Abstract
BackgroundThe objective of this study was to analyse three dimensionally the reliability and correlation of angular and linear measurements in assessment of anteroposterior skeletal discrepancy.Material and MethodsIn this retrospective cross sectional study, a sample of 213 subjects were three-dimensionally analysed from cone-beam computed tomography scans. The sample was divided according to three dimensional measurement of anteroposterior relation (ANB angle) into three groups (skeletal Class I, Class II and Class III). The anterior-posterior cephalometric indicators were measured on volumetric images using Anatomage software (InVivo5.2). These measurements included three angular and seven linear measurements. Cross tabulations were performed to correlate the ANB angle with each method. Intra-class Correlation Coefficient (ICC) test was applied for the difference between the two reliability measurements. P value of < 0.05 was considered significant.ResultsThere was a statistically significant (P<0.05) agreement between all methods used with variability in assessment of different anteroposterior relations. The highest correlation was between ANB and DSOJ (0.913), strong correlation with AB/FH, AB/SN/, MM bisector, AB/PP, Wits appraisal (0.896, 0.890, 0.878, 0.867,and 0.858, respectively), moderate with AD/SN and Beta angle (0.787 and 0.760), and weak correlation with corrected ANB angle (0.550).ConclusionsConjunctive usage of ANB angle with DSOJ, AB/FH, AB/SN/, MM bisector, AB/PP and Wits appraisal in 3D cephalometric analysis provide a more reliable and valid indicator of the skeletal anteroposterior relationship. Clinical relevance: Most of orthodontic literature depends on single method (ANB) with its drawbacks in assessment of skeletal discrepancy which is a cardinal factors for proper treatment planning, this study assessed three dimensionally the degree of correlation between all available methods to make clinical judgement more accurate based on more than one method of assessment. Key words:Anteroposterior relationships, ANB angle, Three-dimension, CBCT.
Highlights
An accurate anteroposterior assessment of jaw relationships is critically important in orthodontic diagnosis and treatment planning
The renewed quest for identifying anteroposterior maxillo-mandibular relationship led Al-Hammadi et al [12],to develop dento-skeletal overjet (DSOJ); this depends on two basic concepts; the first is the dentoalveolar compensation for underlying skeletal base relation, and the second is the overjet that remains due to the incomplete dentoalveolar compensation as a result of large skeletal discrepancy
The highest degree of accordance between ANB angle in skeletal class 1 was with AB/Frankfort Horizontal (FH) (82.1%) while the lowest was with AB/SN (37.7%).In skeletal class II the highest degree of accordance was found between ANB angle and maxillo-mandibular bisector (97.8%) while the lowest was with corrected ANB (45.7%)
Summary
An accurate anteroposterior assessment of jaw relationships is critically important in orthodontic diagnosis and treatment planning. The aim of this study was to use the current 3D tech¬nology with CBCT to analyze the reliability and the degree of correlation of the angular measurements like ANB, Corrected ANB, BETA angle as well as the linear measurements which include WITS appraisal, AB/PP, AB/ FH, AB/SN, AD/SN, AB/MM bisecting plane angle and dento-skeletal overjet. The objective of this study was to analyse three dimensionally the reliability and correlation of angular and linear measurements in assessment of anteroposterior skeletal discrepancy. Conclusions:Conjunctive usage of ANB angle with DSOJ, AB/FH, AB/SN/, MM bisector, AB/PP and Wits appraisal in 3D cephalometric analysis provide a more reliable and valid indicator of the skeletal anteroposterior relationship. Clinical relevance: Most of orthodontic literature depends on single method (ANB) with its drawbacks in assessment of skeletal discrepancy which is a cardinal factors for proper treatment planning, this study assessed three dimensionally the degree of correlation between all available methods to make clinical judgement more accurate based on more than one method of assessment
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