Prospective study on the reproducibility of cephalometric landmarks on conventional and digital lateral headfilms

Abstract

The introduction of digital X-ray techniques offered a variety of new possibilities for digital image enhancement and exposure reduction. In order to compare the reproducibility of cephalometric landmarks on conventional and digital lateral headfilms 100 digital and 100 conventional lateral headfilms of patients attending our clinic were randomly selected. The digital cephalograms were obtained using storage phosphor plates in standard X-ray cassettes. All X-rays had been taken at 77 kV. For the digital images the mAs settings for conventional images minus 4 mAs were used. Two orthodontists traced each X-ray twice (21 reference points) at an interval of at least 1 week. The tracings were superimposed and the distances between the tracings of identical reference points were registered. The average reproducibility of cephalometric landmarks was significantly higher on the digitally obtained images, despite a reduction of radiation exposure of 23.7% in the digital images.

Accuracy of 3D Imaging Software in Cephalometric Analysis

“…Digital radiography offers a number of important advantages over traditional film: reduced radiation exposure to the patient; instantaneous acquisition of the radiographic image; elimination of darkroom facilities and development processing time and expense; simplified storage, handling, and sharing of images with appropriate professionals; and the ability to enhance the image to suit the orthodontist's needs. These advantages, coupled with clinical performance equal to that of conventional radiographic film, have shifted the standard of cephalometric radiography from film to the digital version (McClure, Sadowsky, Ferreria & Jacobson, 2005;Hagemann, Vollmer, Niegel, Ehmer & Reuter, 2000;Geelen, Wenzel, Gotfredsen, Kruger & Hansson, 1998). These advantages facilitate landmark identification and, therefore, overall accuracy.…”

The reproducibility and accuracy of cephalometric analysis using different digital imaging modalities and image compression

“…Few studies have dealt with the accuracy and reproducibility of identifjring cephalometric landrnarks on a direct (SPP) digital image (Hagemann et al 2000, Geelen et al, 1998and Lim and Foong, 1997. Only one study examined cephalometric measurements on digital versus conventional radiographs (Eppley and Sadove,199 1 ).…”

“…Only a few studies have dealt with the accuracy and reproducibility of identiwng cephalometric landmarks on a digital image (Hagemann et al, 2000;Geelen et al, 1998, Lim and Foong, 1997, Nimkam and Miles, 1995and Macri and Wenzel, 1993 and even fewer have evaluated cephalometic measurernents (Eppley and Sadove, 1991). The application of digital imaging to orthodontie cephalometry will depend on whether these images yield as much diagnostic information as is currently available on conventional radiographic films.…”

Evaluation of the CT scanogram for assessment of craniofacial morphology

“…There is also disagreement regarding the accuracy of landmark identification errors when conventional and storage phosphor lateral cephalograms are compared. 12,17,18 In this study, with the use of linear and angular measurements, the role of the CT scanogram for the accurate assessment of craniofacial morphology was assessed. Comparisons were made using direct skull (SK) measurements and those obtained from a digitized cephalometric analysis of lateral scanograms (CTs), conventional cephalograms (CCs), and storage phosphor digital cephalograms (SPs) of dry skulls fixed in a reproducible position.…”