Quality assessment of lateral cephalograms amongst radiologists and orthodontists

This study investigated technical errors in the production of lateral cephalograms necessitating a retake and the extent to which the retake, as ordered by the radiologist, actually produced a gain in quality as assessed by the orthodontist. All the rejected lateral cephalograms taken at the Department of Oral Radiology over a period of 1 year were saved, and 20 such radiographs and their approved counterparts were then studied. Ten orthodontists were asked to decide whether the radiographs were acceptable or not and to provide reasons for those judged unacceptable. Considerable variation was found between the 10 orthodontists in the rate of acceptance of the radiographs. One orthodontist accepted only 13, while another accepted 37 out of the 40 radiographs. The main cause for rejection by the orthodontists of the radiologically approved films was: patients positioning error, and for the rejected: poor (or no) intercuspation. The results show large discrepancies between the radiologists and the orthodontists in quality criteria for cephalometric radiographs, as well as large interindividual variations among the orthodontists. In half of the cases, the radiologists ordered retakes that, according to the orthodontists, were not necessary.