Concordancia entre los análisis de Tatis y Ricketts para el diagnóstico del biotipo facial en imágenes radiográficas de pacientes atendidos en el centro radiológico Insideimagen, Cuenca-Ecuador en el período enero 2023- enero 2024

Abstract

In orthodontic diagnosis, clinical examination, cephalometric analysis, photographs, and study models are essential tools for proper treatment planning. Among the evaluated parameters, facial biotype guides the selection of orthodontic mechanics, as patients with similar malocclusions may present different responses depending on their facial biotype. Traditionally, facial biotype is determined through cephalometric analysis on lateral cephalograms, which has limited the diagnostic value attributed to panoramic radiographs. Objective: to analyze the agreement between the Tatis and Ricketts analyses for facial biotype diagnosis. Materials and methods: a total of 404 radiographs were selected, including 202 lateral cephalometric radiographs and 202 panoramic radiographs, all obtained by the same operator using the same radiographic equipment. Tracings and measurements required for both analyses were performed by a single previously calibrated operator. Diagnostic agreement was assessed using the weighted Cohen’s Kappa coefficient. Results: the Tatis analysis based on the glenoid fossa showed no agreement with the Ricketts analysis (κ = 0.009); the analysis based on condylar deflection demonstrated weak agreement (κ = 0.115); and the maxillomandibular angle showed low agreement (κ = 0.179), which was the highest among the comparisons performed. Conclusion: the Tatis analysis applied to panoramic radiographs showed low or no agreement with the Ricketts cephalometric analysis for facial biotype diagnosis; therefore, it cannot be considered a reliable or interchangeable method and should only be used as a complementary diagnostic tool.