The influence of camera perspective on diagnostic accuracy using orthodontic records

Introduction: Dr. Edward Angle, the "Father of Orthodontics" was also the first orthodontist to incorporate photography into the practice of orthodontics1. With the advent of digital cameras, clinical photography is easier, faster and more cost effective than ever before. Despite technological advances, difficulties with patient-camera positioning and the resultant parallax effect still persist. This cross-sectional survey evaluated the influence of camera perspective changes on the ability of orthodontists to make diagnostic judgments using photographic records.;Methods: Practicing orthodontists (n=205) assessed, via an electronic survey tool, 12 patient casts photographed at three angulations in the axial plane of one of two views: buccal view and frontal view. Participants judged midlines or canine and molar classification based on the images provided at different camera angulations. The relationships between correct responses and demographic information, degree of angulation, and clinical photography practice were assessed using Chi-square for bivariate analyses and conditional logistic regression for multivariate analyses.;Results: The results indicate a statistically significant (P=<0.005) and clinically significant difference in participant's ability to correctly determine Angle classification and midline deviation as camera perspective in the axial plane changes from ideal to non-ideal angulations.;Conclusions: Statistically and clinically significant decreases in diagnostic accuracy were observed when participants were asked to determine Angle classification and midline discrepancy at non-ideal angulations.