Three dimensional reliability analyses of currently used methods for assessment of sagittal jaw discrepancy

BACKGROUND: The objective of this study was to analyse three dimensionally the reliability and correlation of angular and linear measurements in assessment of anteroposterior skeletal discrepancy. MATERIAL AND METHODS: In this retrospective cross sectional study, a sample of 213 subjects were three-dimensionally analysed from cone-beam computed tomography scans. The sample was divided according to three dimensional measurement of anteroposterior relation (ANB angle) into three groups (skeletal Class I, Class II and Class III). The anterior-posterior cephalometric indicators were measured on volumetric images using Anatomage software (InVivo5.2). These measurements included three angular and seven linear measurements. Cross tabulations were performed to correlate the ANB angle with each method. Intra-class Correlation Coefficient (ICC) test was applied for the difference between the two reliability measurements. P value of < 0.05 was considered significant. RESULTS: There was a statistically significant (P<0.05) agreement between all methods used with variability in assessment of different anteroposterior relations. The highest correlation was between ANB and DSOJ (0.913), strong correlation with AB/FH, AB/SN/, MM bisector, AB/PP, Wits appraisal (0.896, 0.890, 0.878, 0.867,and 0.858, respectively), moderate with AD/SN and Beta angle (0.787 and 0.760), and weak correlation with corrected ANB angle (0.550). CONCLUSIONS: Conjunctive usage of ANB angle with DSOJ, AB/FH, AB/SN/, MM bisector, AB/PP and Wits appraisal in 3D cephalometric analysis provide a more reliable and valid indicator of the skeletal anteroposterior relationship. Clinical relevance: Most of orthodontic literature depends on single method (ANB) with its drawbacks in assessment of skeletal discrepancy which is a cardinal factors for proper treatment planning, this study assessed three dimensionally the degree of correlation between all available methods to make clinical judgement more accurate based on more than one method of assessment. Key words:Anteroposterior relationships, ANB angle, Three-dimension, CBCT.