Intra- and inter-examiner reliability of direct facial soft tissue measurements using digital calipers

Validation of two simple, objective tools for the assessment of synovial swelling in the equine fetlock region

Simple objective assessment tools are essential to monitor the efficacy of therapeutic interventions used in clinical settings. The purpose of present study was to investigate different ways of assessing synovial swelling of the equine fetlock region: tape measure and slide calliper, and to examine the method’s inter- and intra-examiner reliability. The hypotheses were that inter-examiner reliability would be fair and intra-examiner reliability strong. Measurements were performed on both hind limbs, on 16 horses. Palpation was done once for each limb, over the plantar pouch of the fetlock joint and the plantar digital flexor tendon sheath (PDFTS). Tape measure and slide calliper registrations were made, in triplicate by two independent assessors blinded to the measurements, horizontally over the fetlock joint and PDFTS areas, respectively. Intra-class correlation was used to measure inter- and intra-examiner reliability. The inter-examiner reliability was fair for the tape measurement of the plantar pouch of the fetlock joint, and almost perfect for the PDFTS. It was moderate for the slide calliper assessment of the PDFTS and almost perfect for the plantar pouch. The intra-examiner reliability was almost perfect for tape measure and slide calliper assessment, for the plantar pouch and PDFTS, respectively. Our results support our hypothesis and indicate that tape measure and slide calliper measurement of plantar pouch of the fetlock joint and PDFTS can be reliably performed by the same therapist. Slide calliper and circumference tape measures are promising objective techniques for assessing synovial swelling of the equine fetlock region.

Relationship between maxillary central incisor proportions and facial proportions

STATEMENT OF PROBLEM

No universally accepted parameter exists for selecting maxillary central incisors (MCIs) relative to facial proportions.

PURPOSE

The purpose of this prospective clinical study was to determine the relationship between MCIs and facial height and width in adults, intersex differences, and measurement differences between right and left MCI.

MATERIAL AND METHODS

A prospective study was undertaken of 149 dental students (F:76; M:73) aged between 18 and 30 years. Anthropometric MCI and horizontal and vertical facial measurements were recorded with digital calipers by 1 operator. Correlation was investigated with Pearson correlation coefficients (α=.05). Two-sample t tests were used for intersex comparisons and paired t tests to compare right and left MCIs. Intraexaminer reliability was tested by remeasuring 25 participants and applying the Bland-Altman and Lin analyses.

RESULTS

The mean MCI height was 10.28 mm (right and left) and the mean widths were 8.65 mm (right) and 8.66 mm (left). Intersex incisor differences existed for height measurements (M:F 0.54 mm [right], 0.46 mm [left]) and width measurements (M:F 0.26 mm) but not for width-to-height ratios (F=0.85; M=0.84). A mean ratio of 15.56 was found between bizygomatic width:tooth width (M=15.75, F=15.37) and of 17.93 between total face height:MCI height (M=17.97, F=17.89). Correlation coefficients were low for all tooth:face measurements. Intraexaminer reliability was clinically acceptable.

CONCLUSIONS

Men had larger teeth and faces but similar width:height ratios. There was no significant size difference between right and left MCI, little individual relationship between tooth:face proportions, and insignificant sex influence. The "biometric ratio"' of 1:16 for MCI:bizygomatic width was not reconfirmed exactly. A ratio of 1:18 is proposed for MCI height to total face height (Tr-Me') and 1:12 for face height (N'-Me').