Correlation between objective evaluation and subjective evaluation of facial profile in skeletal Type II females

Objectives: The objective of this study was to find the cephalometric measurements that correlate with the visual perception. Materials and Methods: A total of 250 lateral cephalograms of patients from the year 2016 to 2018 were hand traced and analyzed. Thirty-six hard- and soft-tissue measurements were obtained from the lateral cephalometric analysis. Silhouettes obtained from cephalometric films were rated by 10 orthodontists based on their level of convexity. For each sample, the rating of visual perception was correlated with all the cephalometric (hard and soft) measurements. Results: ANB, AF-BF, L1-NB (mm), overjet, anterior maxillary alveolar height, posterior maxillary alveolar height, lower lip to E plane, and H angle were positively correlated with the visual perception. On the contrary, Pg. to N perpendicular and Pg. to NB (mm) were negatively correlated with the visual perception. However, the measurements in the vertical dimensions did not have any significant correlations with visual perception. H angle showed a higher correlation with visual perception than the nasolabial angle, facial contour angle, and lower lip to E plane. Conclusion: The agreement between objective cephalometric measurements and subjective visual perception was less than expected. In general, only 27% of the cephalometric measurements had a significant correlation with visual perception. Therefore, orthodontic treatment planning based solely on cephalometric analysis can result in unsatisfactory treatment outcomes. An inclusion of subjective measures such as visual perception in orthodontic diagnosis and treatment planning is necessary.

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A Comparative Study on Use of Manual Versus Digital Method using Mobile Application for Cephalometric Measurements

Orthodontic Journal of Nepal ◽

10.3126/ojn.v10i1.30997 ◽

2020 ◽

Vol 10 (1) ◽

pp. 11-16

Author(s):

Raju Shrestha ◽

Santosh Kandel

Keyword(s):

Computer Software ◽

Smartphone Application ◽

Linear Measurement ◽

Cephalometric Analysis ◽

Lower Incisor ◽

Lower Lip ◽

Manual Method ◽

Nasolabial Angle ◽

Significant Difference ◽

Cephalometric Measurements

Introduction: Various computer software and smartphone applications have been developed for digital cephalometric analysis with ease and in short time. The objective of this study was to compare linear and angular cephalometric measurements obtained, and cephalometric tracing duration between smartphone application tracing (app method) and conventional tracing (manual method) methods. Materials & Method: 35 digital Lateral cephalometric radiographs of patient who came for orthodontic treatment were collected. Measurements of cephalometric parameters of composite analysis were obtained with manual and smartphone application (OneCeph) method and compared statistically. Cephalometric tracing duration was also compared between two methods. Result: Cephalometric tracing duration using manual method was found to be significantly higher (p<.001) than that of the app method. There was no significant difference in values of SNA, SNB, ANB, Nasion perpendicular to point A, Nasion perpendicular to pogonion (pog), Angle of convexity, Go-GN/SN, FMA, U1–NA (degree), U1-NA (linear), L1–NB (degree), Cant of Occlusion, Interincisal angle, Nasolabial angle, Upper lip to Steiner’s S line, Lower lip to Steiner’s S line obtained with the manual and application method. The values of linear measurement between Lower incisor to NB line showed significant difference (p<0.05). Conclusion: Although there was no significant difference in cephalometric measurement, cephalometric tracing duration of cephalometric analysis using Smartphone application was significantly faster than that of conventional method.

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Comparison of cephalometric measurements between conventional and automatic cephalometric analysis using convolutional neural network

Progress in Orthodontics ◽

10.1186/s40510-021-00358-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Sangmin Jeon ◽

Kyungmin Clara Lee

Keyword(s):

Neural Network ◽

Convolutional Neural Network ◽

Rapid Development ◽

Cephalometric Analysis ◽

Anatomical Landmarks ◽

Limits Of Agreement ◽

Mandibular Incisor ◽

Lateral Cephalograms ◽

Dental Measurements ◽

Cephalometric Measurements

Abstract Objective The rapid development of artificial intelligence technologies for medical imaging has recently enabled automatic identification of anatomical landmarks on radiographs. The purpose of this study was to compare the results of an automatic cephalometric analysis using convolutional neural network with those obtained by a conventional cephalometric approach. Material and methods Cephalometric measurements of lateral cephalograms from 35 patients were obtained using an automatic program and a conventional program. Fifteen skeletal cephalometric measurements, nine dental cephalometric measurements, and two soft tissue cephalometric measurements obtained by the two methods were compared using paired t test and Bland-Altman plots. Results A comparison between the measurements from the automatic and conventional cephalometric analyses in terms of the paired t test confirmed that the saddle angle, linear measurements of maxillary incisor to NA line, and mandibular incisor to NB line showed statistically significant differences. All measurements were within the limits of agreement based on the Bland-Altman plots. The widths of limits of agreement were wider in dental measurements than those in the skeletal measurements. Conclusions Automatic cephalometric analyses based on convolutional neural network may offer clinically acceptable diagnostic performance. Careful consideration and additional manual adjustment are needed for dental measurements regarding tooth structures for higher accuracy and better performance.

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Reproducibility of measurements in tablet-assisted, PC-aided, and manual cephalometric analysis

The Angle Orthodontist ◽

10.2319/061513-451.1 ◽

2013 ◽

Vol 84 (3) ◽

pp. 437-442 ◽

Cited By ~ 2

Author(s):

Cecilia Goracci ◽

Marco Ferrari

Keyword(s):

Intraclass Correlation ◽

Occlusal Plane ◽

Cephalometric Analysis ◽

Linear Measurements ◽

High Agreement ◽

Landmark Identification ◽

Lateral Cephalograms ◽

Angular Measurements ◽

Cephalometric Measurements ◽

Good Agreement

ABSTRACT Objective: To assess the reproducibility of cephalometric measurements performed with software for a tablet, with a program for personal computers (PCs), and manually. Materials and Methods: The pretreatment lateral cephalograms of 20 patients that were acquired using the same digital cephalometer were collected. Tracings were performed with NemoCeph for Windows (Nemotec), with SmileCeph for iPad (Glace Software), and by hand. Landmark identification was carried out with a mouse-driven cursor using NemoCeph and with a stylus pen on the iPad screen using SmileCeph. Hand tracings were performed on printouts of the cephalograms, using a 0.3-mm 2H pencil and a protractor. Cephalometric landmarks and linear and angular measurements were recorded. All the tracings were done by the same investigator. To evaluate reproducibility, for each cephalometric measurement the agreement between the value derived from NemoCeph, that given by SmileCeph and that measured manually was assessed with the intraclass correlation coefficient (ICC). Agreement was rated as low for an ICC ≤0.75, and an ICC > 0.75 was considered indicative of good agreement. Also, differences in measurements between each software and manual tracing were statistically evaluated (P < .05). Results: All the measurements had ICC >0.8, indicative of a high agreement among the tracing methods. Relatively lower ICCs occurred for linear measurements related to the occlusal plane and to N perpendicular to the Frankfurt plane. Differences in measurements between both software programs and hand tracing were not statistically significant for any of the cephalometric parameters. Conclusion: Tablet-assisted, PC-aided, and manual cephalometric tracings showed good agreement.

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Effects of palatal crib and bonded spurs in early treatment of anterior open bite: A prospective randomized clinical study

The Angle Orthodontist ◽

10.2319/031815-170.1 ◽

2015 ◽

Vol 86 (5) ◽

pp. 734-739 ◽

Cited By ~ 10

Author(s):

Juliana S. Leite ◽

Luciano B. Matiussi ◽

Anne C. Salem ◽

Maria G. A. Provenzano ◽

Adilson L. Ramos

Keyword(s):

Early Treatment ◽

Primary Outcome ◽

Open Bite ◽

Mixed Dentition ◽

Secondary Outcome ◽

Cephalometric Analysis ◽

Anterior Open Bite ◽

Randomized Clinical Study ◽

Nasolabial Angle ◽

Cephalometric Measurements

ABSTRACT Objective: To evaluate the overbite correction of fixed palatal crib (FPC) and bonded lingual spur (BLS) in the early treatment of anterior open bite (AOB) in mixed dentition (primary outcome) as well as its influence on dental and skeletal cephalometric measurements (secondary outcome). Materials and Methods: The selected patients had AOB and a mean age of 8.23 years. They were divided into the following three groups by casting lots: control (n = 13), palatal crib (n = 13), and spur (n = 13). Data from the lateral teleradiography was obtained at the beginning, at 6 months, and after 1 year. The cephalometric analysis was performed by Cef-X program, recording the values of SNA, SNB, ANB, SnG oGn, 1.PP, IMPA, nasolabial angle, overbite, and overjet. Intergroup and intragroup comparisons were obtained via one-way analysis of variance. Results: The degree of AOB was similar at baseline (P > .05). At 6 months and then after 1 year all groups showed improvement in the overbite. However, only the crib and spur groups showed positive overbite. No cephalometric measurements changed significantly over the period analyzed. Conclusions: We conclude that the FPC and BLS are simple and effective for the treatment of anterior open bite, with the advantage given to the FPC.

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Correlation between objective and subjective evaluation of profile in bimaxillary protrusion patients after orthodontic treatment

The Angle Orthodontist ◽

10.2319/070714-476.1 ◽

2014 ◽

Vol 85 (4) ◽

pp. 690-698 ◽

Cited By ~ 4

Author(s):

Yi-Ping Huang ◽

Wei-ran Li

Keyword(s):

Orthodontic Treatment ◽

Subjective Evaluation ◽

Chinese Patients ◽

Lower Incisor ◽

Lower Lip ◽

Lay Persons ◽

Facial Esthetics ◽

Incisor Inclination ◽

Bimaxillary Protrusion ◽

Cephalometric Measurements

ABSTRACT Objective: To correlate the objective cephalometric measurements with subjective facial esthetics in patients with bimaxillary protrusion. Materials and Methods: The sample consisted of 60 Asian-Chinese patients with bimaxillary protrusion who met the inclusion criteria. The facial esthetics of posttreatment profile and the change of profile on standardized lateral photographs were rated by a panel of 10 orthodontists and a panel of 10 lay persons with bimaxillary protrusion. All of the pretreatment and posttreatment cephalograms were digitized and traced. Twenty-five cephalometric measurements were constructed and analyzed. Correlations between the subjective facial esthetic scores and each cephalometric measurement were evaluated. Results: The cephalometric measurements correlated with the facial esthetic scores of posttreatment profile given by the orthodontist and the lay persons were basically the same. For the evaluation of posttreatment profile in bimaxillary protrusion patients, the upper and lower lip to E-line, upper and lower incisor tip to AP plane, Pg-NB distance, mentolabial angle, and sulcus depth correlated significantly with the esthetic score. For the evaluation of profile change during orthodontic treatment, retraction of upper incisor relative to AP plane or the perpendicular line through sella (line Y), change of upper incisor inclination, change of mentolabial sulcus depth, and retraction of lips relative to E-line were correlated positively with the esthetic value. Conclusions: Cephalometric measurements of lip position, incisor position, and chin morphology were key parameters correlated to facial esthetics.

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An evaluation of the reproducibility of landmark identification in traditional versus computer-assisted digital cephalometric analysis system

APOS Trends in Orthodontics ◽

10.4103/2321-1407.155834 ◽

2015 ◽

Vol 5 ◽

pp. 103-110

Author(s):

Manish Suresh Agrawal ◽

Jiwan Asha Manish Agrawal ◽

Vivek Patni ◽

Lalita Nanjannawar

Keyword(s):

Statistical Significance ◽

T Test ◽

Reliability Coefficient ◽

Computer Assisted ◽

Cephalometric Analysis ◽

Landmark Identification ◽

Lateral Cephalograms ◽

Analysis System ◽

Cephalometric Measurements ◽

Paired T Test

Objective To determine the reliability of Computer Assisted Digital Cephalometric Analysis System (CADCAS) in terms of landmark identification on the values of cephalometric measurements in comparison with those obtained from original radiographs. Materials and Methods The study material consisted of Twenty five lateral cephalograms selected randomly, 16 cephalometric points together with 10 angular and 5 linear cephalometric measurements. The landmarks were manually picked on the tracing & the measurements of X &Y axis done with reference grid. The same tracing was digitized & image loaded in the software (ViewBox 3.1.1) was checked for the magnification (metal ruler) & distortion. The second part of the study compared manual and the CADCAS since the landmarks were manually digitized on screen as against the manually picked ones on the tracing paper. The x and y-coordinates for 16 landmarks were measured, mean and standard deviation calculated, linear and angular measurements compared. Statistical Analysis A paired t-test was done to calculate the statistical significance of the differences. Intraclass reliability coefficient (signifying reproducibility) of the variable was recorded. The observations were tabulated and analysis was done using the paired t test at a P value <0.05. Results Out of 47 variables looked for, 21 showed statistical significance. Direct digitization onscreen (CADCAS) was the quickest and least tedious method. CADCAS was unreliable with linear measurements involving bilateral structures such as Gonion & Articulare. Conclusions Both the methods are equally reliable and reproducible. The intra-class reliability coefficient of all variables differed only slightly, which is not clinically significant.

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Outcome of Orthognathic Surgery in Chinese Patients

The Angle Orthodontist ◽

10.2319/091906-378 ◽

2007 ◽

Vol 77 (5) ◽

pp. 845-850 ◽

Cited By ~ 14

Author(s):

Ming Tak Chew ◽

Andrew Sandham ◽

Jen Soh ◽

Hwee Bee Wong

Keyword(s):

Soft Tissue ◽

Orthognathic Surgery ◽

Subjective Evaluation ◽

Chinese Patients ◽

Lower Lip ◽

Line Drawings ◽

Facial Height ◽

Soft Tissue Profile ◽

Professional Perception ◽

Cephalometric Measurements

Abstract Objective: To evaluate the outcome of orthognathic surgery by objective cephalometric measurement of posttreatment soft-tissue profile and by subjective evaluation of profile esthetics by laypersons and clinicians. Materials and Methods: The sample consisted of 30 Chinese patients who had completed combined orthodontic and orthognathic surgical treatment. The posttreatment cephalograms of these patients were analyzed with respect to profile convexity, facial height, and lip contours and these were compared to the previously established esthetic norms. Line drawings of the soft-tissue profile were displayed to a panel comprising six laypersons and six clinicians who scored the esthetics of each profile using a 7-point scale. Results: Complete normalization of cephalometric soft-tissue variables was not achieved with orthognathic surgery in most patients, with four of the six soft-tissue cephalometric measurements showing significant differences compared to the esthetic norms. There were good correlations in the esthetic scores between laypersons and clinicians, even though clinicians tend to rate the profiles more favorably. Facial convexity and facial height did not significantly influence the subjective scores of both the laypersons and clinicians. Lower lip protrusion was the only cephalometric variable that significantly influenced clinicians' assessment of profile esthetics (P < .01). Conclusions: Profile convexity and lower facial height proportion had little influence on both lay and professional perception of profile esthetics. Lower lip position is the only cephalometric variable that significantly influenced clinicians' assessment of profile esthetics.

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The applicability of centrographic analysis in pleasing craniofacial phenotypes

APOS Trends in Orthodontics ◽

10.4103/2321-1407.159411 ◽

2015 ◽

Vol 5 ◽

pp. 144-150 ◽

Cited By ~ 1

Author(s):

Munish C. Reddy ◽

Shivangi Gupta ◽

Vaibhav Misra ◽

Pradeep Raghav ◽

Shishir Singh

Keyword(s):

Sexual Dimorphism ◽

Treatment Planning ◽

Uttar Pradesh ◽

Arithmetic Mean ◽

Diagnosis And Treatment ◽

Age Group ◽

Upper Lip ◽

Lateral Cephalogram ◽

Lower Lip ◽

Lateral Cephalograms

Context There has always been a need for nonnumeric facial analyses that would not compare an individual’s facial measurements with the preestablished norms, rather evaluate the facial form individually. This would help in diagnosis and treatment planning, unique to that individual. Aims The purpose of the study was to determine and establish a relation between skeletal, dental and soft tissue structures using centrographic analysis (CGA) in pleasing faces of Western Uttar Pradesh population. Materials and Methods A total of 50 subjects (22 males and 28 females) with “most pleasing faces” were taken up for the study, within the age group of 20-25 years. Frontal facial photographs and lateral cephalograms were taken for all the subjects. Conventional cephalometric analysis and CGA were applied to each lateral cephalogram. Arithmetic mean and standard deviation values were calculated, and an independent t-test was performed for calculating cephalomorphic norms and comparison between the male and female sample. Results The results showed that, the adults in the age group of 20-25 years, belonging to the Western Uttar Pradesh population have protrusive maxillary and mandibular skeletal bases and retrusive upper lip on contrary to a protrusive lower lip, though a sexual dimorphism was observed. The upper centroid and lower centroid values were statistically greater in women (P = 0.05 and P = 0.04 respectively) whereas, upper lip linear value was statistically greater in men. Conclusions The CGA is valid for Western Uttar Pradesh population. The Western Uttar Pradesh adults have protrusive mandible and a retrusive upper lip though there exists a sexual dimorphism. These practical centrographic norms can be used as an adjunct to the conventional cephalometric evaluation of an individual for diagnosis and treatment planning.

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Incisal and Soft Tissue Effects of Maxillary Premolar Extraction in Class II Treatment

The Angle Orthodontist ◽

10.2319/081706-336 ◽

2007 ◽

Vol 77 (5) ◽

pp. 808-816 ◽

Cited By ~ 22

Author(s):

Nevenka Tadic ◽

Michael G. Woods

Keyword(s):

Soft Tissue ◽

Class Ii ◽

Individual Response ◽

Lower Lip ◽

Fixed Appliance ◽

Premolar Extraction ◽

Class Ii Treatment ◽

Nasolabial Angle ◽

Lateral Cephalograms ◽

Wide Range

Abstract Objective: This retrospective study was designed to show likely upper incisal and soft tissue lip changes accompanying Class II fixed appliance treatment with only two upper premolar extractions and to assess whether the lips, especially, are predictably and directly affected with such treatment. Materials and Methods: Pretreatment and posttreatment lateral cephalograms and study casts from 61 growing Class II patients (aged 11 to 18 years; 39 division 1 and 22 division 2) were assessed. Upper and lower lip curve depths, nasolabial angle, and upper incisal position and angulation were all assessed and compared with changes in other cephalometric variables. Results: A wide range of individual response in both lip and upper incisor behavior were noted. The observed soft tissue lip changes were most likely to be related to the preexisting morphology of the lips themselves, while upper incisal changes were mainly related to their own pretreatment positions and changes occurring with treatment in the underlying bony structures. Conclusion: Orthodontic treatment involving the extractions of only two upper premolars is likely to result in a wide range of variation in lip and upper incisor behavior. The preexisting soft tissue morphology is likely to be the greatest determinant of lip behavior.

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DENTOSKELETAL, SOFT TISSUE AND AIRWAY EFFECTS OF THE ADVANSYNC2 IN PATIENTS WITH CLASS II DIV 1 MANDIBULAR RETROGNATHISM: A RETROSPECTIVE STUDY

10.36106/ijsr/4203158 ◽

2020 ◽

pp. 1-3

Author(s):

Pasupureddi Keerthana ◽

Prasad Chitra

Keyword(s):

Soft Tissue ◽

Class Ii ◽

Control Group ◽

Class Ii Malocclusion ◽

Lower Lip ◽

Skeletal Class Ii ◽

Nasolabial Angle ◽

Soft Tissue Profile ◽

Lateral Cephalograms ◽

Mandibular Retrognathism

Objective: To evaluate dentoskeletal, soft tissue and airway changes in Class II malocclusion patients treated with AdvanSync2 Class II corrector in conjunction with fixed appliances. Methods: Forty-five subjects with skeletal and dental Class II malocclusion requiring fixed functional therapy were included. Pre-treatment cephalograms served as control group (Group 1), post treatment cephalograms of patients treated using AdvanSync2, as experimental group (Group 2). Changes in skeletal, dental, soft tissue profile and airway were analyzed on lateral cephalograms using 21 variables from multiple cephalometric analysis. Results were tabulated and data was analyzed using Wilcoxon signed rank test for linear parameters and paired student t test for angular parameters. Results: Maxillary skeletal and dental effects included restriction of growth, upper incisor retrusion and retroclination at p<0.001. Mandibular incisors proclined during treatment. Forward mandibular relocation was noted, though not statistically significant. Upper and lower lip repositioning was achieved, establishing lip competency. Changes in Z angle and nasolabial angle were positive, reducing facial convexity. Significant airway dimensional improvements were noted. Conclusion: AdvanSync2 Class II corrector was effective in treating skeletal Class II malocclusions with mandibular retrognathism. It produced its effects mainly through maxillary restriction and mandibular dentoalveolar changes which furthermore helped in achieving good soft tissue profiles in patients. Positive airway changes were also noted.

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