A Novel Method to Determine Cephalometric Measures Best at Assessing a Class II Skeletal Discrepancy

Aim and background: To determine the ranking of 21 anteroposterior cephalometric parameters in assessing patients with a class II skeletal discrepancy.Materials and methods: Mixed methodology study-software development and retrospective analysis of archived radiographic records.Setting: Sri Ramachandra Institute of Higher Education and Research (Deemed to be University).Methods: 356 patients, with clinically verified skeletal class II discrepancy, were selected.Software was developed to evaluate 21 anteroposterior cephalometric parameters.The percent difference between the mean value for class II skeletal discrepancy and the patient value was obtained.The patient values were correlated with lateral cephalograms, which were ranked based on the clinical severity of class II skeletal discrepancy.The scatter plots of the rank vs the patient values of the 21 parameters were obtained.Results: Within angular parameters, FABA angle (0.209%), W angle (1.509%), and Yen angle (1.962%) had the least percent difference, and Pi angle (48.638%),APDI angle (33.066%),ANB angle (15.862%), and Down's AB plane angle (15.796%) had the highest percent difference.Within linear parameters, McNamara differential (0.444%), AF-BF distance (0.801%), and Wits appraisal (3.579%) had the least percent difference, and Pi linear (30.913%),Jenkins "a" plane (29.367%), and APP-BPP distance (27.431%) had the highest percent difference.The scatter plots closely followed the percent differences obtained.Conclusion: Overall, FABA angle, Wits appraisal, and the McNamara differential were most accurate in determining a class II skeletal discrepancy.Clinical significance: This would be of immense value, as clinicians will know, among the 21 parameters, which are the ones to be given priority during the treatment planning phase.