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Comparative Study
. 2015 May-Jun;20(3):29-36.
doi: 10.1590/2176-9451.20.3.029-036.oar.

Radiographic evaluation of orthodontic treatment by means of four different cephalometric superimposition methods

Marcos Augusto Lenza  1 , Adilson Alves de Carvalho  2 , Eduardo Beaton Lenza  2 , Mauricio Guilherme Lenza  2 , Hianne Miranda de Torres  3 , João Batista de Souza  1
Affiliations
Comparative Study

Radiographic evaluation of orthodontic treatment by means of four different cephalometric superimposition methods

Marcos Augusto Lenza et al. Dental Press J Orthod. 2015 May-Jun.

Abstract
in English, Portuguese

Introduction: Despite discussion on the merit of various cephalometric superimposition methods, there remains a need to assess which one can be used in daily practice with reasonably accuracy and less working time.

Objective: The aim of this study was to investigate four methods of cephalometric superimposition by means of assessing the longitudinal changes in craniofacial morphology caused by growth and response of adolescents with Class I malocclusion to orthodontic treatment involving first premolar extraction.

Methods: Pretreatment (T1) and post-treatment (T2) standardized lateral cephalometric radiographs of 31 adolescents (20 females and 11 males), with Angle Class I malocclusion and indication of premolar extraction, participated in this study. Radiographs were digitized, traced and had structures identified by means of a cephalometric software. Four superimposition methods were used: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point. Positional changes were quantified by horizontal and vertical linear changes in the following cephalometric landmarks: anterior/posterior nasal spine (ANS and PNS), gnathion (Gn), Gonion (Go), Pogonion (Pog), A-point and B-point. Differences between T1 and T2 in horizontal and vertical positional changes for all superimposition methods were assessed by one-way analysis of variance (ANOVA) and Bonferroni correction (p < 0.05).

Results: There were no statistically significant differences among the cephalometric superimposition methods or when patients' sex was considered.

Conclusion: Björk structural method, Steiner/Tweed SN line, Ricketts N-Ba line at N-point and Ricketts N-Ba line at CC-point methods were reliable and presented similar precision when the overall facial changes due to active growth and/or orthodontic treatment were examined.

INTRODUÇÃO:: apesar dos debates sobre os méritos dos vários métodos de sobreposição cefalométrica, ainda há necessidade de se avaliar quais deles poderiam ser utilizados na prática diária, com razoável precisão e menor tempo de trabalho.

OBJETIVO:: o objetivo desta pesquisa foi investigar quatro métodos de sobreposição cefalométrica, avaliando as mudanças longitudinais na morfologia craniofacial causadas pelo crescimento e resposta ao tratamento, em adolescentes com má oclusão de Classe I tratados ortodonticamente com extração de primeiros pré-molares.

MÉTODOS:: foram usadas telerradiografias laterais pré-tratamento (T1) e pós-tratamento (T2) de 31 adolescentes (20 do sexo feminino e 11 do sexo masculino), com Classe I de Angle e indicação de extração de pré-molares. As radiografias foram digitalizadas, traçadas e as estruturas, identificadas com um software cefalométrico (Radiocef, Radio Memory, Belo Horizonte, Brasil). Quatro métodos de sobreposição foram utilizados para avaliar mudanças de posição devidas ao crescimento e/ou tratamento: método Estrutural de Björk; método Steiner/Tweed linha SN; Ricketts linha N-Ba no ponto N; e Ricketts linha N-Ba no ponto CC. As mudanças posicionais avaliadas pelos métodos de sobreposição foram quantificadas por mudanças lineares horizontais e verticais nos seguintes pontos cefalométricos: espinha nasal anterior (ENA), espinha nasal posterior (ENP), gnátio (Gn), Gônio (Go), Pogônio (Pog), Ponto A e Ponto B. Mudanças de posição horizontal e vertical entre T1 e T2 para todos os métodos de sobreposição foram avaliadas por análise de variância (ANOVA) e teste de Bonferroni (p < 0,05).

RESULTADOS:: não houve diferença estatística significativa entre os métodos de sobreposição cefalométrica em toda a amostra ou quando o sexo dos pacientes foi considerado.

CONCLUSÃO:: de acordo com a metodologia aplicada nesse estudo, os métodos de sobreposição cefalométrica Estrutural de Björk, de Steiner/Tweed linha SN, Ricketts linha N-Ba no ponto N e de Ricketts linha N-Ba no ponto CC foram confiáveis e com precisão semelhante para examinar as alterações faciais globais devidas ao crescimento ativo e/ou tratamento ortodôntico.

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Figures

Figure 1.
Figure 1.. Anatomical structures and reference cephalometric landmarks used in the study; 1. sella turcica, 2. nasal and frontal bones, 3. orbit, 4. external acoustic meatus, 5. maxilla, 6. mandible, 7. upper and lower central incisors, 8. upper and lower first molars, 9. soft tissue profile.
Figure 2.
Figure 2.. Cephalometric landmarks: 1. S (sella), 2. N (nasion), 3. Po (porion), 4. Or (orbitale), 5. Ba (basion), 6. ANS (anterior nasal spine), 7. PNS (posterior nasal spine), 8. A-point, 9. B-point, 10. Pog (pogonion), 11. Gn (gnation), 12. Go (gonion). Cephalometric planes: NPerp (nasion-perpendicular) and FHP (Frankfort horizontal plane).
See this image and copyright information in PMC

References

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