Comparison between Steiner cephalometric and modified Andrews photometric method for assessing antero-posterior position of the maxillary central incisors.

Abstract

Introduction/Objective. Maxillary incisors, when exposed during smile, are one of the most important facial features. In an attempt to overcome limitations of standard cephalometric methods, Andrews described an approach to determine ideal anteroposterior (AP) position of maxillary central incisors in smiling profile in relation to the forehead. We compared traditional Steiner cephalometric method, using surrounding skeletal landmarks, to the method proposed by Andrews, with the aim of determining whether distant but very noticeable craniofacial structures can affect our impression of tooth position. Methods. The study comprised 90 randomly selected lateral cephalograms, divided into three groups according to maxillary central incisors AP position according to Steiner cephalometric norms. The AP relationship of the maxillary central incisors was measured as a perpendicular distance from facial axis point to the nasion A line and to the vertical line through forehead facial axis point respectively. Student?s t-test and Pearson?s correlation were used to compare tested variables. Results. There was statistically significant difference between two methods (p = 0.01108). According to the Steiner method 46.67% subjects had retrusive incisors and 53.33% subjects had protrusion. Andrews?s method showed different results; 35.56% subjects had retrusion, while 64.4% had protrusion. Conclusion. The method proposed by Andrews showed consistently more protrusion than the traditional cephalometric method according to Steiner. Slightly retruded position of maxillary central incisors according to Steiner analysis does not always imply poor facial esthetics, if they have favorable position to the forehead. Low levels of correlation indicate that we should never rely on just one set of parameters.