Although the importance of facial photography in orthodontics has been recognized, there is only one study on its validity and absolutely no studies on its diagnostic value. This study was conducted, therefore, to evaluate for the first time the diagnostic merit of photography in detecting growth pattern and jaw relationships. Standardized lateral cephalographs and profile photographs were taken from 54girls and 26boys. On cephalometry, growth pattern (normal, horizontal, and vertical) and horizontal bimaxillary classification (Classes I to III) were determined. Using photographs, the angles FH-MP', CP'-MP', Sn-T-Me', cutaneous analog of ANB, facial convexity, and head position were calculated. Diagnostic photography-based measurements for detecting departures from the norm were calculated by counting correct and incorrect diagnoses, according to the gold standard (lateral cephalometry). The sensitivity, specificity and positive predictive values, and the negative predictive value of FH-MP' photographic measurements in detecting growth disorders were 51.4, 77.8, 64.3, and 67.3 percent, respectively. These values were 45.7, 95.6, 88.9, and 69.4 percent for the CP'-MP' measurement, and were 40.0, 93.3, 82.4, and 66.7 percent for Sn-T-Me', and 51.4, 100, 100, and 72.6 percent for all of them combined. In detecting the horizontal relationship between the jaws, the photographic method showed an overall sensitivity, specificity, PPV, and NPV of 80.9, 63.6, 76.0, and 70.0 percent, respectively. These values were 80.9 57.6 73.1 67.9 percent for cutaneous analog of ANB, 87.2, 45.5, 69.5, and 71.4 percent for facial convexity, and 61.7, 66.7, 72.5, and 55.0 percent for head position. Profile photography can be used as a perfectly accurate measurement tool for detecting horizontal and vertical growth patterns. It is also a rather accurate method for detecting the normal growth pattern, as well as both Class I and non-Class I jaw relationships. These results highlight this non-invasive and economic method as an effective clinical diagnostic tool.
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