Agreement between orthodontists in the diagnosis of sagittal facial patterns / Concordância de ortodontistas no diagnóstico dos padrões sagitais da face

The cephalometric analysis has assisted orthodontics in describing face features in terms of numbers/angles, but these results are not always consistent with ideal individual patterns. Some orthodontists have made use of subjective analysis as an auxiliary method in the diagnosis; however, the consistency of the reproducibility of these methods has been questioned. Hence, this study aimed to verify whether the diagnosis of sagittal facial patterns can be accomplished with a reliable reproduction. This is an analytical observational study including an initial sample of 120 teleradiographs and 120 photographs in lateral norm of patients from the Graduate Program in Dentistry, Faculty of Health of the Methodist University of São Paulo. First, a previously calibrated examiner separated the photographs into three Sagittal Facial Patterns (Pattern I, II and III). Thus, it was obtained three groups comprising 45 photographs for the Pattern I; 45 photographs for the Pattern II and 30 photographs for the Pattern III. After this initial selection, the cephalometric analysis of 120 teleradiographs was performed using measurements of ANB and SN-GoGn angles. From this second analysis, it was selected only the photographs in which the result of subjective analysis matched the cephalometric analysis, totalizing a final sample size of 52 photographs. These 52 photographs were separated and set on an album to be reassessed by 19 orthodontists, in order to observe or not an agreement between the facial patterns among professionals. The kappa test analyzed the level of agreement of 19 professionals in relation to the cephalometric reference. The degree of agreement between professional judgment and cephalometry was found to be 73.08%, and the result of the kappa test was 0.59 (moderate agreement). Taken together, the accuracy in the diagnosis of facial pattern by means of subjective facial analysis demonstrates that the subjective method is reliable for clinical use.

A análise cefalométrica auxiliou a ortodontia a descrever numericamente as características da face, mas nem sempre estes resultados condizem com os padrões individuais ideais. Alguns ortodontistas utilizam análises subjetivas como método auxiliar no diagnóstico, porém a reprodução do método é discutida. Sendo assim, o trabalho objetiva verificar se o diagnóstico do Padrão sagital da face é possível de ser realizado com reprodução confiável. Trata-se de um estudo observacional analítico com uma amostra inicial de 120 telerradiografias e 120 fotografias em norma lateral de pacientes pertencentes ao Programa de Pós-Graduação em Odontologia da Faculdade da Saúde da Universidade Metodista de São Paulo. Primeiramente, um avaliador, previamente treinado, separou as fotografias nos Três Padrões sagitais da face (Padrão I, II e III). Dessa forma obtiveram-se três grupos compostos por 45 fotografias no Padrão I; 45 fotografias no Padrão II e 30 fotografias no Padrão III. Após essa seleção inicial foi realizado a análise cefalométrica das 120 telerradiografias desses pacientes utilizando as medidas dos ângulos ANB e SN.GoGn. A partir dessa segunda análise foram selecionadas apenas as fotografias em que o resultado da análise subjetiva coincidiu com a análise cefalométrica resultando em um novo número amostral final de 52 fotografias. Estas 52 fotografias foram separadas e montadas em um álbum para serem reavaliadas por 19 ortodontistas com o intuito de observar ou não a concordância dos Padrões Faciais entre os profissionais. Para a análise de dados utilizou-se o Teste Kappa com o intuito de analisar o nível de concordância dos 19 profissionais com a referência cefalométrica. Dessa forma, o grau de concordância entre a avaliação profissional e a cefalometria encontrado foi de 73,08% sendo o resultado do Teste Kappa de 0,59 - considerado moderado. Conclui-se que existe exatidão no diagnóstico do padrão facial por meio da analise subjetiva da face, o que demonstra que este método subjetivo é confiável para a utilização na prática clínica.

Assessment of torque angle of brackets from different brands

To measure torque angle values of brackets designed for canines, comparing it to their prescription values. METHODS: One hundred and sixty maxillary -2o and mandibular -11o canine brackets of Roth prescription from the following brands were selected: Abzil, Eurodonto, Morelli and Ormco. The brackets were set in wax and images were obtained by scanning. Reference points were determined over these images, lines drawn and the torque angle was measured. The Student's t-test and the Wilcoxon signed-rank test were used at a significance level of 5%. RESULTS: For maxillary canine brackets, the medium torque angle values were: Abzil -0.93o ± 0.88o; Eurodonto 0.13o ± 0.34o; Morelli -2.56o ± 0.50o, and Ormco -1.16o ± 1.27o. For mandibular canine brackets, the values were: Abzil -11.76o ± 0.40o; Eurodonto -10.40o ± 0.25o; Morelli -11.18o ± 0.56o, and Ormco -11.36o ± 0.30o. For maxillary canine brackets, the brands Abzil, Morelli, and Ormco presented statistically diferente values from those indicated for prescription. For mandibular canine brackets, the brands Abzil, Eurodonto, and Ormco presented statistically different values from the prescribed ones. CONCLUSIONS: Some marketed brands present differences between the torque angle found in the brackets and those recommended in the prescription. However, these differences are clinically acceptable...