating posteroanterior cephalograms to see either small deviations from normal or transverse changes caused by orthodontic treatment. The aim of this study was to determine horizontal and vertical intraexaminer and interexaminer agreement in localization of landmarks in posteroanterior cephalograms of adult patients.
The sample was gathered retrospectively from the archives of the Department of Orthodontics of Yeditepe University in Istanbul, Turkey. Radiographs of 39 patients diagnosed with skeletal asymmetries (20 women, 19 men) were drawn manually, and a coordinate system was established with software. The tracings were made by 2 operators, after a calibration session on 29 landmarks (22 bilateral, 7 midline). Intraclass correlation coefficients and the Bland-Altman test were used for detecting interexaminer and intraexaminer agreement for each cephalometric variable.
The interexaminer agreement test showed that the most problematic landmark was crista galli, which showed moderate consistency between 2 examiners in the y coordinates at 2 time points. Condylar and zygomatic landmarks showed good agreement. The greater wing inferior and superior orbit, maxillary point, menton, anterior nasal spine, antegonial notch, mandibular and maxillary molar point, maxillary and mandibular incisor point, and maxillary and mandibular incisor edge landmarks had excellent agreement between the 2 examiners at the 2 time points in both the x and y coordinates.
There are fewer errors in intraexaminer than in interexaminer correlations in landmark identifications on posteroanterior radiographs. All landmarks investigated except crista galli showed good agreement between measurements.
在评估正位头颅侧位片时，减少方法误差对于观察与正常情况的微小偏差或正畸治疗引起的横向变化至关重要。本研究的目的是确定成年患者正位头颅侧位片中标志点定位的水平和垂直方向上的检查者内和检查者间一致性。
样本是从土耳其伊斯坦布尔耶迪特佩大学正畸科档案中回顾性收集的。对39例诊断为骨骼不对称的患者（20名女性，19名男性）的X光片进行手动绘制，并使用软件建立坐标系。在对29个标志点（22个双侧，7个中线）进行校准后，由2名操作人员进行描图。组内相关系数和Bland-Altman检验用于检测每个头影测量变量的检查者间和检查者内一致性。
检查者间一致性测试表明，最成问题的标志点是鸡冠，在两个时间点的y坐标上，两名检查者之间显示出中等一致性。髁突和颧骨标志点显示出良好的一致性。翼突下、眶上、上颌点、颏下点、前鼻棘、下颌角切迹、下颌和上颌磨牙点、上颌和下颌切牙点以及上颌和下颌切缘标志点在两个时间点的x和y坐标上，两名检查者之间都具有极好的一致性。
在正位X线片上标志点识别中，检查者内相关性的误差比检查者间相关性的误差少。除鸡冠外，所有研究的标志点在测量之间都显示出良好的一致性。
