Predictive variables analysis for the tongue crib treatment of anterior crossbite in mixed dentition

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OBJECTIVE: This study aimed to identify key prognostic variables and to develop and validate a clinical prediction model for pre-treatment assessment of tongue crib applicability. METHODS: This retrospective study included 128 cases with anterior crossbite treated with tongue crib in mixed dentition. The total samples were categorized into applicable (n = 80, corrected within 6 months without relapse) and non-applicable (n = 48) groups. Cephalometric parameters were measured using Dolphin Imaging 11.8, with Python (3.9.12) for statistical analysis. Randomly select 80% as the training set and the remaining 20% as the testing set with 100 iterations to establish logistic regression models incorporating SNB-ANB, Wits, and APDI sagittal parameters as predictors. Three predictive equations P = Exp(L)/1 + Exp(L), with a critical score of 0.5 underwent apparent validation on the training set and internal validation performed on the test set. The model demonstrating optimal validity and accuracy was selected to guide the clinical application. RESULTS: As for the total prediction accuracy of apparent validation on the training set and internal validation performed on the test set, SNB-ANB model was 79.9% and 77.0%; Wits model was 80.3% and 78.9%; APDI model was the highest, which was 81.1% and 80.5%. When the three prediction models changed from apparent validation on the training set to internal validation performed on the test set, the total prediction accuracy decreased slightly (-0.6% ~ -2.9%) with the APDI model exhibiting superior stability. CONCLUSIONS: The APDI simplified prediction model expression was P = Exp(L)/1+ Exp(L), L = -0.305(APDI)-0.341(MP-FH)-0.263(Co-Go)+50.496. "P" was the probability predicted to be applicable for tongue crib treatment, with a critical score of 0.5 (that was, p >0.5 was applicable, p < 0.5 was non-applicable). Applying the prediction model was able to effectively predict the results of anterior crossbite in mixed dentition treated with tongue crib.

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