How orthodontic records can influence torque choice decisions?

Area of Science:

• Orthodontics
• Dental Diagnostics

Background:

• Assessing torque selection agreement in orthodontics is crucial for consistent treatment outcomes.
• Variability in diagnostic records may influence clinician agreement on torque application.

Purpose of the Study:

• To evaluate the impact of additional diagnostic records on intra- and inter-rater agreement for orthodontic torque selection.
• To determine if extraoral photographs and cephalograms enhance consensus among orthodontists regarding torque application.

Main Methods:

• Five orthodontic specialists evaluated 48 patient cases across three sessions.
• Records progressively increased from models/intraoral photos to include extraoral photos, then cephalometric X-rays.
• Mean weighted kappa coefficients were calculated to quantify agreement levels.

Main Results:

• Inter-observer agreement was consistently low across all sessions (mean kappa coefficients ranging from 0.34 to 0.54).
• Intra-rater agreement also showed low to moderate coefficients (0.18-0.66), with slight improvements after adding records.
• Extraoral photographs appeared to influence torque selection decisions more than cephalograms.

Conclusions:

• The addition of diagnostic records, particularly extraoral photographs, significantly impacts intra- and inter-rater agreement in torque selection.
• Clinician consensus on the optimal torque for treating various malocclusions remains a challenge.
• Standardized guidelines for torque selection in orthodontics are needed.