Establishing cephalometric norms for the Indian population using Steiner's cephalometric analysis
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Abstract
Objective: Current cephalometric norms are based on an untreated Caucasian sample and may not apply to other ethnic groups. It is essential to establish standard norms for different populations. Aim: To create cephalometric norms for the Indian population by utilizing Steiner’s analysis to aid in diagnosis and treatment planning. Method: The sample consisted of 200 adult subjects of Indian ethnic origin (100 males and 100 females). To avoid regional bias, samples were collected from four metropolitan cities: Delhi, Mumbai, Calcutta, and Chennai. The primary inclusion criterion required the participants to have a Class I molar relationship and an aesthetically pleasing profile (assessed through intra-oral and extra-oral profile photographs). All the radiographs were traced digitally using Dolphin (version 11.95) in random order by a single operator to reduce bias. Another operator randomly selected and retraced fifty cephalograms to check the operator's reliability and reproducibility. Inter-operator and intra-operator reliability was deemed satisfactory. Steiner’s cephalometric analysis was used to compare each participant's cephalogram, calculating all variables' means and standard deviations. Unpaired t-tests were used to determine differences in variable means between the Indian and Caucasian populations. The probability value (P value) of 0.05 was considered statistically significant. Results: Significant variations in specific parameters of Steiner’s cephalometric analysis were found between Indian and Caucasian populations. Steiner’s analysis showed a significant increase (P<0.05) in SNA (84°), SNB (82°), SND (79°), U1 to NA (8mm), U1 to NA (28°), L1 to NB (7mm), L1 to NB (28°), and reduced Go-Gn to SN (26°), Interincisal angle (122°), Occ plane to SN (12°) while ANB remained constant. Conclusions: This study emphasizes the necessity of establishing cephalometric norms for the Indian population. Understanding cephalometric differences in norms for various ethnic groups is critical for customized diagnosis and treatment.