Assessing the Accuracy and Reliability of Various Sagittal Dysplasia Indicators in Skeletal Class II Pattern

AbstractBackground: Traditional Sagittal dysplasia indicators like ANB and WITS appraisal have limitations, hence, newer parameters such as Beta, YEN, W, MKG and Tau angles have been developed of late as no single parameter is definitive for diagnosing sagittal dysplasia.Aim & Objectives:To assess the reliability and accuracy of various Sagittal dysplasia indicators in identifying Class II skeletal patterns and to determine the most reliable indicator.Materials & Method: 30 Lateral Cephalograms of Skeletal Class II subjects( ANB>4° and WITS AO ahead of BO >1.5mm) were analyzed further for Beta, W, YEN, MKG and Tau angles. Results obtained were tabulated and subjected to Chi square test to asses accuracy of various Sagittal dysplasia indicators.Results: W angle showed the highest accuracy (100%) in predicting Class II cases, followed by the Tau angle (92%). While Beta and Yen angles had moderate accuracy (68%) with similar performance, the MKG angle had slightly lower accuracy (66%). Overall, the W and Tau angles were the most reliable for Class II predictions.Conclusion: The study identifies the W angle as the most precise Sagittal dysplasia indicator for Class II skeletal patterns, followed by the Tau angle. While ANB/WITS analysis demonstrated high specificity, its limitations in adaptability across skeletal patterns were evident. Beta, YEN, and MKG angles exhibited moderate predictive reliability, necessitating a multimodel diagnostic approach to ensure comprehensive assessment and accuracy in complex cases.