Intra- and Interexaminer Measurement Variability Analysis of an Orthodontic Gauge Device to Determine Incisor Occlusal Surface Angles in the Horse.

Abstract

Simple SummaryAnnual tooth rasping is integral to prophylaxis work in equine dentistry. The procedure begins with a thorough examination of the oral cavity, including assessment of incisor occlusal surface angles. Any dental misalignment should be corrected or reduced to prevent abnormal forces from acting on teeth and supporting tissues and to maximize functionality of the masticatory apparatus. Thus far, clinical methods for dental angle assessment are scarce and not validated in terms of data reproducibility and comparability. These parameters are vital to objectively assess treatment needs and outcome, obtain population data, and establish data comparability among studies. However, this is the first study systematically validating a commercial dental angle measuring device. The data indicate high device performance and its applicability in practice.Incisor malocclusions are common in horses. As yet, an evidence-based understanding of incisor occlusal surface angle dynamics and normocclusal range is missing. Orthodontic measuring devices could help unravel this information objectively but imply measurement validation. We evaluated intra- and interexaminer variability of repeated sagittal and transversal incisor occlusal surface angle measures using a commercial orthodontic gauge device (MaPHorse1). Five examiners (two experienced, three inexperienced) measured six cadaver heads on 2 consecutive days in a blinded block-randomization design, resulting in 16 measures per examiner*head. Sagittal and transversal angle measures revealed low intraexaminer variability at scale-level independent mean SDs of α 0.58° and α 0.69°, respectively. Sagittal angle measures associate with low interexaminer variability, showing small mean angle differences (max. α 0.51° ± 0.35°), small scatter, and more consistent data reproducibility. Despite comparable mean interexaminer differences, the spread of transversal angle measures was relevantly higher using the proposed landmarks (average 2.2-fold higher interquartile range). The measurement performance of experienced and inexperienced examiners did not systematically differ. The time required for individual measurements was already comparable after 24/96 repetitions. This instrument may help deciphering sagittal angle normocclusal range and orthognathic dynamics and, with a proposed procedural amendment, transversal angle as well.