Outcome prediction of the anterior open bite. Comparison of computer and clinician analysis of cephalograms

Anterior open bite (AOB) may be expected to close spontaneously in approximately 50% of Caucasian patients. Computer-derived discriminant analysis of a single cephalometric radiograph has been shown to predict closure or non-closure in 88% of patients at the pre-puberal stage, in 74% at the puberal stage, and in 94% at the post-puberal stage. In this study, the predictive capacity of the computer analysis was tested against predictions made by groups of clinicians in Belfast and Toronto. The computer analysis was carried out on the first cephalometric radiographs of a new sample of 34 open bite cases collected serially and recorded over a minimum of 2 years. Thus, the spontaneous outcome was known to the authors. The first radiographs were shown to 20 clinicians in Belfast and 22 in Toronto who were asked to predict the spontaneous outcome. The computerised discriminant analysis made correct predictions in 85% and the clinicians in 64% of the sample. There were no significant differences between the predictions of clinicians in Belfast and Toronto, but computer prediction was more accurate than all grades of clinician. The predictions of qualified orthodontists were generally more accurate than prequalified orthodontists which were more accurate than those of undergraduate dental students but the differences did not rise to the level of statistical significance. For patients at the puberal stage the predictive capacity of qualified orthodontists was less than orthodontists in training. Computer prediction of the spontaneous outcome in open bite improves clinical diagnosis.