Comparison of Orthopantomogram and Lateral Cephalogram in Assessing Gonial Angle, Ramal Height, Ramal Height and Body Length

ABSTRACT OBJECTIVES This study aimed to obtain an orthopantomogram (OPG) and a lateral cephalogram to measure the gonial angle, ramus height, and mandibular body length. METHODOLOGY This cross-sectional comparative study was conducted at Rehmat Hospital, Abbottabad, and Peshawar, and included 160 participants selected through nonprobability consecutive sampling. Patients aged 16 to 40 years, of Pakistani nationality, with both OPG and lateral cephalogram in their orthodontic records were included. Radiographs of poor quality or patients with craniofacial anomalies, facial asymmetry, trauma, cancer, or previous head radiotherapy were excluded. Ramus height was measured from condylion to gonion, body length from gonion to menton, and the gonial angle was determined by the intersection of tangents along the lower and posterior borders of the mandible. Data were analyzed using a paired t-test to compare measurements between the two radiographic techniques. RESULTSThe mean age of participants was 24.93 ± 7.18 years, with 82 females (51.3 percent) and 78 males (48.8 percent). Significant differences were found between OPG and cephalogram measurements. The mean ramus height was 65.46 ± 10.40 mm on OPG and 50.21 ± 7.96 mm on cephalogram (p < 0.001). The mean body length was 95.99 ± 11.41 mm on OPG and 64.75 ± 7.85 mm on cephalogram (p < 0.001). The mean gonial angle was smaller on OPG (116.73 ± 6.85°) compared with the cephalogram (119.10 ± 8.31°, p < 0.001). CONCLUSION Panoramic radiographs tend to overestimate linear measurements but underestimate angular values compared with lateral cephalograms.