The alternative use of a nonconventional orthopantomograms analysis technique for facial skeletal assessment

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Context: Cephalometric analysis to assess facial skeletal patterns does not come without limitations. Complementary radiographic analysis has been suggested by many authors to better analyze facial patterns and discrepancies. Aims: This study aims to find correlations between the vertical and sagittal relationships of cephalograms and orthopantomograms (OPG), use the OPG to assess facial symmetry, and test the efficacy of a novel OPG analysis technique in the skeletal facial analysis. Settings and Design: Cephalograms, OPG, and facial pictures were taken from 23 volunteers from the orthodontic clinic at RAKCODS (13 males and 10 females). Subjects and Methods: Symmetry was assessed in the OPG. The traditional cephalometric analysis was performed and correlated to an experimental OPG technique. Facial convexity (pictures) and cephalometric measurements were used to identify participants with normal facial skeletal patterns. Preliminary standards for the OPG analysis technique were determined from this normal subgroup. Statistical Analysis Used: Pearson's correlation was used to assess the relation between angles. means and standard deviations were calculated to establish norms. Results: Significant correlations were observed between the cephalometric analyses and the OPG technique. Perfect symmetry was uncommon. Sagittal, vertical, and transverse preliminary norms were established. Conclusions: Perfect symmetry is uncommon, which makes lateral cephalometric analysis insufficient to analyze facial skeletal patterns. Complementary frontal assessment may improve the accuracy of orthodontic diagnosis. The OPG technique introduced in this study correlates with traditional cephalometric analysis and can be a potential adjunct to cephalometric analysis. Further studies using a larger sample should be used to establish more reliable measurement standards.