Evaluation of diagnostic agreement among cephalometric measurements for determining incisor position and inclination

Abstract

The incisors are a key factor in dental occlusion and dentofacial aesthetics; therefore, the sagittal position and inclination of the incisors is a key parameter in diagnosis and orthodontic treatment planning. In some cases, the orthodontist will use more than one cephalometric analysis, and thus different results can be obtained. The aim of this study was to establish the diagnostic agreement among the different cephalometric measurements used to determine the anteroposterior position and the inclination of the incisors. Lateral cephalometric radiograms of patients between 18 and 59 years old were measured (n=260). Digital cephalometric measurements were made with Dolphin Imaging software, by a single calibrated operator. Here, a specific cephalometric analysis was designed in the software analysis editor. The results for each variable and each measurement were registered and compared. Fleiss's Kappa statistical tests, Cohen's Kappa, and Kendall's coefficient were used to determine the strength of agreement using the Minitab software. The results showed diagnostic strength agreement between slight and moderate among measurements of the same variable. This indicates that same diagnosis might not be obtained when using different approaches to measure the anteroposterior position and inclination of the incisors. It was concluded that there is a difference in the diagnosis between one measurement and another because the results showed slight or moderate strength of agreement. However, in some cases, better agreement was found when the measurements were compared as a function of the diagnostic response.