ArticleCureus2025
Concordance of Cephalometric Classifications of Divergence in Orthodontics.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Styloid Process Elongation as an Incidental Finding in Adult Orthodontic Patients: Prevalence, Morphology and Diagnostic Implications from Panoramic Radiography.Diagnostics (Basel, Switzerland) · 2026Article
- External Root Resorption Associated with Orthodontic Treatment-Descriptive Correlations of Biological and Dental Risk Factors.Dentistry journal · 2026Article
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Authors and funding
1 author.
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No grant is acknowledged in the PubMed record.
Abstract
Background Vertical skeletal pattern is central to orthodontic diagnosis. We compared five cephalometric methods-Steiner (Sella-Nasion to mandibular plane, SN/GoGn), Downs (mandibular plane to Sella-Nasion, MP/SN), Tweed (Frankfort-mandibular plane angle, FMA), Arnett (palatal plane to mandibular plane, PP/MP), and Ricketts (facial axis angle, FAA)-for classifying facial divergence. Methods We retrospectively analyzed 300 lateral cephalograms (114 males, 186 females; mean age 26.4 ± 9.9 years) from skeletal Class I adults (A point-Nasion-B point angle, ANB, 0° < ANB < 4°). Each method classified subjects as hypo-, normo-, or hyperdivergent. Agreement was assessed using Cohen's kappa (κ), and ordinal association using Kendall's tau-b (τ_b). Results Divergence prevalence varied by method: hypodivergent 16% (48/300) with MP/SN to 30% (90/300) with SN/GoGn; hyperdivergent 15.3% (46/300) with PP/MP to 25% (75/300) with MP/SN. Agreement was substantial for SN/GoGn vs MP/SN (κ = 0.656, p < 0.001), moderate for several other pairs (κ ≈ 0.49-0.54), and lowest when FAA was compared (κ ≈ 0.11-0.22). Overall agreement was fair (κ = 0.375, p < 0.001). Conclusions Cephalometric methods are not interchangeable for vertical classification. Reporting at least two complementary indices is advisable; FAA should not be used alone. Standardized thresholds and multi-index confirmation may improve diagnostic consistency.
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