Kotuła Jacek, Szendoł Konrad, Kotuła Krzysztof, Dobrzyński Wojciech, Lis Joanna, Kawala Beata, Sarul Michał, Kuc Anna Ewa
Department of Dentofacial Orthopedics and Orthodontics, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland.
Faculty of Medicine, Pomeranian Medical University, 70-204 Szczecin, Poland.
J Clin Med. 2025 Apr 1;14(7):2408. doi: 10.3390/jcm14072408.
: Cephalometric analysis is an essential tool used in orthodontic diagnosis and treatment planning. : The aim of this study was to compare the measurement reliabilities (repeatability and reproducibility) of the Tau and Yen angles and compare them to the results obtained for the ANB angle. : Repeatability and reliability assessments for the seven points (N, A, B, S, W, M, G) used in the analysis of ANB, Yen and Tau angles were performed twice with an interval of 7 days by 22 orthodontists. The measurement results for ANB, Yen and Tau angles were assessed using the Bland-Altman formula, Dahlberg formula, intraclass correlation coefficients (ICCs), R coefficients and R&R. In order to assess the number of individual skeletal classes of sagittal discrepancy, the Pearson chi-squared test was used. With common parameters of df = 4, < 0001, for the ANB angle, the result was χ = 9104; for the Tau angle, χ = 4556; and for the Yen angle, χ = 4207. In order to determine the inter-rater reliability based on two-way ANOVA analysis without repetitions, the ICC (2,2) was used. The ICC (2,2) index at the 95% confidence level was 0.998 for the ANB angle, 0.997 for Tau and 0.998 for Yen. High values of the ICC index close to 1 indicate the agreement of the measurements and their high reliability. : The orthodontists in the study measured sagittal discrepancy significantly more accurately using the ANB angle compared to the Yen and Tau angles. Using a Bland-Altman plot, the bias and range of agreement within which 95% of the differences between measurements were accounted for were determined. For the ANB angle, the mean difference between measurements was 0.07 with a confidence interval of -1.55 to +1.69; for the Tau angle, the mean difference between measurements was 0.19 with a confidence interval of -2.92 to 3.30; and for the Yen angle, the mean difference was 0.09 with a confidence interval of -2.71 to +2.89. Using regression analysis, the measurements were assessed using the R2 index, which for the ANB angle was 0.952 ( < 0.001); for the Tau angle, R2 = 0.928 ( < 0.001), and for the Yen angle, R2 = 0.942 ( < 0.001). The obtained results of the assessment of the ANB, Tau and Yen angles confirm the thesis of the highest reliability, including repeatability and reproducibility, in the assessment of sagittal discrepancy in orthodontic diagnostics using the ANB angle, previously considered the gold standard. One of the basic factors attributed to the poorer repeatability and reproducibility of Tau and Yen measurements is human error related to the precision of determining new anthropometric points. Further studies to assess the usefulness of using the new Tau and Yen angle measurements in orthodontic diagnostics for sagittal discrepancy should be correlated with other measurements used so far, depending on the type of defects in the vertical dimension. It is necessary to consider enlarging the study group and performing longitudinal studies.
头影测量分析是正畸诊断和治疗计划中使用的重要工具。本研究的目的是比较Tau角和Yen角的测量可靠性(重复性和再现性),并将其与ANB角的测量结果进行比较。22位正畸医生对用于分析ANB、Yen和Tau角的七个点(N、A、B、S、W、M、G)进行了重复性和可靠性评估,间隔7天进行了两次测量。使用Bland-Altman公式、Dahlberg公式、组内相关系数(ICC)、R系数和R&R评估ANB、Yen和Tau角的测量结果。为了评估矢状差异的个体骨骼类别的数量,使用了Pearson卡方检验。对于自由度df = 4、P < 0.001的常见参数,对于ANB角,结果为χ² = 91.04;对于Tau角,χ² = 45.56;对于Yen角,χ² = 42.07。为了基于无重复的双向方差分析确定评分者间的可靠性,使用了ICC(2,2)。在95%置信水平下,ANB角的ICC(2,2)指数为0.998,Tau角为0.997,Yen角为0.998。接近1的ICC指数高值表明测量结果一致且可靠性高。与Yen角和Tau角相比,本研究中的正畸医生使用ANB角测量矢状差异的准确性明显更高。使用Bland-Altman图,确定了测量值之间95%差异所在的偏差和一致性范围。对于ANB角,测量值之间的平均差异为0.07,置信区间为-1.55至+1.69;对于Tau角,测量值之间的平均差异为0.19,置信区间为-2.92至3.30;对于Yen角,平均差异为0.09,置信区间为-2.71至+2.89。使用回归分析,使用R²指数评估测量结果,对于ANB角,R² = 0.952(P < 0.001);对于Tau角,R² = 0.928(P < 0.001),对于Yen角,R² = 0.942(P < 0.001)。ANB角、Tau角和Yen角的评估结果证实了在正畸诊断中使用ANB角评估矢状差异具有最高可靠性(包括重复性和再现性)这一论点,ANB角此前被视为金标准。Tau和Yen测量的重复性和再现性较差的一个基本因素是与确定新人体测量点的精度相关的人为误差。根据垂直维度缺陷的类型,进一步评估在正畸诊断中使用新的Tau和Yen角测量矢状差异的有用性的研究应与迄今为止使用的其他测量方法相关联。有必要考虑扩大研究组并进行纵向研究。