Comparison of the Reliability of Anatomic Landmarks based on PA Cephalometric Radiographs and 3D CT Scans in Patients with Facial Asymmetry

Bajaj, Kamal; Rathee, Pooja; Jain, Pradeep; Panwar, Vasim Raja
September 2011
International Journal of Clinical Pediatric Dentistry;Sep-Dec2011, Vol. 4 Issue 3, p213
Academic Journal
Introduction: Conventional cephalometry is an inexpensive and well-established method for evaluating patients with dentofacial deformities. However, patients with major deformities and in particular asymmetric cases are difficult to evaluate by conventional cephalometry. Reliable and accurate evaluation in the orbital and midfacial region in craniofacial syndrome patients is difficult due to inherent geometric magnification, distortion and the superpositioning of the craniofacial structures on cephalograms. Both two- and three-dimensional computed tomography (CT) have been proposed to alleviate some of these difficulties. Aims and objectives: The aim of our study is to compare the reliability of anatomic cephalometric points obtained from the two modalities: Conventional posteroanterior cephalograms and 3D CT of patients with facial asymmetry, by comparison of intra- and interobserver variation of points recorded from frontal X-ray to those recorded from 3D CT. Materials and methods: The sample included nine patients (5 males and 4 females) with an age range of 14 to 21 years and a mean age of 17.11 years, whose treatment plan called for correction of facial asymmetry. All CT scans were measured twice by two investigators with 2 weeks separation for determination of intraobserver and interobserver variability. Similarly, all measurement points on the frontal cephalograms were traced twice with 2 weeks separation. The tracings were superimposed and the average distance between replicate points readings were used as a measure of intra- and interobserver reliability. Intra- and interobserver variations are calculated for each method and the data were imported directly into the statistical program, SPSS 10.0.1 for windows. Results: Intraobserver variations of points defined on 3D CT were small compared with frontal cephalograms. The intraobserver variations ranged from 0 (A1, B1) to 0.6 mm with the variations less than 0.5 mm for most of the points. Interobserver variations of points between first and second tracings defined on PA Ceph and 3D CT were less than 1.5 mm for all the points. A direct comparison of frontal cephalometry and 3D CT using intraobserver variation for the first observer showed that 3D CT was more reliable than frontal cephalometry for 11 points. Direct comparison of frontal cephalometry and 3D CT for the second observer showed a similar tendency with 14 points significantly more reliable for 3D CT. Comparison of frontal cephalometry and 3D CT using interobserver variation for the tracings showed that 3D CT was more reliable than frontal cephalometry. Summary and conclusion: The study has shown that 3D CT is consistently more accurate and reliable than conventional frontal cephalometry. Unfortunately, the cost of a computerized tomography examination is considerable; this means that, at this stage, its use by surgeons and orthodontists is a last resort.


Related Articles

  • Craniofacial Morphology in Prematurely Born Children. Paulsson, Liselotte; Bondemark, Lars // Angle Orthodontist;Mar2009, Vol. 79 Issue 2, p276 

    Objective: To test the null hypothesis that there is no difference between the craniofacial morphology of prematurely born children and that of matched full-term born controls. Materials and Methods: White children 8 to 10 years of age, born at the University Hospitals of Lund and Malmö and...

  • Comparative Assessment of Anatomic and Machine Frankfort Plane to True Horizontal Plane in New Digital Radiographs. OmidKhoda, SeyedehMaryam; ShahAkbari, Reza; Ghanbarzadeh, Majid; Ghanei, Saeideh; HoseiniZarch, SeyedHosein; Esmaily, Habibollah // Journal of Mashhad Dental School;Autumn2012, Vol. 36 Issue 3, p173 

    Introduction: Contemporary cephalometric analysis in orthodontics is based on comparison between craniofacial portions and reference planes. One of these planes is Frankfort Horizontal (FH) Plane that can be made by anatomic portion or machine portion. The aim of this study was to determine and...

  • Crecimiento facial vertical en 44 mestizos colombianos sin tratamiento desde los 6 hasta los 25 años Grupo CES-LPH. Jiménez, Iván Darío; Fernanda Villegas, Luisa; Gonzalo Álvarez, Luis // CES Odontología;2011, Vol. 24 Issue 2, p9 

    The postnatal craniofacial growth is a complex process that continues even after 20 years of age. To quantify for the first time, the anterior (AFA) and posterior vertical facial (AFP) developmental growth, in a mestizo Colombian and a latin-american population. Materials and Methods: Biannual...

  • Rendgenkraniometrijska evaluacija kraniofacijalnih dimenzija kod osoba sa simptomima temporomandibularnih disfunkcija. Dodic, Slobodan; Vukadinovic, Miroslav; Sinobad, Vladimir // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;Sep2006, Vol. 63 Issue 9, p793 

    Background/Aim. The aim of this study was to evaluate the possible association between certain morphologic features of the craniofacial skeleton and the presence of symptoms of temporomandibular disorders in young subjects with natural dentitions. Methods. The investigation was carried out on 80...

  • Size and shape measurement in contemporary cephalometrics. McIntyre, Grant T.; Mossey, Peter A. // European Journal of Orthodontics;Jun2003, Vol. 25 Issue 3, p231 

    The traditional method of analysing cephalograms--conventional cephalometric analysis (CCA)--involves the calculation of linear distance measurements, angular measurements, area measurements, and ratios. Because shape information cannot be determined from these 'size-based' measurements, an...

  • Craniofacial Morphology of Croatian Patients with Obstructive Sleep Apnea. Vidović, Neven; Meštrović, Senka; Đogaš, Zoran; Buković, Dino; Brakus, Ivan; Brakus, Ratka Borić; Kovačić, Ivan // Collegium Antropologicum;Mar2013, Vol. 37 Issue 1, p271 

    Currently, there is no information available regarding craniofacial morphology of Croatian patients with obstructive sleep apnea (OSA). The aim of the study was to determine the craniofacial characteristics of patients with OSA and to assess the association of cephalometric and anthropometric...

  • Craniofacial Morphology of Dutch Patients With Bilateral Cleft Lip and Palate and Noncleft Controls at the Age of 15 Years. van den Dungen, Geer M.; Ongkosuwito, Edwin M.; Aartman, Irene H. A.; Prahl-Andersen, Birte // Cleft Palate-Craniofacial Journal;Nov2008, Vol. 45 Issue 6, p661 

    Objective: Comparison of craniofacial morphology in bilateral cleft lip and palate patients to that of a noncleft control group at the age of 15 years. Design: A cross-sectional study of cephalometric data. Subjects and Methods: Cephalometric records of 41 consecutive patients (32 boys and 9...

  • Gender Differences in Class III Malocclusion. Baccetti, Tiziano; Reyes, Brian C.; McNamara Jr., James A. // Angle Orthodontist;Jul2005, Vol. 75 Issue 4, p510 

    This study evaluated gender differences in the cephalometric records of a large-scale cross-sectional sample of Caucasian subjects with Class III malocclusion at different developmental ages. The purpose also was to provide average age-related and sex-related data for craniofacial measures in...

  • Cephalometric Characteristics of Korean Children with Class Ill Malocclusion in the Deciduous Dentition. Hyung-Jun Choi; Ji-Yeon Kim; Seung Eun Yoo; Jang-Hyuk Kwon; Kitae Park // Angle Orthodontist;Jan2010, Vol. 80 Issue 1, p86 

    Objective: To compare the cephalometric characteristics of children with Class III malocclusion to those of children with normal occlusion during the deciduous dentition phase. Materials and Methods: Cephalometric measurements of 27 children (mean age: 5.03 years) diagnosed with Class III...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics