Helal Narmin M, Basri Osama A, Baeshen Hosam A
Department of Pediatric Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Craniofacial Orthodontists, King Faisal Specialists Hospital and Research Center, Jeddah, Kingdom of Saudi Arabia.
J Contemp Dent Pract. 2019 Jul 1;20(7):789-793.
The lateral cephalometric radiograph is a standard component of clinical records taken for orthodontic diagnosis and treatment planning. The present study was conducted to assess the utility of cephalometric radiography and analysis in modern orthodontic diagnosis and treatment planning.
A research survey was conducted at Jacksonville University School of Orthodontics. Thirty-one residents and faculty were the participants. The survey sample was collected from the university patients' pool. A survey was given to participants at two time points. At the first time point (T1), the participants were given full records without lateral cephalogram. At the second time point (T2), they were given full records with lateral cephalogram. Two measures were analyzed: (1) a change in orthodontic treatment decision and (2) a change in the orthodontic treatment plan. A traditional McNemar's test was used on paired binary data. We used the conditional logistic regression model with robust variance at a participant level to adjust for a participant-level clustering effect to test the difference in treatment decision before and after. A statistical significance was determined at = 0.05.
It was found that 93.6% of the treatment decisions and 70% of the extraction decisions were consistent after the introduction of lateral cephalograms. There was no statistically significant association observed between two outcome measures and the use of cephalograms ( = 0.80).
Sufficient evidence does not exist to warrant lateral cephalometric radiographs be taken as a part of standard diagnostic records on every individual seeking orthodontic treatment.
Evidenced-based selection criteria for prescribing lateral cephalometric radiographs should be developed to reduce the amount of radiation exposure to the general public.
头颅侧位X线片是正畸诊断和治疗计划临床记录的标准组成部分。本研究旨在评估头颅侧位X线摄影及分析在现代正畸诊断和治疗计划中的效用。
在杰克逊维尔大学正畸学院进行了一项研究调查。31名住院医师和教员参与了调查。调查样本取自该大学的患者库。在两个时间点向参与者发放调查问卷。在第一个时间点（T1），向参与者提供不包含头颅侧位片的完整记录。在第二个时间点（T2），向他们提供包含头颅侧位片的完整记录。分析了两项指标：（1）正畸治疗决策的变化；（2）正畸治疗计划的变化。对配对二元数据使用传统的麦克尼马尔检验。我们在参与者层面使用具有稳健方差的条件逻辑回归模型来调整参与者层面的聚类效应，以检验前后治疗决策的差异。显著性水平设定为α = 0.05。
发现引入头颅侧位片后，93.6%的治疗决策和70%的拔牙决策是一致的。在两项结果指标与头颅侧位片的使用之间未观察到统计学上的显著关联（P = 0.80）。
没有足够的证据证明头颅侧位X线片应作为每一位寻求正畸治疗患者标准诊断记录的一部分。
应制定基于证据的头颅侧位X线片开具选择标准，以减少公众的辐射暴露量。
