Lateral photographs versus lateral cephalograms: role in assessment of craniofacial morphology

Objective: To correlate craniofacial measurements from standardized facial photographs with analogous measurements from lateral cephalograms. Design: A prospective cross sectional study. Setting: A postgraduate department of Orthodontics and Dentofacial Orthopaedics based in India. Participants: patients with no previous orthodontic or surgical treatment, no history of craniofacial trauma lateral, all six maxillary anterior teeth present, no history of craniofacial trauma and cephalograms required as a part of routine treatment records were included. Method: The lateral cephalograms and standardised lateral profile photographs of 250 subjects ( 12 – 25 years) were taken with the patient in natural head position. Standard cephalometric angular and linear measurements were compared with angular and linear measurements on the photographs by identifying 8 facial landmarks. The landmarks on the face were first palpated and then marked, to ensure the position of respective skeletal landmark. Descriptive statistics for all measurements in the entire sample were computed and compared to assess Pearson correlation coefficients. Results: The reliability of the photographic technique was satisfactory. On comparing the cephalometric and photographic variables for the entire sample, positive and significant correlations were found for all linear and angular variables studied. Highest correlations were found for ANB and ANB’ (0.696, p ≤ 0.05) and the lowest correlations were found for ML and ML’(0.575, p ≤ 0.05). Conclusion: Both linear and angular measurements useful for characterising facial morphology can be reliably measured from facial photographs. The photographic method was found to be repeatable, low-cost, non-invasive diagnostic alternative for epidemiologic research, provided a standardised protocol is followed.