Assessing the Diagnostic Value of Lateral Cephalometric Radiographs in Class I Dental Malocclusions

Abstract

Introduction: Controversy exists over the value of a lateral cephalogram for treatment planning in different malocclusion types. Discord has been found in the literature, and no studies on the matter have focused solely on Class I dental malocclusions. The aim of this study was to elucidate whether treatment decisions of extraction or non-extraction and the perceived need for a lateral cephalogram would change depending on whether a lateral cephalogram was provided or eliminated in the patient record set. Methods: A survey was distributed to a random sample of AAO members. The survey consisted of four different patient record sets, each with a Class I dental malocclusion. Each record set had two versions—one with the lateral cephalogram and one without. The survey had randomization of each version of the record sets so that each record set would be viewed an equal number of times with and without its corresponding cephalogram. Subjects were then asked a series of four questions pertaining to each case: was a cephalogram necessary for treatment planning, treatment of extraction versus non-extraction, retention method, and if records were adequate to treatment plan. Results: In total, 79 orthodontists completed the survey. For all cases combined, record sets viewed with the lateral cephalogram had an increase in the: perceived need for a lateral cephalogram, decision of extraction, and opinion of the records being adequate to treatment plan. All were statistically significant at P ≤ 0.001. For each record set, the difference in perceived need for a lateral cephalogram was statically significant. Conclusions: The use of a lateral cephalogram for diagnosing and treatment planning seems to hold value in Class I dental malocclusions, justifying radiation exposure for this diagnostic record. Additionally, the perceived need for a lateral cephalogram is greater when it is presented with the record sets, demonstrating the diagnostic value this radiograph holds.