Presentations 2020: Ortho&Paeds

435 - An audit to assess the quality of lateral cephalometric radiographs taken for Orthodontic/Orthognathic purposes.

S Juman S Merrett N Drage
Presented by: Saarah Juman
Cardiff Dental Hospital

Introduction This retrospective audit was undertaken to assess whether the lateral cephalometric radiographs are of consistently high quality, providing adequate diagnostic information for Orthodontic/Orthognathic purposes. Methods From January 2019, 50 consecutive lateral cephalograms were retrospectively assessed by 2 observers and an agreed quality rating recorded. Only pre-treatment lateral cephalometric radiographs used for Orthodontic/Orthognathic surgery treatment planning were included. The standard follows the NRPB’s criteria and was set at 70%. Radiograph quality was rated using the NRPB’s subjective quality rating scale and quality standards for patient preparation, positioning and exposure as outlined in the European guidelines on radiation protection in dental radiology. The results were discussed with the staff in the Dental Radiology department. Results The standards were not met as only 23 (46%) were excellent (grade 1) and 27 (54%) diagnostically acceptable (grade 2). However, none were found to be diagnostically unacceptable (grade 3). Of the 27 diagnostically acceptable radiographs, patient positioning errors were most frequently found (n=24). These errors included landmarks such as throat point, gnathion, soft and hard tissue menton not being captured as well as Frankfort plane and antero-posterior positioning errors. Conclusion The results highlighted that essential landmarks were not always being captured, particularly in high angle or large stature patients. This was due to equipment limitations rather than a true positioning error. Having the patient raise their chin to capture these lower facial third landmarks would compromise Frankfort plane, their soft tissue profile and reproducibility. Instead, it was agreed that for these cases, the ear rods will be placed below the earlobes rather than in the external auditory meatus. To investigate the effects of these changes, a re-audit is planned.
Consent Statement: There are no details on individual patients reported within the abstract.

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