Table 1.

Publications related to the importance and contribution of cephalometry on the orthodontic treatment planning

Authors (year)	Aim of the study	Observers	Subjects	Design of the study	Statistical method	Results according to authors	Level of evidence
Silling et al. [9]	Assess usefulness of cephalometric analysis	24 orthodontists	6 patients	Stratified random design: 12 orthodontists analysed 6 patients with cephalograms and 12 orthodontists studied 6 patients without cephalogram	Not referred	Class I patient: disagreement on extractions, anchorage and growth potential decisions	Low
						No need for lateral cephalometry, except for atypical class II division 1 patients, by 4 orthodontists
						Anchorage problems SS between patients with and without lateral cephalogram
Bruks et al. [6]	Evaluation of lateral cephalometric and panoramic radiography	4 dentists and senior orthodontist	70 patients	Clinical evaluations and treatment plan by 4 dentists:	Descriptive statistics and statistical analyses with computer software. Kruskal-Wallis test to evaluate differences between groups	Impact on diagnosis relating to the ordering sequence of cephalogram: first choice, 68%; second choice, 73%; third choice, 80%	Low
				1. Study casts + photographs		93% of cases: same treatment plan before and after radiographic analysis
				2. Adding radiographs
Pae et al. [7]	Examine the link between lateral cephalograms and occlusal trays	16 orthodontists	80 patients	T1: casts evaluated; T2 (1 week later): casts + lateral cephalograms	Rash model, regression plots, two-way ANOVA, post hoc multiple comparison Bonferroni and paired t test	Class II division 2 patients: 126 extractions planned at T1; 80 at T2	Moderate
						A lateral cephalogram influenced degree of severity, but not the difficulty of treatment
Nijkamp et al. [3]	Influence of lateral cephalometry on treatment plan	10 post-graduatetrainees and 4 orthodontists	48 patients	Randomised crossover design - T1: casts, T2 (1 month after): with lateral cephalometry and tracing, and T3 and T4 (repeated after 1 and 2 months)	Overall proportion of agreement	Consistency of treatment plan was NS between the use only of dental casts or with additional cephalometry	Low
						Influence of cephalometrics on orthodontic treatment planning: NS
Devereux et al. [2]	Influence of lateral cephalometry on treatment plan	114 orthodontists	6 patients	3 groups: (a) no lateral cephalogram and tracings, (b) some with lateral cephalogram and tracings and (c) all with lateral cephalogram and tracings	Chi-square and binary logistic regression	Treatment plan changed for extraction pattern (42.9%), anchorage reinforcement (24%) and decision to extract (19.7%)	Low
						Class I patient: lateral cephalogram less times ordered. Only patients where treatment plan changed after its analysis
						NS impact of cephalometrics on treatment plan
Atchison et al. [4]	Determine quantitatively the diagnosis and treatment plan information after radiograph evaluation	39 orthodontists	6 patients	A 2-h interview for diagnosis and treatment planning of 6 cases. Study cast, intra- and extra-oral photographs, tracing and clinical findings available.	Analysis of variance with repeated measures and covariance, homogeneity value and descriptive statistics	98% of cases: at least one of the radiographs unproductive	Low
				A radiograph only if judged helpful		3/4 of radiographs did not provide information to change diagnosis and treatment plan
Atchison et al. [10]	Identify selection criteria for ordering orthodontic radiographs	39 orthodontists	6 patients	A 2-h interview for diagnosis and treatment planning of 6 cases. Study cast, intra- and extra-oral photographs, tracing and clinical findings available	Not referred	14.4% of radiographs ordered for skeletal relationship of the jaws	Low
						Lateral cephalograms accounted for 34% of required information
						26% of all ordered radiographs produced modifications on diagnosis or treatment plan
						Pretreatment lateral cephalogram required in all patients needing orthodontic treatment

NS, non-significant.