Can photographs replace lateral cephalograms? An evaluation of orthodontic clinician’s ability to assess selected cephalometric readings from extra-oral photographs

Abstract

Introduction: The lateral cephalogram has become an integral part of the diagnosis and treatment planning of orthodontic patients. However, there have been rising concerns over unnecessary exposure to X-rays. The purpose of this study was to evaluate whether the orthodontists working in three dental hospitals of Rawalpindi and Islamabad were able to judge cephalometric values using only photographs.

Material and Methods: This was a questionnaire based study. The sample consisted of 24 orthodontists divided into 2 groups according to their number of years of clinical experience (more than 5 years and less than 5 years of experience). The subjects were asked to diagnose the sagittal, vertical and soft tissue discrepancies of a series of patients using only the lateral profile photographs. An independent t-test was used to compare the diagnostic abilities of the two groups.

Results: The independent t-test showed a statistically insignificant difference (p-value > 0.05) in the diagnostic abilities of the two groups. 83% of the orthodontists with less than 5 years of experience were able to diagnose the sagittal discrepancy correctly, compared to 81 % of the orthodontists with more than 5 years of experience. 74% of the less experienced clinicians estimated the vertical discrepancy and 71% the soft tissue discrepancy, compared to the more experienced clinician’s results of 76% and 79%, respectively.

Conclusions: Photographs cannot be used solely to form an accurate diagnosis and treatment plan for orthodontic patients. The number of years of clinical experience has no effect on the accuracy of the diagnosis of cephalometric values from a lateral profile photograph by an orthodontist.