Treatment of adult Class III malocclusions with orthodontic therapy or orthognathic surgery: Receiver operating characteristic analysis

The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. We used lateral cephalometric radiographs of 80 subject...

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Published in	American journal of orthodontics and dentofacial orthopedics Vol. 139; no. 5; pp. e485 - e493
Main Authors	Tseng, Yu-Chuan, Pan, Chin-Yun, Chou, Szu-Ting, Liao, Chen-Yi, Lai, Sheng-Tsung, Chen, Chun-Ming, Chang, Hong-Po, Yang, Yi-Hsin
Format	Journal Article
Language	English
Published	United States Mosby, Inc 01.05.2011
Subjects	Adolescent Adult Area Under Curve Cephalometry - statistics & numerical data Chin - pathology Dentistry Discriminant Analysis Female Humans Incisor - pathology Male Malocclusion, Angle Class III - surgery Malocclusion, Angle Class III - therapy Mandible - pathology Maxilla - pathology Nasal Bone - pathology Orthodontics, Corrective - statistics & numerical data Orthognathic Surgical Procedures - statistics & numerical data Retrospective Studies ROC Curve Sella Turcica - pathology Sensitivity and Specificity Treatment Outcome Young Adult
Online Access	Get full text
ISSN	0889-5406 1097-6752 1097-6752
DOI	10.1016/j.ajodo.2010.12.014

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Abstract	The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. We used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness. For a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤–4.73 mm; Wits appraisal, ≤–11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤–0.18 mm; and gonial angle, ≥120.8°. We selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions.
AbstractList	The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. We used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness. For a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤–4.73 mm; Wits appraisal, ≤–11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤–0.18 mm; and gonial angle, ≥120.8°. We selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions. The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables.INTRODUCTIONThe aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables.We used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness.METHODSWe used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness.For a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤-4.73 mm; Wits appraisal, ≤-11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤-0.18 mm; and gonial angle, ≥120.8°.RESULTSFor a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤-4.73 mm; Wits appraisal, ≤-11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤-0.18 mm; and gonial angle, ≥120.8°.We selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions.CONCLUSIONSWe selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions. The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. We used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness. For a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤-4.73 mm; Wits appraisal, ≤-11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤-0.18 mm; and gonial angle, ≥120.8°. We selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions. IntroductionThe aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery by conducting a receiver operating characteristic analysis of cephalometric variables. MethodsWe used lateral cephalometric radiographs of 80 subjects (40 nonsurgical and 40 surgical patients) with Class III malocclusions and obtain 25 cephalometric measurements using computerized cephalometry. Of these, 14 measurements showed statistically significant differences between the 2 groups. Receiver operating characteristic analysis was used to determine the ability of the 14 cephalometric measurements in distinguishing between the 2 groups. Six statistically validated and clinically relevant measurements were used to obtain the optimum discriminant effectiveness. ResultsFor a Class III malocclusion patient with any 4 of these 6 measurement criteria, the sensitivity was 88% and the specificity was 90% in determining the need for surgical treatment: overjet, ≤–4.73 mm; Wits appraisal, ≤–11.18 mm; L1-MP angle, ≤80.8°; Mx/Mn ratio, ≤65.9%; overbite, ≤–0.18 mm; and gonial angle, ≥120.8°. ConclusionsWe selected 6 cephalometric measurements as the minimum number of discriminators required to obtain the optimum discriminant effectiveness of diagnosis between surgical and nonsurgical treatment of skeletal Class III malocclusions.
Author	Lai, Sheng-Tsung Yang, Yi-Hsin Liao, Chen-Yi Chen, Chun-Ming Tseng, Yu-Chuan Pan, Chin-Yun Chang, Hong-Po Chou, Szu-Ting
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Snippet	The aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not requiring surgery... IntroductionThe aim of this study was to distinguish between orthodontic patients with skeletal Class III malocclusions requiring surgery and those not...
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SubjectTerms	Adolescent Adult Area Under Curve Cephalometry - statistics & numerical data Chin - pathology Dentistry Discriminant Analysis Female Humans Incisor - pathology Male Malocclusion, Angle Class III - surgery Malocclusion, Angle Class III - therapy Mandible - pathology Maxilla - pathology Nasal Bone - pathology Orthodontics, Corrective - statistics & numerical data Orthognathic Surgical Procedures - statistics & numerical data Retrospective Studies ROC Curve Sella Turcica - pathology Sensitivity and Specificity Treatment Outcome Young Adult
Title	Treatment of adult Class III malocclusions with orthodontic therapy or orthognathic surgery: Receiver operating characteristic analysis
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