J Korean Assoc Oral Maxillofac Surg.  2010 Aug;36(4):262-269. 10.5125/jkaoms.2010.36.4.262.

Comparison of the observer reliability of cranial anatomic landmarks based on cephalometric radiograph and three-dimensional computed tomography scans

• Kim JY
• Lee DK
• Lee SH

• KMID: 1457777
• DOI: http://doi.org/10.5125/jkaoms.2010.36.4.262

Abstract

INTRODUCTION
Accurate diagnosis and treatment planning are very important for orthognathic surgery. A small error in diagnosis can cause postoperative functional and esthetic problems. Pre-existing 2-dimensional (D) chephalogram analysis has a high likelihood of error due to its intrinsic and extrinsic problems. A cephalogram can also be inaccurate due to the limited anatomic points, superimposition of the image, and the considerable time and effort required. Recently, an improvement in technology and popularization of computed tomography (CT) provides patients with 3-D computer based cephalometric analysis, which complements traditional analysis in many ways. However, the results are affected by the experience and the subject of the investigator.
MATERIALS AND METHODS
The effects of the sources human error in 2-D cephalogram analysis and 3-D computerized tomography cephalometric analysis were compared using Simplant CMF program. From 2008 Jan to 2009 June, patients who had undergone CT, cephalo AP, lat were investigated.
RESULTS
1. In the 3 D and 2 D images, 10 out of 93 variables (10.4%) and 11 out 44 variables (25%), respectively, showed a significant difference. 2. Landmarks that showed a significant difference in the 2 D image were the points frequently superimposed anatomically. 3. Go Po Orb landmarks, which showed a significant difference in the 3 D images, were found to be the artificial points for analysis in the 2 D image, and in the current definition, these points cannot be used for reproducibility in the 3 D image.
CONCLUSION
Generally, 3-D CT images provide more precise identification of the traditional cephalometric landmark. Greater variability of certain landmarks in the mediolateral direction is probably related to the inadequate definition of the landmarks in the third dimension.

Keyword

Anatomic landmark; Reliability; Cephalographic radilograph; 3 dimensional computed tomography (3-D CT)

MeSH Terms

Anatomic Landmarks
Complement System Proteins
Humans
Orthognathic Surgery
Research Personnel
Complement System Proteins

Figure

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  Fig. 1. Two-dimensional analysis of V-Ceph (version 4.0): cephalometric lateral view.

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  Fig. 2. Three-dimensional analysis of SimPlant Pro (version 12.02): 3-dimentional image and axial, coronal, sagittal view.

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  Fig. 3. Coronal and sagittal view: sagittal plane makes using 3 point (nasion, ANS, dens of axis) coronal plane makes using porion. (ANS: anterior nasal spine)

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  Fig. 4. Skeletal landmark distance: measure from 3 standard plane to point.

Reference

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