Validity of the Extraoral Photograph as a Diagnostic Tool for Assessment of the Malocclusion

Human face is living mirror held out to the world. Conventionally orthodontist rely generally on cephalometric measurement for daignostic & prognostic information. Many a times due to demographic constraints of unavailability of specialised radiographic equipment & patient related issues that photographic investigation gains priorit.

1 Assess the reliability of the photographic analysis as a diagnostic tool to study the type of malocclusion extraorally with facial type & facial profile. 2. To compare the validity of photographic analysis against cephalometric analysis to detect the existing malocclusion. 3. To recommend if photographs could be used as a valid diagnostic aid in situations where cephalograms cannot be obtained.

Sample size 60 male & female subjects, age group of 18-27 years. Profile photograph & cephalogram taken and examined twice by two examiners & nine possible profile variants were classified by the evaluators. The examiners were blinded to the cephalometric measures of the same subjects which constituted the study sample. After examining the photographs, the cephalometric facial types were compared to the facial types detected by the examiners on the basis of photographic analysis. The descriptive & statistical analysis were done to study the reliability between the examiners and the measure of agreement between the examiner.

Statistically significant difference between the judgement of the examiners when compared to the facial profiles observed on cephalograms, however no significant inter and intra examiner variability was observed. Therefore the Reliability of photographic analysis in determining malocclusion using different facial types & facial profiles are questionable. Hence use of standardised grid or standardised head positioner will be more helpful while using photographic analysis as a diagnostic tool.