Steiner Cephalometric Analysis: Predicted and Actual Treatment Outcome Compared

Objective: To examine the accuracy and precision of the Steiner prediction cephalometric analysis.

Setting And Subjects: The sample consisted of 275 randomly selected patients, treated between 1970 and 1995 at a university department.

Methods: Lateral cephalograms before (T1) and after orthodontic treatment (T2) were analyzed using the Steiner analysis. A prediction of the final outcome at T2 for the variables ANB degrees, U1 to NA mm, L1 to NB mm, and Pg to NB mm was performed at T1. The difference between the actual outcome at T2 and the Steiner predicted value (SPV), which was done at T1, was calculated. Accuracy (mean difference between T2 and SPV) and precision (standard deviation of the mean prediction discrepancies) of the prediction were studied. Paired t-test was used to detect under- or overestimation of the predicted values.

Results: The mean decrease in angle ANB was 1.4 +/- 2.7 degrees and for U1 to NA 2.0 +/- 2.6 mm, while L1 to NB increased 0.8 +/- 2.0 mm and Pg to NB 0.7 +/- 1.1 mm. The predicted values for the changes in ANB angle, the distance of upper incisor U1 to NA as well as the distance Pg to NB were significantly overestimated when compared with the actual outcome, while the change in the distance of lower incisor L1 to NB was underestimated.

Conclusion: The prediction of cephalometric treatment outcome as used in the Steiner analysis is not accurate enough to base orthodontic treatment decisions upon.