Conceptual Standards in Orthodontic Care: Analysis of the Dentition

The cephalometric radiograph has become an integral part of the process of orthodontic therapy. It is currently utilized as an important tool in orthodontic diagnosis and the planning of treatment. The concept of using ideal cephalometric values as a yardstick to measure treatment outcomes is not new and remains an enticing idea. The validity of so doing, however, has not been tested. The purpose of this study was to determine if orthodontic cases finished to excellent clinical results actually attain the ideal found in the Bolton Standards. The subjects used for this study were patients who were deemed to have well- treated orthodontic outcomes. The dentition of each patient was evaluated cephalometrically and compared to Bolton Standards. Three categories of comparisons were made using pretreatment and post-treatment lateral cephalometric radiographs. There existed some significant differences (p\u3c0.05) among cephalometric variables in each comparison study. Two out of seven mean z-scores were significantly different when comparing pretreatment values to Bolton Standards and pretreatment to post-treatment values. The pretreatment z-scores of L1 to GoGn and U1 tip to NA were significantly larger than the Bolton Standards. Also, the values of U1 to L1 and L1 t o GoGn differed when pretreatment and posttreatment z-score means were compared. In the comparison of post-treatment to Bolton Standards, U1 to L1, L1 to GoGn, and L1 to NB were significantly different. The influence was that since differences existed, \u27\u27 ideal dentitions, as defined by the Bolton Standards, were not completely achieved through orthodontic treatment. The results of this investigation do not support the contention that orthodontic treatment results with excellent clinical outcomes can be appropriately assessed using ideal cephalometric standards