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Imaging Sci Dent. 2015 Mar;45(1):15-22. English. Original Article.
Pittayapat P , Jacobs R , Odri GA , Vasconcelos KD , Willems G , Olszewski R .
OIC, OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, University of Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand.
Service de Chirurgie Orthopedique et Traumatologique, Centre Hospitalier Regional d'Orleans, Orleans Cedex 2, France.
Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, Sao Paulo, Brazil.
Orthodontics, Department of Oral Health Sciences, KU Leuven and Dentistry, University Hospitals Leuven, University of Leuven, Leuven, Belgium.
Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Universite Catholique de Louvain, Brussels, Belgium.

PURPOSE: This study was performed to assess the reproducibility of identifying the sella turcica landmark in a threedimensional (3D) model by using a new sella-specific landmark reference system. MATERIALS AND METHODS: Thirty-two cone-beam computed tomographic scans (3D Accuitomo(R) 170, J. Morita, Kyoto, Japan) were retrospectively collected. The 3D data were exported into the Digital Imaging and Communications in Medicine standard and then imported into the Maxilim(R) software (Medicim NV, Sint-Niklaas, Belgium) to create 3D surface models. Five observers identified four osseous landmarks in order to create the reference frame and then identified two sella landmarks. The x, y, and z coordinates of each landmark were exported. The observations were repeated after four weeks. Statistical analysis was performed using the multiple paired t-test with Bonferroni correction (intraobserver precision: p<0.005, interobserver precision: p<0.0011). RESULTS: The intraobserver mean precision of all landmarks was <1 mm. Significant differences were found when comparing the intraobserver precision of each observer (p<0.005). For the sella landmarks, the intraobserver mean precision ranged from 0.43+/-0.34 mm to 0.51+/-0.46 mm. The intraobserver reproducibility was generally good. The overall interobserver mean precision was <1 mm. Significant differences between each pair of observers for all anatomical landmarks were found (p<0.0011). The interobserver reproducibility of sella landmarks was good, with >50% precision in locating the landmark within 1 mm. CONCLUSION: A newly developed reference system offers high precision and reproducibility for sella turcica identification in a 3D model without being based on two-dimensional images derived from 3D data.

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