American Journal of Orthodontics and Dentofacial Orthopedics
Original articleReliability and validity of mandibular posterior vertical asymmetry index in panoramic radiography compared with cone-beam computed tomography
Section snippets
Material and methods
For sample size calculation, a pilot test was executed with 20 patients who visited the Department of Orthodontics of Dankook University Dental Hospital in Cheonan, South Korea. To achieve power of at least 80% using the paired t test with a significance level of 0.05 and using effect sizes calculated from differences (mean, 0.342; pooled standard deviation, 0.780), at least 43 patients were needed. Those who had syndromic disease (eg, cleft lip and palate) and those with a history of
Results
Table I shows the ICC values, the Dahlberg33 values for the asymmetry index on the panoramic radiography and CBCT, and agreement between CBCT measurements. When CBCT was used, reliability of asymmetry indexes was good (ICC, >0.853). However, ranges of the 95% limits of agreement in condylar height 1 and ramal height 1 showed relatively greater values than the rest of the measurements. For all vertical variables, CBCT was more reliable than panoramic radiography. When panoramic radiographs were
Discussion
Accurate diagnosis of asymmetry in the mandibular facial region is important for both orthodontists and patients for establishing adequate treatment plans and to obtain the best treatment outcomes. For detecting mandibular posterior asymmetry, in many studies,15, 16, 17, 18, 19, 20, 21, 22 panoramic radiography was used with a formula for the asymmetry index.15 By the development of radiologic technology, the effective dose for CBCT can be decreased by limiting the field to structures of
Conclusions
The asymmetry index value for condylar height 1 was noninformative and showed lower reliability and validity than did that of condylar height 2. The asymmetry index of ramal height 1 showed lower reliability and validity than did that of ramal height 2. Although the asymmetry indexes of condylar height 2 and ramal height 2 were used, their accuracies were 0.47 and 0.85, respectively. Therefore, one should use caution when detecting asymmetry of condylar and ramal heights using only panoramic
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All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest, and none were reported.