Concordância dos ortodontistas no diagnóstico do padrão facial Agreement among orthodontists regarding facial pattern diagnosis

OBJETIVO: avaliar a concordância de ortodontistas treinados no diagnóstico do Padrão Facial, por meio da avaliação morfológica da face. MÉTODOS: foram utilizadas fotografias faciais de frente, perfil e sorriso de 105 indivíduos selecionados aleatoriamente entre pacientes que procuraram tratamento ortodôntico, as quais foram enviadas a ortodontistas treinados na classificação do Padrão Facial. A concordância intraexaminador, dos examinadores com o Padrão-Ouro e interexaminadores foi avaliada por meio do Índice Kappa. RESULTADOS: a concordância na avaliação intraexaminador foi quase perfeita, com Índice Kappa 0,85. A concordância entre os examinadores e o Padrão-Ouro foi moderada (Kappa 0,48), sendo mais alta no Padrão I (Kappa 0,62) e mais baixa no Padrão Face Curta (Kappa 0,33). A concordância entre os examinadores foi substancial (Kappa 0,61), mais alta que a concordância com o Padrão-Ouro em todos os Padrões. CONCLUSÃO: os critérios utilizados pelos examinadores para determinação do Padrão Facial foram os mesmos na primeira e na segunda avaliação. A concordância entre os examinadores e o Padrão-Ouro é moderada, e eles apresentam maior concordância entre si que com o Padrão-Ouro.<br>OBJECTIVE To assess agreement among orthodontists trained in facial pattern diagnosis through the morphological evaluation of the face. METHODS: Facial photographs were taken in front and side view, as well as photos of the smiles of 105 individuals randomly selected among patients seeking orthodontic treatment. The photos were sent to orthodontists trained in facial pattern classification. Intra-rater agreement, agreement between raters and the Gold Standard, as well as inter-rater agreement were assessed using the Kappa index. RESULTS: Intra-rater agreement was almost perfect, with Kappa index reaching 0.85. Agreement between raters and the Gold Standard was moderate (Kappa = 0.48), higher for Pattern I (Kappa = 0.62) and lower for the short face pattern (Kappa = 0.33). Agreement between raters was significant (Kappa = 0.61) and even higher than agreement with the Gold Standard for all patterns. CONCLUSIONS: The criteria used by raters to determine the facial pattern were the same in the first and second evaluation. Agreement between raters and the Gold Standard was moderate, with raters exhibiting greater agreement between them than with the Gold Standard

Evaluation of proximal caries in images resulting from different modes of radiographic digitalization

Objective: The aim of this study was to evaluate the performances of observers in diagnosing proximal caries in digital images obtained from digital bitewing radiographs using two scanners and four digital cameras in Joint Photographic Experts Group (JPEG) and tagged image file format (TIFF) files, and comparing them with the original conventional radiographs. Method: In total, 56 extracted teeth were radiographed with Kodak Insight film (Eastman Kodak, Rochester, NY) in a Kaycor Yoshida X-ray device (Kaycor X-707;Yoshida Dental Manufacturing Co., Tokyo, Japan) operating at 70 kV and 7 mA with an exposure time of 0.40 s. The radiographs were obtained and scanned by CanonScan D646U (Canon USA Inc., Newport News, VA) and Genius ColorPage HR7X (KYE Systems Corp. America, Doral, FL) scanners, and by Canon Powershot G2 (Canon USA Inc.), Canon RebelXT (Canon USA Inc.), Nikon Coolpix 8700 (Nikon Inc., Melville, NY), and Nikon D70s (Nikon Inc.) digital cameras in JPEG and TIFF formats. Three observers evaluated the images. The teeth were then observed under the microscope in polarized light for the verification of the presence and depth of the carious lesions. Results: The probability of no diagnosis ranged from 1.34% (Insight film) to 52.83% (CanonScan/JPEG). The sensitivity ranged from 0.24 (Canon RebelXT/JPEG) to 0.53 (Insight film), the specificity ranged from 0.93 (Nikon Coolpix/JPEG, Canon Powershot/TIFF, Canon RebelXT/JPEG and TIFF) to 0.97 (CanonScan/TIFF and JPEG) and the accuracy ranged from 0.82 (Canon RebelXT/JPEG) to 0.91 (CanonScan/JPEG). Conclusion: The carious lesion diagnosis did not change in either of the file formats (JPEG and TIFF) in which the images were saved for any of the equipment used. Only the CanonScan scanner did not have adequate performance in radiography digitalization for caries diagnosis and it is not recommended for this purpose. Dentomaxillofacial Radiology (2011) 40, 338-343. doi: 10.1259/dmfr/6718596

Evaluation of the position of lower incisors in the mandibular symphysis of individuals with Class II malocclusion and Pattern II profiles

OBJECTIVES: This study evaluated the position of mandibular incisors in the mandibular symphysis of individuals with Class II malocclusion and Pattern II profiles. METHODS: The sample consisted of 40 Caucasian patients (20 male and 20 female) with Class II malocclusion and Pattern II profile from 10 to 18 years of age (mean age of 12.84 years) who were selected from the records of the School of Dentistry of Universidade de Passo Fundo, Brazil. The linear cephalometric measurements used in this study were Ricketts' 1- AP, Interlandi's line I and Vigorito's 1-VT; and the angular measurement studied was the mandibular plane angle (IMPA). RESULTS: Mandibular incisors of individuals with Class II malocclusion and Pattern II profile tended to be buccally inclined and protruded