Influence of Lateral Cephalometric Radiography on Treatment Planning and Preferences in Skeletal Open-Bite Patients: Do Lateral Cephalograms Influence Treatment Planning

To investigate the influence of diagnostic data derived from lateral cephalometric radiographs (LCR) on treatment preferences of specialists planning skeletal open-bite treatment. Methods: Diagnostic records of 25 patients who had been treated at the University of Zurich, Department of Orthodontics, between 1988 and 2007 comprised the study material. Inclusion criteria were 1) skeletal open-bite with no marked antero-posterior discrepancy, 2) dental open-bite, and 3) crowding less than 5 mm. Records consisted of extra-intraoral photographs, panoramic-cephalometric X-rays, casts, and results of analyses. Records, with cephalograms of randomly chosen patients removed, were digitally presented to two orthodontists (A and B), and treatment preferences were asked using Likert-type questionnaires. Three months later, the same records were redelivered with missing cephalograms provided and present cephalograms removed with the questionnaire. Data were evaluated for consistency and tendency to extract using Kappa-κ and McNemar tests. Results: Orthodontist B had no poor-agreement scores, whereas orthodontist A presented very-poor agreement for headgear use. Both A (κ=0.833) and B (κ=0.737) had good to very-good agreement in terms of extraction decisions. Neither orthodontist had any significant tendency for extraction/non-extraction therapy (A=0.99; B=0.5). Conclusion: Information deduced from LCRs had limited influence on treatment planning preferences in skeletal/dental open-bite patients with no marked antero-posterior discrepancy and no influence on extraction/non-extraction decision.