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The European Journal of Orthodontics Advance Access published online on May 15, 2009

The European Journal of Orthodontics, doi:10.1093/ejo/cjp011
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© The Author 2009. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Systematic evaluation of the features influencing the accuracy of third order measurements

Michael Knösel*, Klaus Jung**, Thomas Attin***, Rengin Attin****, Dietmar Kubein-Meesenburg* and Liliam Gripp-Rudolph*

* Department of Orthodontics
** Department of Medical Statistics, University of Göttingen, Germany
*** Clinic for Preventive Dentistry, Periodontology and Cariology, University of Zürich
**** Private Practice, Zürich, Switzerland

Address for correspondence Dr Michael Knösel, Department of Orthodontics, Center of Dentistry, University of Göttingen, Robert-Koch-Street 40, 37099 Göttingen, Germany, E-mail: mknoesel{at}yahoo.de


   Abstract

The aims of this study were to evaluate the relationship of third order measurements on dental casts with those on lateral radiographs, and to identify those incisor features on radiographs which can best explain third order measurements on dental casts.

Lateral cephalograms and corresponding dental casts were obtained from 39 untreated Caucasians (12 males, 27 females; mean age 19.5 years; standard deviation 3.7 years) with occlusal relationships considered to be ‘normal’. The upper (U1) and lower (L1) incisors were assessed with reference to the occlusal plane perpendicular which was established on the lateral radiographs, including third order angles (U1TR, L1TR) which were also derived from direct dental cast measurements (U1TA, L1TA). Both single regression and multiple linear regression analysis with stepwise variable selection were performed using third order measurements on casts as the dependent variable and crown axis (U1C, L1C), root axis (U1R, L1R), tip–apex connecting line (U1E, L1E), and radiographic third order measurements as independent variables.

Single regression analysis indicated an overall difference of 0.02 degrees between radiographic third order inclination and cast assessment in the maxilla (mandible: –2.83 degrees). A change of 1 degree in radiographic third order inclination would produce a change of 0.65 degrees for U1TA and 0.86 degrees for L1TA assessments. Third order measurements on dental casts can best be explained by a linear combination of U1TR and U1E (maxilla) and of L1TR and L1C (mandible) measurements.

This study demonstrates the functional enmeshment between two different third order assessments and the most common incisor features on lateral radiographs. Both methods of third order evaluation show sufficient reliability and are appropriate for routine orthodontic practice.


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