Agreement among orthodontists regarding facial pattern diagnosis

Abstract

Objective: To assess agreement among orthodontists trained in facial pattern diagnosis through the morphological evaluation of the face. Methods: Facial photographs were taken in front and side views, as well as photographs of the smiles of 105 individuals randomly selected among patients seeking orthodontic treatment. The photographs were sent to orthodontists trained in facial pattern classification. Intra-rater agreement, agreement between raters and the Gold Standard, as well as inter-rater agreement were assessed using the Kappa index. Results: Intra-rater agreement was almost perfect, with Kappa index reaching 0.85. Agreement between raters and the Gold Standard was moderate (Kappa = 0.48), higher for Pattern I (Kappa = 0.62) and lower for the Short Face Pattern (Kappa = 0.33). Agreement between raters was significant (Kappa = 0.61) and even higher than agreement with the Gold Standard for all patterns. Conclusions: The criteria used by raters to determine the facial pattern were the same in the first and second evaluation. Agreement between raters and the Gold Standard was moderate, with raters exhibiting greater agreement between them than with the Gold Standard.