ABO objective grading system based on clinical photography

Purpose. To determine if the American Board of Orthodontics' Objective Grading System can be accurately applied through clinical photography. Materials and method. The sample consisted of ten ABO Board graders and ten orthodontic residents from Saint Louis University. The sample graded ten finished orthodontic cases using the Objective Grading System based only on clinical photography and their scores were subsequently compared to the same cases scored traditionally using the final plaster orthodontic models. A Cronbach's alpha reliability test was performed to determine individual subject categorical reliability and a oneway ANOVA was completed to compare the results of the Board graders and residents as two groups.Results. Only five of the twenty subjects were found reliable for more than one of the eight categories evaluated in the Objective Grading System. Within groups, the ANOVA revealed that only Board graders evaluating buccolingual inclination was found to be significantly different than gold standard scores from plaster models. The Board graders significantly underestimated the gold standard in this category. Conclusion. The American Board of Orthodontics thrives on examiner synchronization and reliability. Since individual reliability in this study tested poorly, it cannot be recommended to replace plaster models with clinical photography when applying the Objective Grading System.