Accuracy of Digital Measurements: Analysis of Orthopantomography versus Lateral Cephalograms for Evaluation of Facial Asymmetry

Background: /Objectives: This study aimed to compare the accuracy of digital measurements obtained from orthopantomographies (OPGs) or panoramic radiographs and lateral cephalograms in evaluating facial asymmetry in patients with different skeletal classes. The sample consisted of 128 Romanian patients (67 females, 61 males; median age 21 years) who sought orthodontic treatment. Methods: Lateral cephalograms and OPGs were obtained for each patient, and digital tracing was performed using the WEBCEPH program. Angular measurements (ANB, FMA, gonial angles) and linear measurements (ramus height, mandibular body length) were assessed on both imaging modalities. Results: Strong positive correlations were found between the gonial angle and ramus height measurements obtained from lateral cephalograms and OPGs (rs range: 0.800-0.946; p < 0.001). However, mandibular body length showed weaker correlations between the two methods. Significant sex differences were observed, with males exhibiting larger craniofacial measurements compared to females (p < 0.05). Conclusions: The findings suggest that OPGs can be reliably used to measure the gonial angle and ramus height, providing results comparable to lateral cephalograms. However, caution should be exercised when predicting horizontal measurements from OPGs. Standardization of the OPG recording process and further research with larger sample sizes are required to establish standard panoramic norms for OPG parameters in the assessment of facial asymmetry.