Comparison between cephalometric classification methods for sagittal jaw relationships

Abstract

The present study evaluated how 2 widely used cephalometric sagittal analyses, ANB angle and WITS appraisal, classify skeletal classes I, II, and III in a random selection of 497 Finnish boys aged 4-20 years. This distribution was also compared with the visual inspection of cephalometric structures judged by 2 university instructors in orthodontics. The results showed remarkable differences and even sparked controversy concerning classification of the sagittal jaw relationships. The ANB angle and the WITS appraisal emphasized the role of class II based on a failure to distinguish the proportion of class I. The low-angle influence skewed the distribution of the ANB pattern in the class III direction, and the WITS pattern, conversely, towards class II. High- or low-angle influence had only minor effects on the visual inspection of cephalometric structures. This cross-sectional study showed an age-related decreasing mean value for the ANB angle and increasing mean value for the WITS appraisal, thus explaining the remarkable difference in the distribution of sagittal classes. However, the findings of age-related changes makes the use of the fixed norms questionable. For extreme or controversial cephalometric interpretations, visual inspection provides an essential aid in diagnosis and skeletal classification.

ANB, Wits And Molar Relationship, Do They Correlate In Orthodontic Patients?

“…Our results revealed a statistically significant regression between ANB angle and Wits appraisal which was in agreement with Hurmerinta et al and Zhou et al, however, Hurmerinta et al reported a lower R2 value [10,29]. This might be due to age differences because their study included patients with primary dentition [29].…”

Changes in psychological health, subjective food intake ability and oral health‐related quality of life during orthodontic treatment

“…Each or patient's sagittal skeletal relationship was classified into skeletal classes I, II III according to the ANB (point A, nasion, point B) angle on lateral cephalograms obtained for pre‐treatment diagnosis and treatment planning as follows: skeletal Class I, 0°−4°; skeletal Class II, >4°; skeletal Class III, <0° .…”

“…Each or patient's sagittal skeletal relationship was classified into skeletal classes I, II III according to the ANB (point A, nasion, point B) angle on lateral cephalograms obtained for pre-treatment diagnosis and treatment planning as follows: skeletal Class I, 0°À4°; skeletal Class II, >4°; skeletal Class III, <0° ( 19). We also assessed patients using the Dental Health Component of the Index of Orthodontic Treatment Need (IOTN-DHC), which represents a simple, easy and reasonably reproducible method of determining (20).…”

Rendimiento de la evaluación cefalométrica para el diagnóstico sagital intermaxilar: Revisión narrativa

“…A pesar de que el ángulo ANB es ampliamente utilizado en odontología, habitualmente se usa considerando un valor promedio de 2º y una variación de la normalidad de más/menos 2º (37) . Dicho abordaje diagnóstico no toma en cuenta la edad ni los fenómenos de crecimiento y desarrollo esperados para un determinado individuo, que se reflejan en la reducción del ángulo ANB a lo largo del desarrollo (24,26,29,31,38,39) . Esto puede llevar a un diagnóstico errado, y por ende a resultados clínicos distintos de los esperados.…”

“…Esto ha sido reportado por numerosos autores (24)(25)(26)(27)(28)(29)(30) . Utilizando una muestra longitudinal, Ochoa y Nanda (30) evaluaron 28 individuos de ambos sexos y observaron que el ángulo ANB disminuye significativamente durante el crecimiento.…”