Diagnostic value of lateral cephalometric parameters in determining vertical and horizontal maxillofacial growth...

Aim: To assess the diagnostic value of qualitative and quantitative lateral cephalometric parameters in determining vertical, horizontal, and neutral maxillofacial growth patterns in patients with orthodontic pathology.

Materials and Methods: The study included 292 lateral cephalograms of patients aged 5 to 50 years who sought orthodontic consultation. Eleven quantitative cephalometric parameters were analysed in the full sample. In a randomised subgroup of 160 cephalograms, seven additional qualitative parameters were assessed. Growth pattern determination was performed using an integrated approach based on the absolute majority of diagnostic signs. In addition, 134 cephalograms were independently evaluated by 34 orthodontic trainees using qualitative characteristics only. The diagnostic performance of each parameter was assessed using balanced accuracy, sensitivity, specificity, and positive predictive value.

Results: Among 292 patients, 121 had a neutral growth pattern, 103 a vertical pattern, and 68 a horizontal pattern. Evaluation based only on qualitative signs resulted in correct classification in 60.45% of cases on average. Among quantitative parameters, ∠N-Go-Me demonstrated the highest diagnostic performance, with a positive predictive value of 82.9%, followed by ∠Ar-Go-Me and ∠Pn-MP. Among qualitative parameters, the mandibular angle, condylar process height, and contour of the lower mandibular border showed the highest diagnostic value.

Conclusions: Quantitative cephalometric parameters, particularly ∠N-Go-Me, are more diagnostically reliable than isolated qualitative assessment for determining maxillofacial growth patterns. A combined approach may improve diagnostic accuracy in orthodontic treatment planning.