Confiabilidade da análise morfológica da telerradiografia em norma lateral na determinação da tendência de crescimento craniofacial de pacientes na dentadura mista
Cephalometry, Growth and develpoment Radiology
Introduction: The determination of the craniofacial growth tendency has a fundamental importance in Orthodontics, since it is directly related to the prognosis of the case and guides the orthodontist in the selection of an individualized orthodonticTo mechanic. Purpouse: To evaluate the level of orthodontists concordance in morphological analysis of the lateral radiographs to determinate the craniofacial growth tendency in mixed dentition patients. Materials: A researcher selected 3 digital lateral radiographs of children between age of 7-11 years in the mixed denture phase, diagnosed with Class I Angle dental and skeletal function. Each radiographs represented a craniofacial gowth tendency (vertical, balanced and horizontal) which was confirmed cephalometrically through manual tracing of the cephalogram on ultraphan paper measurements of SN.GoGn and FMA angles and the Vert index. A form was developed on the Google Forms® platform, which was aswered by orthodontists randomly divided in 3 study groups, according to the time of orthodontic training: Group 1 (G1) consisting of orthodontists trained for up 1 year, Group 2 (G2) composed of orthodontists graduated for more than 1 and up to 5 years, and Group 3 (G3) composed of orthodontists trained for more than 5 years ago. The cephalograms were cut in the regions of mandibular head, mandibular ramus, gonial angle, mandibular plane, mandibular bevel, mandibular symphysis, occlusal plane and interincisal angle using the Adobe Photoshop CS6® software. The images obtained from the clippings, as well as the complete cephalometric radiographs, were ramdomly distributed throughout the questionnaire so the orthodontists did not know which cut belonged to each cephalometric radiograph. The orthodontists should define the craniofacial growth tendency that the images suggested. Results: Orthodontists demonstrated a low level of concordance for the mandibular head in the horizontal growth tendency and a almost perfect concordance for the gonial angle e the mandibular plane in the vertical growth tendency, for the mandibular bevel and for the mandibular plane in the horizontal growth tendency, and when all the anatomical structures were analysed concomitantly in the complete cephalograms. There were no significant differences in the morphologival analysis performed by the studied groups. Orhodontists demonstrated similar levels of difficulty or ease to morphologically analyse the interincisal angle, mandibular ramus and the complete radiographs in the 3 growth tendencys. Conclusion: Orthodontists demonstrated different levels of concordance in the morphological analysis of lateral cephalometric radiography, depending on the anatomical structure and the craniofacial growth tendency analyzed. Additionally, the time of graduation as a specialist did not influence the ability to determine the craniofacial growth tendency from the observation of lateral radiographs.