Korean J Orthod.  2012 Aug;42(4):169-181. 10.4041/kjod.2012.42.4.169.

A method for mandibular dental arch superimposition using 3D cone beam CT and orthodontic 3D digital model

  • 1Department of Orthodontics, Graduate School, Kyung Hee University School of Dentistry, Seoul, Korea. kislee@khu.ac.kr


The purpose of this study was to develop superimposition method on the lower arch using 3-dimensional (3D) cone beam computed tomography (CBCT) images and orthodontic 3D digital modeling.
Integrated 3D CBCT images were acquired by substituting the dental portion of 3D CBCT images with precise dental images of an orthodontic 3D digital model. Images were acquired before and after treatment. For the superimposition, 2 superimposition methods were designed. Surface superimposition was based on the basal bone structure of the mandible by surface-to-surface matching (best-fit method). Plane superimposition was based on anatomical structures (mental and lingual foramen). For the evaluation, 10 landmarks including teeth and anatomic structures were assigned, and 30 times of superimpositions and measurements were performed to determine the more reproducible and reliable method.
All landmarks demonstrated that the surface superimposition method produced relatively more consistent coordinate values. The mean distances of measured landmarks values from the means were statistically significantly lower with the surface superimpositions method.
Between the 2 superimposition methods designed for the evaluation of 3D changes in the lower arch, surface superimposition was the simpler, more reproducible, reliable method.


3D cone beam CT image; Digital model; Superimposition; Mandibular arch

MeSH Terms

Cone-Beam Computed Tomography
Dental Arch


  • Figure 1 Overall procedure of the mandibular dental arch superimposition method. 3D, 3-dimensional; CBCT, cone beam computed tomography; ICI, integrated 3D CBCT image; T1, pre-treatment; T2, post-treatment.

  • Figure 2 Reconstructed 3-dimensional image of the mandible. A, Pre-treatment; B, post-treatment.

  • Figure 3 Orthodontic 3-dimensional digital model of mandibular dentition. A, Pre-treatment; B, post-treatment.

  • Figure 4 Preliminary fusion model by surface-to-surface matching (best-fit method). A, Pre-treatment; B, post-treatment.

  • Figure 5 Final individual integrated 3D CBCT image of the mandible. A, Pre-treatment; B, post-treatment. 3D, 3-dimensional; CBCT, cone beam computed tomography.

  • Figure 6 Two different registration methods designed for superimposing ICIT1 and ICIT2. ICI, Integrated 3D CBCT image; T1, pre-treatment; T2, post-treatment.

  • Figure 7 The procedure for surface superimposition. A, Selecting 2 ICI. B, Selecting the registration area (the inferior portion of mandible body and posterior portion of mandible ramus were selected). C, Superimposed ICIT1 and ICIT2 by surface-to-surface matching (best-fit method). ICI, Integrated 3D CBCT image.

  • Figure 8 Aspect for the examination of lingual foramen. Arrows indicate the orifice of the lingual foramen.

  • Figure 9 The center of the foramen was selected with a grid on the monitor by selecting 4 points of the foramen, the most superior, inferior and both lateral points, with the mandible rotated to give a perpendicular view to the foramen. Each procedure was performed on each mental foramen and lingual foramen on both ICIT1 and ICIT2. ICI, Integrated 3D CBCT image; T1, pre-treatment; T2, post-treatment.

  • Figure 10 The procedure for plane superimposition. A, Selecting 2 ICI with the constituted plane. B, Superimposed ICIT1 and ICIT2 with the registration of 2 anatomical structure oriented planes. ICI, Integrated 3D CBCT image; T1, pre-treatment; T2, post-treatment.

  • Figure 11 Facial axis points are marked on the lower central incisor, canine, and 2nd premolar on both left and right sides. White-spots indicate the marked points. A, Pre-treatment model; B, post-treatment model.

  • Figure 12 The dentition extracted from the superimposed image. A, Combined image, B, dentition was extracted.

  • Figure 13 Final image of superimposed mandibular dental arch. A, By surface superimposition; B, by plane superimposition.

  • Figure 14 Scatter plot of post-treatment coordinate values of the lower left incisor after 2 superimposition methods. Blue dot, point from surface superimposition; red cross, point from plane superimposition; green dot, mean coordinate value of lower left incisor after 30 trials of surface superimposition; black circle, mean coordinate value of lower left incisor after 30 trials of plane superimposition. A, x-y axis; B, y-z axis; C, z-x axis. The scatter plot shows the reproducibility with the surface superimposition method and the large variation of points generated by the plane superimposition method.

Cited by  2 articles

Comparison of cone-beam computed tomography cephalometric measurements using a midsagittal projection and conventional two-dimensional cephalometric measurements
Pil-Kyo Jung, Gung-Chol Lee, Cheol-Hyun Moon
Korean J Orthod. 2015;45(6):282-288.    doi: 10.4041/kjod.2015.45.6.282.

In-vitro assessment of the accuracy and reliability of mandibular dental model superimposition based on voxel-based cone-beam computed tomography registration
Gaofeng Han, Jing Li, Shuo Wang, Yan Liu, Xuedong Wang, Yanheng Zhou
Korean J Orthod. 2019;49(2):97-105.    doi: 10.4041/kjod.2019.49.2.97.


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