Objective: To compare the reproducibility of landmark identification on three-dimensional (3D) conebeam computed tomography (CBCT) images between procedures based on traditional cephalometric definitions (procedure 1) and those tentatively proposed for 3D images (procedure 2). Materials and Methods: A phantom with embedded dried human skull was scanned using CBCT. The acquired volume data were transferred to a personal computer, and 3D images were reconstructed. Eighteen dentists plotted nine landmarks related to the jaws and teeth four times: menton (Me), pogonion (Po), upper-1 (U1), lower-1 (L1), left upper-6 (U6), left lower-6 (L6), gonion (Go), condyle (Cd), and coronoid process (Cp). The plotting reliabilities of the two procedures were compared by calculating standard deviations (SDs) in three components (x, y, and z) of coordinates and volumes of 95% confidence ellipsoid. Results: All 27 SDs for procedure 2 were less than 1 mm, and only five of them exceeded 0.5 mm. The variations were significantly different between the two procedures, and the SDs of procedure 2 were smaller than those of procedure 1 in 21 components of coordinates. The ellipsoid volumes were also smaller for procedure 2 than procedure 1, although a significant difference was not found. Conclusions: Definitions determined strictly on each three sectional images, such as for procedure 2, were required for sufficient reliability in identifying the landmark related to the jaws and teeth. (Angle Orthod. 2011;81:843-849.)
Objectives We propose a method for evaluating the reliability of a coordinate system based on maxillofacial skeletal landmarks and use it to assess two coordinate systems. Methods Scatter plots and 95% confidence ellipses of an objective landmark were defined as an index for demonstrating the stability of the coordinate system. A head phantom was positioned horizontally in reference to the Frankfurt horizontal and occlusal planes and subsequently scanned once in each position using cone-beam computed tomography. On the three-dimensional images created with a volume-rendering procedure, six dentists twice set two different coordinate systems: coordinate system 1 was defined by the nasion, sella, and basion, and coordinate system 2 was based on the left orbitale, bilateral porions, and basion. The menton was assigned as an objective landmark.
ResultsThe scatter plot and 95% ellipse of the menton indicated the high-level reliability of coordinate system 2. The patterns with the two coordinate systems were similar between data obtained in different head positions.Conclusions The method presented here may be effective for evaluating the reliability (reproducibility) of coordinate systems based on skeletal landmarks.
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