Open Access Open Badges Review

Validity of 2D lateral cephalometry in orthodontics: a systematic review

Ana R Durão1*, Pisha Pittayapat2, Maria Ivete B Rockenbach3, Raphael Olszewski4, Suk Ng5, Afonso P Ferreira6 and Reinhilde Jacobs2

Author Affiliations

1 Department of Dental Radiology, Faculty of Dental Medicine, University of Porto, Porto, Portugal

2 Oral Imaging Center, OMFS-IMPATH research group, Dept Imaging & Pathology, Faculty of Medicine, University of Leuven, Leuven, Belgium

3 Department of Surgery, Dentistry School, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil

4 Department of Oral and Maxillofacial Surgery, Université Catholique de Louvain, Brussels, Belgium

5 Department of Dental Radiology, Guy's, King's and St. Thomas' Dental Institute, King's College London, London, UK

6 Department of Orthodontics, Faculty of Dental Medicine, University of Porto, Porto, Portugal

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Progress in Orthodontics 2013, 14:31  doi:10.1186/2196-1042-14-31

Published: 20 September 2013


Lateral cephalometric radiography is commonly used as a standard tool in orthodontic assessment and treatment planning. The aim of this study was to evaluate the available scientific literature and existing evidence for the validation of using lateral cephalometric imaging for orthodontic treatment planning. The secondary objective was to determine the accuracy and reliability of this technique. We did not attempt to evaluate the value of this radiographic technique for other purposes. A literature search was performed using specific keywords on electronic databases: Ovid MEDLINE, Scopus and Web of Science. Two reviewers selected relevant articles, corresponding to predetermined inclusion criteria. The electronic search was followed by a hand search of the reference lists of relevant papers. Two reviewers assessed the level of evidence of relevant publications as high, moderate or low. Based on this, the evidence grade for diagnostic efficacy was rated as strong, moderately strong, limited or insufficient. The initial search revealed 784 articles listed in MEDLINE (Ovid), 1,034 in Scopus and 264 articles in the Web of Science. Only 17 articles met the inclusion criteria and were selected for qualitative synthesis. Results showed seven studies on the role of cephalometry in orthodontic treatment planning, eight concerning cephalometric measurements and landmark identification and two on cephalometric analysis. It is surprising that, notwithstanding the 968 articles published in peer-reviewed journals, scientific evidence on the usefulness of this radiographic technique in orthodontics is still lacking, with contradictory results. More rigorous research on a larger study population should be performed to achieve full evidence on this topic.

Cephalometry; Orthodontics; Systematic review; Reliability; Validity