Diagnostic performance of various cephalometric parameters for the assessment of vertical growth pattern. 2016

Maheen Ahmed, and Attiya Shaikh, and Mubassar Fida
Resident in Orthodontics, The Aga Khan University Hospital, Section of Dentistry, Department of Surgery, Karachi, Pakistan.

BACKGROUND Multiple cephalometric analyses are used to diagnose vertical skeletal facial discrepancy. A multitude of times, these parameters show conflicting results, and a specific diagnosis is hard to reach. OBJECTIVE Hence, this study aimed to identify the skeletal analysis that performs best for the identification of vertical skeletal pattern in borderline cases. METHODS The sample consisted of 161 subjects (71 males and 90 females; mean age = 23.6 ± 4.6 years). Y-axis, Sella-Nasion to mandibular plane angle (SN.MP), maxillary plane to mandibular plane angle (MMA), Sella-Nasion to Gonion-Gnathion angle (SN.GoGn), Frankfort to mandibular plane angle (FMA), R-angle and facial height ratio (LAFH.TAFH) were used to evaluate vertical growth pattern on lateral cephalograms. The subjects were divided into three groups (hypodivergent, normodivergent and hyperdivergent groups), as indicated by the diagnostic results of the majority of parameters. Kappa statistics was applied to compare the diagnostic accuracy of various analyses. To further validate the results, sensitivity and positive predictive values (PPV) for each parameter were also calculated. RESULTS SN.GoGn showed a substantial interclass agreement (k = 0.850). In the hypodivergent group, MMA showed the highest sensitivity (0.934), whereas FMA showed the highest PPV (0.964). In the normodivergent group, FMA showed the highest sensitivity (0.909) and SN.GoGn had the highest PPV (0.903). SN.GoGn showed the highest sensitivity (0.980) and PPV (0.87) in the hyperdivergent group. CONCLUSIONS SN.GoGn and FMA were found to be the most reliable indicators, whereas LAFH.TAFH is the least reliable indicator in assessing facial vertical growth pattern. Hence, the cephalometric analyses may be limited to fewer analyses of higher diagnostic performance.

UI MeSH Term Description Entries
D008297 Male Males
D008334 Mandible The largest and strongest bone of the FACE constituting the lower jaw. It supports the lower teeth. Mylohyoid Groove,Mylohyoid Ridge,Groove, Mylohyoid,Grooves, Mylohyoid,Mandibles,Mylohyoid Grooves,Mylohyoid Ridges,Ridge, Mylohyoid,Ridges, Mylohyoid
D008437 Maxilla One of a pair of irregularly shaped bones that form the upper jaw. A maxillary bone provides tooth sockets for the superior teeth, forms part of the ORBIT, and contains the MAXILLARY SINUS. Maxillae,Maxillary Bone,Bone, Maxillary,Bones, Maxillary,Maxillary Bones,Maxillas
D002508 Cephalometry The measurement of the dimensions of the HEAD. Craniometry
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D005147 Facial Bones The facial skeleton, consisting of bones situated between the cranial base and the mandibular region. While some consider the facial bones to comprise the hyoid (HYOID BONE), palatine (HARD PALATE), and zygomatic (ZYGOMA) bones, MANDIBLE, and MAXILLA, others include also the lacrimal and nasal bones, inferior nasal concha, and vomer but exclude the hyoid bone. (Jablonski, Dictionary of Dentistry, 1992, p113) Bone, Facial,Bones, Facial,Facial Bone
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D055815 Young Adult A person between 19 and 24 years of age. Adult, Young,Adults, Young,Young Adults

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