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Alhazmi N, Alsaeed S, Almutairi L, Almohammadi D. Accuracy of and dental students' preferences toward manual and digital cephalometric landmark identification: A randomized cross-over study. J Dent Educ 2024; 88:815-822. [PMID: 38343342 DOI: 10.1002/jdd.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 01/05/2024] [Accepted: 01/13/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE To evaluate dental students' perceptions of manual and digital cephalometric landmark identification methods based on their preferences, difficulty level, and procedure time required to provide insights into the future of dental education, considering incorporating digital technology in dental schools. MATERIALS AND METHODS Fifty-five second-year dental students were randomly divided into two groups: (1) group A, students who performed manual landmark identification first, followed by digital method; and (2) group B, students who performed digital method first, followed by manual method. The duration of the procedure was recorded. Subsequently, all students completed a questionnaire regarding the difficulty they experienced using a visual analog scale and their preferences. Landmark identification accuracy was measured. RESULTS Digital landmark identification was preferred by 93% of students. The mean procedure time for digital method was significantly lower than that of manual method (13.00 ± 5.60 vs. 9.70 ± 4.60; p = 0.002). Group B completed manual and digital methods in a shorter time than group A. Group A experienced less difficulty with manual procedure than group B. However, statistically significant differences were not observed in the difficulty level of digital technique. A statistically significant difference in the mean accuracy was shown in favor of the manual method. However, this difference is clinically insignificant (p = 0.001). CONCLUSIONS Students considered digital method to be effective for learning and preferred it over manual method. Furthermore, digital landmark identification demonstrated better performance and was faster than manual method, suggesting that this must be incorporated in undergraduate dental education.
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Affiliation(s)
- Nora Alhazmi
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Suliman Alsaeed
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Lamia Almutairi
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Duaa Almohammadi
- Department of Preventive Dental Science, College of Dentistry, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Ministry of the National Guard Health Affairs, Riyadh, Saudi Arabia
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Guinot-Barona C, Alonso Pérez-Barquero J, Galán López L, Barmak AB, Att W, Kois JC, Revilla-León M. Cephalometric analysis performance discrepancy between orthodontists and an artificial intelligence model using lateral cephalometric radiographs. J ESTHET RESTOR DENT 2024; 36:555-565. [PMID: 37882509 DOI: 10.1111/jerd.13156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 10/10/2023] [Accepted: 10/11/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE The purpose of the present clinical study was to compare the Ricketts and Steiner cephalometric analysis obtained by two experienced orthodontists and artificial intelligence (AI)-based software program and measure the orthodontist variability. MATERIALS AND METHODS A total of 50 lateral cephalometric radiographs from 50 patients were obtained. Two groups were created depending on the operator performing the cephalometric analysis: orthodontists (Orthod group) and an AI software program (AI group). In the Orthod group, two independent experienced orthodontists performed the measurements by performing a manual identification of the cephalometric landmarks and a software program (NemoCeph; Nemotec) to calculate the measurements. In the AI group, an AI software program (CephX; ORCA Dental AI) was selected for both the automatic landmark identification and cephalometric measurements. The Ricketts and Steiner cephalometric analyses were assessed in both groups including a total of 24 measurements. The Shapiro-Wilk test showed that the data was normally distributed. The t-test was used to analyze the data (α = 0.05). RESULTS The t-test analysis showed significant measurement discrepancies between the Orthod and AI group in seven of the 24 cephalometric parameters tested, namely the corpus length (p = 0.003), mandibular arc (p < 0.001), lower face height (p = 0.005), overjet (p = 0.019), and overbite (p = 0.022) in the Ricketts cephalometric analysis and occlusal to SN (p = 0.002) and GoGn-SN (p < 0.001) in the Steiner cephalometric analysis. The intraclass correlation coefficient (ICC) between both orthodontists of the Orthod group for each cephalometric measurement was calculated. CONCLUSIONS Significant discrepancies were found in seven of the 24 cephalometric measurements tested between the orthodontists and the AI-based program assessed. The intra-operator reliability analysis showed reproducible measurements between both orthodontists, except for the corpus length measurement. CLINICAL SIGNIFICANCE The artificial intelligence software program tested has the potential to automatically obtain cephalometric analysis using lateral cephalometric radiographs; however, additional studies are needed to further evaluate the accuracy of this AI-based system.
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Affiliation(s)
- Clara Guinot-Barona
- Department of Dental Orthodontics, Faculty of Medicine and Health Sciences, Catholic University of Valencia, Valencia, Spain
| | | | - Lidia Galán López
- Department of Dental Orthodontics, Faculty of Medicine and Health Sciences, Catholic University of Valencia, Valencia, Spain
| | - Abdul B Barmak
- Clinical Research and Biostatistics, Eastman Institute of Oral Health, University of Rochester Medical Center, Rochester, New York, USA
| | - Wael Att
- Department of Prosthodontics, University Hospital of Freiburg, Freiburg, Germany, USA
| | - John C Kois
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Private Practice, Seattle, Washington, USA
| | - Marta Revilla-León
- Kois Center, Seattle, Washington, USA
- Department of Restorative Dentistry, School of Dentistry, University of Washington, Seattle, Washington, USA
- Department of Prosthodontics, School of Dental Medicine, Tufts University, Boston, Massachusetts, USA
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Thet PH, Kaboosaya B. Reproducibility of Computerized Cephalometric Analysis Software Compared with Conventional Manual Tracing for Analyzing Skeletal Stability After Orthognathic Surgery. J Maxillofac Oral Surg 2023; 22:833-840. [PMID: 38105843 PMCID: PMC10719199 DOI: 10.1007/s12663-023-02071-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Accepted: 10/29/2023] [Indexed: 12/19/2023] Open
Abstract
Objective This study aimed to compare the difference between analyzing skeletal stability after orthognathic surgery by lateral cephalogram measurement created from Dolphin software (version 11.95) compared with the manual technique. Methods Twenty-eight patients who underwent mandibular setback surgery (BSSRO) were randomly selected between 2015 and 2021. Serial lateral cephalograms were analyzed at four different time sets postoperatively, and a total of 112 cephalometric radiographs were obtained. Horizontal measurement (BX), vertical measurement (BY), and 3 angular measurements (SNB, ANB, and Gonial angle) were analyzed by manual tracing and Dolphin software by 2 examiners. The intraclass correlation coefficient determined the intra-rater reliability. Parameter differences between timelines were observed for skeletal stability, and mean values between methods were compared using the Student's t-test. Results Both examiners were generally consistent in the repeated measurements (ICCs of the manual method ranged from 0.926 to 0.994, and the digital method ranged from 0.719 to 0.956). All variables represented skeletal stability at T0-T1, T0-T2, and T0-T3 showed no statistically significant differences between methods except ANB (T0-T1; p value = 0.009). Conclusions Computerized cephalometric analysis software is relatively reproducible for assessing skeletal changes after orthognathic surgery and can be used routinely in follow-up.
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Affiliation(s)
- Phu Hnin Thet
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330 Thailand
| | - Boosana Kaboosaya
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Chulalongkorn University, 34 Henri Dunant Road, Wangmai, Patumwan, Bangkok, 10330 Thailand
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Menezes LDS, Silva TP, Lima Dos Santos MA, Hughes MM, Mariano Souza SDR, Leite Ribeiro PM, Freitas PHLD, Takeshita WM. Assessment of landmark detection in cephalometric radiographs with different conditions of brightness and contrast using the an artificial intelligence software. Dentomaxillofac Radiol 2023; 52:20230065. [PMID: 37869886 DOI: 10.1259/dmfr.20230065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2023] Open
Abstract
OBJECTIVES To evaluate the reliability and reproducibility of an artificial intelligence (AI) software in identifying cephalometric points on lateral cephalometric radiographs considering four settings of brightness and contrast. METHODS AND MATERIALS Brightness and contrast of 30 lateral cephalometric radiographs were adjusted into four different settings. Then, the control examiner (ECont), the calibrated examiner (ECal), and the CEFBOT AI software (AIs) each marked 19 cephalometric points on all radiographs. Reliability was assessed with a second analysis of the radiographs 15 days after the first one. Statistical significance was set at p < 0.05. RESULTS Reliability of landmark identification was excellent for the human examiners and the AIs regardless of the type of brightness and contrast setting (mean intraclass correlation coefficient >0.89). When ECont and ECal were compared for reproducibility, there were more cephalometric points with significant differences on the x-axis of the image with the highest contrast and the lowest brightness, namely N(p = 0.033), S(p = 0.030), Po(p < 0.001), and Pog'(p = 0.012). Between ECont and AIs, there were more cephalometric points with significant differences on the image with the highest contrast and the lowest brightness, namely N(p = 0.034), Or(p = 0.048), Po(p < 0.001), A(p = 0.042), Pog'(p = 0.004), Ll(p = 0.005), Ul(p < 0.001), and Sn(p = 0.001). CONCLUSIONS While the reliability of the AIs for cephalometric landmark identification was rated as excellent, low brightness and high contrast seemed to affect its reproducibility. The experienced human examiner, on the other hand, did not show such faulty reproducibility; therefore, the AIs used in this study is an excellent auxiliary tool for cephalometric analysis, but still depends on human supervision to be clinically reliable.
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Affiliation(s)
| | - Thaísa Pinheiro Silva
- Department of Oral Diagnosis, Piracicaba Dental School, University of Campinas, São Paulo, Brazil
| | | | | | | | | | | | - Wilton Mitsunari Takeshita
- Diagnosis and Surgery, São Paulo State University (Unesp), School of Dentistry, Araçatuba, São Paulo, Brazil
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Popova T, Stocker T, Khazaei Y, Malenova Y, Wichelhaus A, Sabbagh H. Influence of growth structures and fixed appliances on automated cephalometric landmark recognition with a customized convolutional neural network. BMC Oral Health 2023; 23:274. [PMID: 37165409 PMCID: PMC10173502 DOI: 10.1186/s12903-023-02984-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 04/20/2023] [Indexed: 05/12/2023] Open
Abstract
BACKGROUND One of the main uses of artificial intelligence in the field of orthodontics is automated cephalometric analysis. Aim of the present study was to evaluate whether developmental stages of a dentition, fixed orthodontic appliances or other dental appliances may affect detection of cephalometric landmarks. METHODS For the purposes of this study a Convolutional Neural Network (CNN) for automated detection of cephalometric landmarks was developed. The model was trained on 430 cephalometric radiographs and its performance was then tested on 460 new radiographs. The accuracy of landmark detection in patients with permanent dentition was compared with that in patients with mixed dentition. Furthermore, the influence of fixed orthodontic appliances and orthodontic brackets and/or bands was investigated only in patients with permanent dentition. A t-test was performed to evaluate the mean radial errors (MREs) against the corresponding SDs for each landmark in the two categories, of which the significance was set at p < 0.05. RESULTS The study showed significant differences in the recognition accuracy of the Ap-Inferior point and the Is-Superior point between patients with permanent dentition and mixed dentition, and no significant differences in the recognition process between patients without fixed orthodontic appliances and patients with orthodontic brackets and/or bands and other fixed orthodontic appliances. CONCLUSIONS The results indicated that growth structures and developmental stages of a dentition had an impact on the performance of the customized CNN model by dental cephalometric landmarks. Fixed orthodontic appliances such as brackets, bands, and other fixed orthodontic appliances, had no significant effect on the performance of the CNN model.
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Affiliation(s)
- Teodora Popova
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Thomas Stocker
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Yeganeh Khazaei
- Department of Statistics, Statistical Consultation Unit, StaBLab, LMU Munich, Akademiestr. 1, 80799, Munich, Germany
| | - Yoana Malenova
- Department of Oral and Maxillofacial Surgery, University Hospital, LMU Munich, Lindwurmstrasse 2a, 80337, Munich, Germany
| | - Andrea Wichelhaus
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany
| | - Hisham Sabbagh
- Department of Orthodontics and Dentofacial Orthopedics, University Hospital, LMU Munich, Goethestrasse 70, 80336, Munich, Germany.
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Mansour NM, Abdelshaheed ME, El-Sabbagh AH, El-Din AMB, Kim YC, Choi JW. Three-Dimensional Evaluation of Skeletal Stability following Surgery-First Orthognathic Approach: Validation of a Simple and Effective Method. Arch Plast Surg 2023; 50:254-263. [PMID: 37256039 PMCID: PMC10226798 DOI: 10.1055/a-2058-8108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/03/2023] [Indexed: 06/01/2023] Open
Abstract
Background The three-dimensional (3D) evaluation of skeletal stability after orthognathic surgery is a time-consuming and complex procedure. The complexity increases further when evaluating the surgery-first orthognathic approach (SFOA). Herein, we propose and validate a simple time-saving method of 3D analysis using a single software, demonstrating high accuracy and repeatability. Methods This retrospective cohort study included 12 patients with skeletal class 3 malocclusion who underwent bimaxillary surgery without any presurgical orthodontics. Computed tomography (CT)/cone-beam CT images of each patient were obtained at three different time points (preoperation [T0], immediately postoperation [T1], and 1 year after surgery [T2]) and reconstructed into 3D images. After automatic surface-based alignment of the three models based on the anterior cranial base, five easily located anatomical landmarks were defined to each model. A set of angular and linear measurements were automatically calculated and used to define the amount of movement (T1-T0) and the amount of relapse (T2-T1). To evaluate the reproducibility, two independent observers processed all the cases, One of them repeated the steps after 2 weeks to assess intraobserver variability. Intraclass correlation coefficients (ICCs) were calculated at a 95% confidence interval. Time required for evaluating each case was recorded. Results Both the intra- and interobserver variability showed high ICC values (more than 0.95) with low measurement variations (mean linear variations: 0.18 mm; mean angular variations: 0.25 degree). Time needed for the evaluation process ranged from 3 to 5 minutes. Conclusion This approach is time-saving, semiautomatic, and easy to learn and can be used to effectively evaluate stability after SFOA.
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Affiliation(s)
- Nabil M. Mansour
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt
| | - Mohamed E. Abdelshaheed
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt
| | - Ahmed H. El-Sabbagh
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt
| | - Ahmed M. Bahaa El-Din
- Faculty of Medicine, Department of Plastic and Reconstructive Surgery, Mansoura University, Mansoura, Egypt
| | - Young Chul Kim
- Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center, Seoul, South Korea
| | - Jong-Woo Choi
- Department of Plastic and Reconstructive Surgery, Ulsan University College of Medicine, Seoul Asan Medical Center, Seoul, South Korea
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Prince STT, Srinivasan D, Duraisamy S, Kannan R, Rajaram K. Reproducibility of linear and angular cephalometric measurements obtained by an artificial-intelligence assisted software (WebCeph) in comparison with digital software (AutoCEPH) and manual tracing method. Dental Press J Orthod 2023; 28:e2321214. [PMID: 37018830 PMCID: PMC10069747 DOI: 10.1590/2177-6709.28.1.e2321214.oar] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 02/21/2022] [Indexed: 04/07/2023] Open
Abstract
INTRODUCTION It has been suggested that human errors during manual tracing of linear/angular cephalometric parameters can be eliminated by using computer-aided analysis. The landmarks, however, are located manually and the computer system completes the analysis. With the advent of Artificial Intelligence in the field of Dentistry, automatic location of the landmarks has become a promising tool in digital Orthodontics. METHODS Fifty pretreatment lateral cephalograms obtained from the Orthodontic department of SRM dental college (India) were used. Analysis were done by the same investigator using the following methods: WebCeph™, AutoCEPH© for Windows or manual tracing. Landmark identification was carried out automatically by Artificial Intelligence in WebCeph™ and with a mouse driven cursor in AutoCEPH©, and manually using acetate sheet and 0.3-mm pencil, ruler and a protractor. The mean differences of the cephalometric parameters obtained between the three methods were calculated using ANOVA with statistical significance set at p<0.05. Intraclass correlation coefficient (ICC) was used to determine both reproducibility and agreement between linear and angular measurements obtained from the three methods and intrarater reliability of repeated measurements. ICC value of >0.75 indicated good agreement. RESULTS Intraclass correlation coefficient between the three groups was >0.830, showing good level of agreement, and the value within each group was >0.950, indicating high intrarater reliability. CONCLUSION Artificial Intelligence assisted software showed good agreement with AutoCEPH© and manual tracing for all the cephalometric measurements.
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Affiliation(s)
- S Tsander Tito Prince
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopedics (Chennai, Tamil Nadu, India)
| | - Dilip Srinivasan
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopedics (Chennai, Tamil Nadu, India)
| | - Sangeetha Duraisamy
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopedics (Chennai, Tamil Nadu, India)
| | - Ravi Kannan
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopedics (Chennai, Tamil Nadu, India)
| | - Krishnaraj Rajaram
- SRM Dental College, Department of Orthodontics and Dentofacial Orthopedics (Chennai, Tamil Nadu, India)
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Tsolakis IA, Tsolakis AI, Elshebiny T, Matthaios S, Palomo JM. Comparing a Fully Automated Cephalometric Tracing Method to a Manual Tracing Method for Orthodontic Diagnosis. J Clin Med 2022; 11:jcm11226854. [PMID: 36431331 PMCID: PMC9693212 DOI: 10.3390/jcm11226854] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/11/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: This study aims to compare an automated cephalometric analysis based on the latest deep learning method of automatically identifying cephalometric landmarks with a manual tracing method using broadly accepted cephalometric software. Methods: A total of 100 cephalometric X-rays taken using a CS8100SC cephalostat were collected from a private practice. The X-rays were taken in maximum image size (18 × 24 cm lateral image). All cephalometric X-rays were first manually traced using the Dolphin 3D Imaging program version 11.0 and then automatically, using the Artificial Intelligence CS imaging V8 software. The American Board of Orthodontics analysis and the European Board of Orthodontics analysis were used for the cephalometric measurements. This resulted in the identification of 16 cephalometric landmarks, used for 16 angular and 2 linear measurements. Results: All measurements showed great reproducibility with high intra-class reliability (>0.97). The two methods showed great agreement, with an ICC range of 0.70−0.92. Mean values of SNA, SNB, ANB, SN-MP, U1-SN, L1-NB, SNPg, ANPg, SN/ANS-PNS, SN/GoGn, U1/ANS-PNS, L1-APg, U1-NA, and L1-GoGn landmarks had no significant differences between the two methods (p > 0.0027), while the mean values of FMA, L1-MP, ANS-PNS/GoGn, and U1-L1 were statistically significantly different (p < 0.0027). Conclusions: The automatic cephalometric tracing method using CS imaging V8 software is reliable and accurate for all cephalometric measurements.
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Affiliation(s)
- Ioannis A. Tsolakis
- Department of Orthodontics, School of Dentistry, Aristotle University of Thessaloniki, 541 24 Thessaloniki, Greece
- Correspondence:
| | - Apostolos I. Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian, University of Athens, 157 72 Athens, Greece
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Tarek Elshebiny
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - Stefanos Matthaios
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
| | - J. Martin Palomo
- Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, OH 44106, USA
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Mamedov AA, Zangieva OT, Fedotov RN, Mazurina LA, Dudnik OV. An algorithm of orthodontic treatment of teenagers with the bilateral cleft lip and palate. Pediatr Dent 2021. [DOI: 10.33925/1683-3031-2020-20-4-317-323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ad. A. Mamedov
- I.M.Sechenov First Moscow State Medical University (Sechenov University)
| | - O. T. Zangieva
- I.M.Sechenov First Moscow State Medical University (Sechenov University)
| | - R. N. Fedotov
- A.I. Yevdokimov Moscow State University of Medicine and Dentistry
| | - L. A. Mazurina
- I.M.Sechenov First Moscow State Medical University (Sechenov University)
| | - O. V. Dudnik
- I.M.Sechenov First Moscow State Medical University (Sechenov University)
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Meriç P, Naoumova J. Web-based Fully Automated Cephalometric Analysis: Comparisons between App-aided, Computerized, and Manual Tracings. Turk J Orthod 2020; 33:142-149. [PMID: 32974059 DOI: 10.5152/turkjorthod.2020.20062] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Accepted: 07/16/2020] [Indexed: 11/22/2022]
Abstract
Objective To compare the accuracy of cephalometric analyses made with fully automated tracings, computerized tracing, and app-aided tracings with equivalent hand-traced measurements, and to evaluate the tracing time for each cephalometric analysis method. Methods Pre-treatment lateral cephalometric radiographs of 40 patients were randomly selected. Eight angular and 4 linear parameters were measured by 1 operator using 3 methods: computerized tracing with software Dolphin Imaging 13.01(Dolphin Imaging and Management Solutions, Chatsworth, Calif, USA), app-aided tracing using the CephNinja 3.51 app (Cyncronus LLC, WA, USA), and web-based fully automated tracing with CephX (ORCA Dental AI, Las Vegas, NV). Correction of CephX landmarks was also made. Manual tracings were performed by 3 operators. Remeasurement of 15 radiographs was carried out to determine the intra-examiner and inter-examiner (manual tracings) correlation coefficient (ICC). Inter-group comparisons were made with one-way analysis of variance. The Tukey test was used for post hoc testing. Results Overall, greater variability was found with CephX compared with the other methods. Differences in GoGn-SN (°), I-NA (°), I-NB (°), I-NA (mm), and I-NB (mm) were statistically (p<0.05) and clinically significant using CephX, whereas CephNinja and Dolphin were comparable to manual tracings. Correction of CephX landmarks gave similar results to CephNinja and Dolphin. All the ICCs exceeded 0.85, except for I-NA (°), I-NB (°), and I-NB (mm), which were traced with CephX. The shortest analyzing time was obtained with CephX. Conclusion Fully automatic analysis with CephX needs to be more reliable. However, CephX analysis with manual correction is promising for use in clinical practice because it is comparable to CephNinja and Dolphin, and the analyzing time is significantly shorter.
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Affiliation(s)
- Pamir Meriç
- Department of Orthodontics, Faculty of Dentistry, Trakya University, Edirne, Turkey
| | - Julia Naoumova
- Specialist Clinic of Orthodontics, Public Dental Service, Västra Götaland Region, Gothenburg, Sweden
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Deshmukh T, Sahoo NK. Transverse Changes in Mandible Following Bilateral Sagittal Split Ramus Osteotomy Advancement. J Maxillofac Oral Surg 2019; 18:447-451. [PMID: 31371889 DOI: 10.1007/s12663-018-1161-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 10/02/2018] [Indexed: 11/29/2022] Open
Abstract
Background BSSRO is the most frequently performed surgical procedure for mandibular advancement. However, the effect of advancement on proximal segment is not clearly understood. Aim and Objectives The aim of the study was to evaluate the radiographic transverse changes in mandible following BSSRO advancement and to compare the amount of transverse displacement of the proximal segment with the amount of surgical advancement. Materials and Methods Twelve cases of skeletal class II deformity undergoing fixed orthodontic mechanotherapy and requiring mandibular advancement were selected for the study. Pre-operative (T0) PA ceph and OPG were used to measure the linear distances from right to left Co-Go, Go-Me, Go-Go, Co-Co, Rp-Rp and Co-Me points. The cases were operated for BSSRO mandibular advancement. Post-operative (T1) PA ceph and OPG were used to compare the changes in linear measurements. Result There were six male and six female patients with an average age of 19.5 years. The average mandibular advancement was 6.5 mm. Post-operative radiographic changes in transverse measurements of Go-Me, Go-Go, Co-Co, Rp-Rp and Co-Me were statistical significant. The changes in Co-Go measurements were statistically not significant. We could not establish any correlation between mandibular advancement and amount of transverse changes. Conclusion Significant changes were noticed in transverse dimensions of mandible following BSSRO advancement in both PA ceph and OPG. The transverse changes had no clinical implication during the post-operative follow-up.
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Affiliation(s)
| | - N K Sahoo
- Oral and Maxillofacial Surgery, CMDC (CC), Lucknow, India
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İzgi E, Pekiner FN. Comparative Evaluation of Conventional and OnyxCeph™ Dental Software Measurements on Cephalometric Radiography. Turk J Orthod 2019; 32:87-95. [PMID: 31294411 DOI: 10.5152/turkjorthod.2019.18038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Accepted: 11/23/2018] [Indexed: 11/22/2022]
Abstract
Objective Cephalometry can be measured with traditionally conventional analysing methods (hand tracing), as well as using computers. Many dental softwares have been developed for this purpose. The reliability of these programs are often compared with the conventional method. The aim of the present study was to compare the conventional method of manual cephalometric analysis with a computerized one, OnyxCeph ™ (Image Instruments, Chemnitz, Germany) dental software. Methods Lateral cephalometric radiographs of 150 patients (75 males and 75 females) age range 12-34 were traced by two methods. Conventional method and computerized (OnyxCeph) cephalometric analysis method. 2 maxillar, 3 mandibular, 2 maxillo-mandibular, 3 vertical, 7 dental and 1 soft tissue parameters; 10 angular, 8 linear totally 18 cephalometric parameters were measured. Intra-class correlation coefficients were performed for both methods to assess the reliability of the measurements. Results The results 9 of 18 parameters were found statistically significant. They were Cd-A distance, Cd-Gn distance, Go-Me distance, GoGnSN angle, ANS-Me distance, upper incisor-NA distance, lower incisor-NB distance, lower incisor-NB angle, overbite distance. Conclusion Despite some discrepancies in measured values between hand-tracing cephalometric analysis method and the OnyxCeph cephalometric analysis method, statistical differences were minimal and only Cd-A, Cd-Gn, Go-Me, ANS-Me, GoGnSN° were clinically important for cephalometric analysis OnyxCeph was evaluated as an efficient method to replace conventional method.
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Affiliation(s)
- Elif İzgi
- Department of Oral Diagnosis and Radiology, Marmara University School of Dentistry, İstanbul, Turkey
| | - Filiz Namdar Pekiner
- Department of Oral Diagnosis and Radiology, Medipol University School of Dentistry, İstanbul, Turkey
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Matthews M, Cook EA, Cook J, Johnson L, Karthas T, Collier B, Hansen D, Manning E, McKenna B, Basile P. Long-Term Outcomes of Corrective Osteotomies Using Porous Titanium Wedges for Flexible Flatfoot Deformity Correction. J Foot Ankle Surg 2019; 57:924-930. [PMID: 29891128 DOI: 10.1053/j.jfas.2018.03.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Indexed: 02/03/2023]
Abstract
Common corrective osteotomies used in flexible flatfoot deformity reconstruction include Cotton and Evans osteotomies, which require structural graft to maintain correction. Auto-, allo-, and xenografts are associated with a number of limitations, including disease transmission, rejection, donor site morbidity, technical challenges related to graft fashioning, and graft resorption. Porous titanium is a synthetic substance designed to address these flaws; however, few studies have been reported on the efficacy, safety, and long-term outcomes. A multicenter retrospective cohort of 63 consecutive preconfigured porous titanium wedges (PTWs) used in flexible flatfoot reconstructions from June 1, 2009 to June 30, 2015 was evaluated. The primary outcome measure was the pre- to postdeformity correction efficacy. The secondary outcomes included maintenance of correction at a minimum follow-up point of 12 months, complications, graft incorporation, and graft safety profile. Multivariate linear regression found a statistically significant improvement in all radiographic parameters from preoperatively to the final weightbearing radiographs (calcaneocuboid 18.850 ± 4.020 SE, p < .0001; Kite's, 7.810 ± 3.660 SE, p = .04; Meary's 13.910 ± 3.100 SE, p = .0001; calcaneal inclination, 5.550 ± 2.140 SE, p = .015). When restricted to patients with >4 years of follow-up data, maintenance of correction appeared robust in all 4 measurements, demonstrating a lack of bone or graft resorption. No patients were lost to follow-up, no major complications or implant explantation or migration occurred, and all implants were incorporated. Minor complications included hardware pain from plates over grafts (8%), 1 case of scar neuritis, and a 5% table incidence of transfer pain associated with the PTWs. These results support the use of PTWs for safety and degree and maintenance of correction in flatfoot reconstruction.
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Affiliation(s)
- Michael Matthews
- Chief Resident, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA.
| | - Emily A Cook
- Director of Resident Training, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA; Instructor, Department of Surgery, Harvard Medical School, Boston, MA
| | - Jeremy Cook
- Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Director of Research and Quality Assurance, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA
| | - Lindsay Johnson
- Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Chief, Department of Podiatry, Atrius Health, Boston, MA
| | - Timothy Karthas
- Chief Resident, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA; Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA
| | - Byron Collier
- Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA
| | - Daniel Hansen
- Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA
| | - Elena Manning
- Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA
| | - Bryon McKenna
- Clinical Fellow, Department of Surgery, Harvard Medical School, Boston, MA
| | - Philip Basile
- Instructor, Department of Surgery, Harvard Medical School, Boston, MA; Chief, Division of Podiatric Surgery, Department of Surgery, Mount Auburn Hospital, Cambridge, MA
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Finn SC, Silver MT, Canary B, Kantarci A, Allareddy V, Katebi N, Masoud MI. A modified Steiner's analysis that does not require radiographic exposure of the cranial base. Orthod Craniofac Res 2018; 22:1-8. [PMID: 30365248 DOI: 10.1111/ocr.12250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 10/09/2018] [Accepted: 10/10/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To correlate traditional Steiner's skeletal and dental measurements to similar measurements that use the eyes and natural head position as references instead of the cranial base. SETTING AND SAMPLE One hundred and fifty-two lateral cephalometric radiographs (66 female and 86 male) from the Harvard Forsyth twin sample were included in the study based on record availability. MATERIAL AND METHODS This was an observational study in which all cephalometric radiographs were traced and analysed using Steiner's cephalometric analysis. Each cephalogram was then altered to perform a similar analysis that uses the maximum convexity of the cornea together with natural head position as references instead of the cranial base. A Pearson product-moment correlation coefficient was measured to determine the correlation between the conventional Steiner's analysis measurements and the novel measurements relying on the eyes and natural head position. RESULTS Steiner's cephalometric measurements of the jaws to each other, the divergency and the orientation of the incisors had a strong positive correlation with their counterparts that relied on true horizontal and/or the eyes (P < 0.001). CONCLUSION The eyes and true horizontal can be used as alternatives to the cranial base when diagnosing the relationship between the jaws and the position and orientation of the teeth. Since the eyes and natural head position are identifiable without ionizing radiation, future research should focus on the use of radiographic exposures limited to the upper and lower jaws for orthodontic diagnosis and outcome assessment.
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Affiliation(s)
- Stephanie C Finn
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts.,Private Practice, Boston, Massachusetts
| | - Mathew T Silver
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts.,Private Practice, Boston, Massachusetts
| | - Benjamin Canary
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts
| | | | | | - Negin Katebi
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts
| | - Mohamed I Masoud
- Department of Developmental Biology, Harvard School of Dental Medicine, Boston, Massachusetts
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Verdenik M, Ihan Hren N. Three-dimensional facial changes correlated with sagittal jaw movements in patients with class III skeletal deformities. Br J Oral Maxillofac Surg 2017; 55:517-523. [DOI: 10.1016/j.bjoms.2017.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Accepted: 02/17/2017] [Indexed: 10/19/2022]
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16
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de Sena LMF, de Sena PPM, Pereira HSG. Cephalometric analysis: Orthodontists versus oral radiologists. J World Fed Orthod 2016. [DOI: 10.1016/j.ejwf.2016.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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17
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Agrawal MS, Manish Agrawal JA, Patni V, Nanjannawar L. An evaluation of the reproducibility of landmark identification in traditional versus computer-assisted digital cephalometric analysis system. APOS TRENDS IN ORTHODONTICS 2015. [DOI: 10.4103/2321-1407.155834] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objective
To determine the reliability of Computer Assisted Digital Cephalometric Analysis System (CADCAS) in terms of landmark identification on the values of cephalometric measurements in comparison with those obtained from original radiographs.
Materials and Methods
The study material consisted of Twenty five lateral cephalograms selected randomly, 16 cephalometric points together with 10 angular and 5 linear cephalometric measurements. The landmarks were manually picked on the tracing & the measurements of X &Y axis done with reference grid. The same tracing was digitized & image loaded in the software (ViewBox 3.1.1) was checked for the magnification (metal ruler) & distortion. The second part of the study compared manual and the CADCAS since the landmarks were manually digitized on screen as against the manually picked ones on the tracing paper. The x and y-coordinates for 16 landmarks were measured, mean and standard deviation calculated, linear and angular measurements compared.
Statistical Analysis
A paired t-test was done to calculate the statistical significance of the differences. Intraclass reliability coefficient (signifying reproducibility) of the variable was recorded. The observations were tabulated and analysis was done using the paired t test at a P value <0.05.
Results
Out of 47 variables looked for, 21 showed statistical significance. Direct digitization onscreen (CADCAS) was the quickest and least tedious method. CADCAS was unreliable with linear measurements involving bilateral structures such as Gonion & Articulare.
Conclusions
Both the methods are equally reliable and reproducible. The intra-class reliability coefficient of all variables differed only slightly, which is not clinically significant.
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Affiliation(s)
- Manish Suresh Agrawal
- Department of Orthodontics, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
| | - Jiwan Asha Manish Agrawal
- Department of Orthodontics, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
| | - Vivek Patni
- Department of Orthodontics, MGM Dental College and Hospital, Mumbai, Maharashtra, India
| | - Lalita Nanjannawar
- Department of Orthodontics, Bharati Vidyapeeth Dental College and Hospital, Sangli, Maharashtra, India
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Reliability of skeletal maturity analysis using the cervical vertebrae maturation method on dedicated software. Int Orthod 2014; 12:483-93. [PMID: 25457719 DOI: 10.1016/j.ortho.2014.10.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVES The aim of this study was to assess the feasibility of skeletal maturation analysis using the Cervical Vertebrae Maturation (CVM) method by means of dedicated software, developed in collaboration with Outside Format (Paullo-Milan), as compared with manual analysis. MATERIALS AND METHODS From a sample of patients aged 7-21 years, we gathered 100 lateral cephalograms, 20 for each of the five CVM stages. For each cephalogram, we traced cervical vertebrae C2, C3 and C4 by hand using a lead pencil and an acetate sheet and dedicated software. All the tracings were made by an experienced operator (a dentofacial orthopedics resident) and by an inexperienced operator (a student in dental surgery). Each operator recorded the time needed to make each tracing in order to demonstrate differences in the times taken. RESULTS Concordance between the manual analysis and the analysis performed using the dedicated software was 94% for the resident and 93% for the student. Interobserver concordance was 99%. The hand-tracing was quicker than that performed by means of the software (28 seconds more on average). CONCLUSIONS The cervical vertebrae analysis software offers excellent clinical performance, even if the method takes longer than the manual technique.
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Fiabilité de l’analyse de la maturité squelettique selon la méthode CVM des vertèbres cervicales faite par un logiciel dédié. Int Orthod 2014. [DOI: 10.1016/j.ortho.2014.10.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Seehra J, Sherriff M, Winchester L. Craniofacial characteristics of successful responders to mandibular advancement splint therapy: a pilot study. Br J Oral Maxillofac Surg 2014; 52:314-6. [PMID: 24636249 DOI: 10.1016/j.bjoms.2014.01.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2013] [Accepted: 01/31/2014] [Indexed: 11/15/2022]
Abstract
Cephalometric variables that can be used to identify patients with obstructive sleep apnoea who are suitable for mandibular advancement splints and surgical maxillomandibular advancement are lacking. The aim of this pilot study was to describe the craniofacial characteristics of patients whose symptoms of obstructive sleep apnoea were successfully treated with mandibular advancement splints and who were subsequently considered for maxillomandibular advancement. We retrospectively compared the craniofacial characteristics of our patients with data from 2 previously published studies. There were significant differences between the 2 groups for ANB (p<0.000), overjet (p<0.0001), Go-Me (p<0.0002), and ANS-PNS (p<0.0009). Patients, whose symptoms improve with the use of mandibular advancement splints and are potential candidates for maxillomandibular advancement, may have unique craniofacial features consisting of bimaxillary retrusion characterised by a shorter maxilla and mandible, and a greater class II skeletal tendency. The results of this study should be viewed as a pilot. Further research is required.
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Affiliation(s)
| | - Martyn Sherriff
- School of Oral and Dental Sciences, Bristol Dental Hospital, University of Bristol and Kings College London Dental Institute at Guy's, King's College and St Thomas' Hospitals
| | - Lindsay Winchester
- Queen Victoria Hospital NHS Foundation Trust, Holtye Road, East Grinstead, West Sussex RH19 3DZ, UK
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21
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Tikku T, Khanna R, Maurya RP, Srivastava K, Bhushan R. Comparative evaluation of cephalometric measurements of monitor-displayed images by Nemoceph software and its hard copy by manual tracing. J Oral Biol Craniofac Res 2014; 4:35-41. [PMID: 25737917 DOI: 10.1016/j.jobcr.2013.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2013] [Accepted: 11/20/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate and compare the cephalometric measurements obtained from computerized tracing of direct digital radiographs and hand tracing of their digital radiographic printouts. MATERIAL AND METHODS The soft- and hard-copies of pre-treatment lateral cephalograms of 40 subjects (both males and females) within the age group of 10-30 years, irrespective of the type of malocclusion were taken. Total 26 measurements (13 linear and 13 angular) were obtained using both the manual and the digital technique. RESULTS Amongst the linear measurements, Anterior facial height (AFH), Posterior facial height (PFH), Upper lip length (ULL), Lower lip length (LLL), Anterior cranial base length (ACBL), Posterior cranial base length (PCBL), Maxillary length (MxL), Mandibular length (MdL), Lower incisor to NB line (L1 to NB) and Lower lip protrusion (LLP) showed statistically significant difference between the two techniques but were clinically acceptable (difference between the digital and manual technique were less than 2 units (1 unit = 1 mm for linear measurements and 1° for angular measurements). While amongst the angular measurements, only occlusal plane angle showed statistically significant difference between the two techniques that was not clinically acceptable. CONCLUSION Digital measurements obtained from monitor-displayed images (soft copy) were found to be reproducible and comparable to the manual method done on its hard copy, for all the measurements except occlusal plane angle (SN-occlusal plane).
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Affiliation(s)
- Tripti Tikku
- Professor and Head of Department, Department of Orthodontics and Dentofacial Orthopedics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Rohit Khanna
- Professor, Department of Orthodontics and Dentofacial Orthopedics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - R P Maurya
- Reader, Department of Orthodontics and Dentofacial Orthopedics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Kamna Srivastava
- Senior Lecturer, Department of Orthodontics and Dentofacial Orthopedics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
| | - Rastra Bhushan
- P.G. Student, Department of Orthodontics and Dentofacial Orthopedics, Babu Banarasi Das College of Dental Sciences, Lucknow, Uttar Pradesh, India
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Goracci C, Ferrari M. Reproducibility of measurements in tablet-assisted, PC-aided, and manual cephalometric analysis. Angle Orthod 2013; 84:437-42. [PMID: 24160993 DOI: 10.2319/061513-451.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To assess the reproducibility of cephalometric measurements performed with software for a tablet, with a program for personal computers (PCs), and manually. MATERIALS AND METHODS The pretreatment lateral cephalograms of 20 patients that were acquired using the same digital cephalometer were collected. Tracings were performed with NemoCeph for Windows (Nemotec), with SmileCeph for iPad (Glace Software), and by hand. Landmark identification was carried out with a mouse-driven cursor using NemoCeph and with a stylus pen on the iPad screen using SmileCeph. Hand tracings were performed on printouts of the cephalograms, using a 0.3-mm 2H pencil and a protractor. Cephalometric landmarks and linear and angular measurements were recorded. All the tracings were done by the same investigator. To evaluate reproducibility, for each cephalometric measurement the agreement between the value derived from NemoCeph, that given by SmileCeph and that measured manually was assessed with the intraclass correlation coefficient (ICC). Agreement was rated as low for an ICC≤0.75, and an ICC>0.75 was considered indicative of good agreement. Also, differences in measurements between each software and manual tracing were statistically evaluated (P<.05). RESULTS All the measurements had ICC>0.8, indicative of a high agreement among the tracing methods. Relatively lower ICCs occurred for linear measurements related to the occlusal plane and to N perpendicular to the Frankfurt plane. Differences in measurements between both software programs and hand tracing were not statistically significant for any of the cephalometric parameters. CONCLUSION Tablet-assisted, PC-aided, and manual cephalometric tracings showed good agreement.
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Affiliation(s)
- Cecilia Goracci
- a Professor, Department of Medical Biotechnologies, University of Siena, Siena, Italy
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23
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Toy E, Malkoç S, Altındiş S, Aksakallı S. Assessment of Reliability of Three Different Computer-Assisted Analysis Programs. Turk J Orthod 2013. [DOI: 10.13076/tjo-d-13-00013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Albarakati SF, Kula KS, Ghoneima AA. The reliability and reproducibility of cephalometric measurements: a comparison of conventional and digital methods. Dentomaxillofac Radiol 2012; 41:11-7. [PMID: 22184624 DOI: 10.1259/dmfr/37010910] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of this study was to assess the reliability and reproducibility of angular and linear measurements of conventional and digital cephalometric methods. METHODS A total of 13 landmarks and 16 skeletal and dental parameters were defined and measured on pre-treatment cephalometric radiographs of 30 patients. The conventional and digital tracings and measurements were performed twice by the same examiner with a 6 week interval between measurements. The reliability within the method was determined using Pearson's correlation coefficient (r²). The reproducibility between methods was calculated by paired t-test. The level of statistical significance was set at p < 0.05. RESULTS All measurements for each method were above 0.90 r² (strong correlation) except maxillary length, which had a correlation of 0.82 for conventional tracing. Significant differences between the two methods were observed in most angular and linear measurements except for ANB angle (p = 0.5), angle of convexity (p = 0.09), anterior cranial base (p = 0.3) and the lower anterior facial height (p = 0.6). CONCLUSION In general, both methods of conventional and digital cephalometric analysis are highly reliable. Although the reproducibility of the two methods showed some statistically significant differences, most differences were not clinically significant.
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Affiliation(s)
- S F Albarakati
- Department of Orthodontics, College of Dentistry, King Saud University, Riyadh, Saudi Arabia
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Cook EA, Cook JJ, Basile P. Identifying risk factors in subtalar arthroereisis explantation: a propensity-matched analysis. J Foot Ankle Surg 2011; 50:395-401. [PMID: 21708340 DOI: 10.1053/j.jfas.2011.03.019] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Indexed: 02/03/2023]
Abstract
A case-control study was undertaken to identify differences in patients with flexible flatfoot deformity who required explantation of subtalar arthroereisis compared with those who did not. All patients who required removal of a self-locking wedge-type subtalar arthroereisis were identified between 2002 and 2008. Propensity scores matched 22 explanted subtalar arthroereises to 44 controls (nonexplanted arthroereises), resulting in a total of 66 implants that met all inclusion and exclusion criteria. Multivariate logistic regression found that patients who required explantation had a greater odds of radiographic undercorrection, determined from radiographic anteroposterior talar-first metatarsal angles postoperatively, P = .0012, odds ratio (OR) = 1.175 (95% confidence interval [CI] 1.066 to 1.295), or residual transverse plane-dominant deformities, as determined from radiographic calcaneocuboid abduction angles postoperatively, P = .05, OR = 1.096 (95% CI 1.06 to 1.203). Patients with smaller postoperative anteroposterior talocalcaneal angles had a 16.7% reduction in odds for arthroereisis explantation (P = .0019) (95% CI 6.5% to 25.8%). Age, gender, implant size, shape, duration, implant position, surgeon experience, and concomitant procedures were not statistically different between the 2 groups. This study helps identify key factors that may result in subtalar arthroereisis explantation.
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Affiliation(s)
- Emily A Cook
- Harvard Medical School, Beth Israel Deaconess Medical Center, Division of Podiatric Surgery, Department of Surgery, Boston, MA 02215, USA
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Tan SSW, Ahmad S, Moles DR, Cunningham SJ. Picture archiving and communications systems: a study of reliability of orthodontic cephalometric analysis. Eur J Orthod 2010; 33:537-43. [PMID: 21106665 DOI: 10.1093/ejo/cjq116] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The objectives of this study were to investigate the possibility of using a picture archiving and communications system (PACS) for basic chairside cephalometric analysis and to compare PACS with hand-tracing and on-screen digitization using a commercial program (Dolphin Imaging Plus Version 10.0). One hundred digital lateral cephalometric radiographs were selected and analysed using the Eastman analysis. Angular and linear measurements were recorded and a single operator traced each radiograph twice, using each of the following methods: PACS, hand-tracing, and Dolphin Imaging. The British Standards Institution Coefficient of Repeatability was used to investigate repeatability within each method and the Bland and Altman method to investigate systematic and random errors between methods. The PACS was more repeatable than Dolphin for measuring the angle between the upper incisors and the maxillary plane but was less repeatable than hand-tracing for measuring percentage lower anterior face height (LAFH). There were statistically significant systematic differences between PACS, hand-tracing, and Dolphin for measurement of lower incisor inclination. However, all three methods agreed, on average, and differences between methods were all within clinically acceptable limits. PACS was found to be clinically acceptable to be used chairside, without the need for hand-tracing or involvement of any orthodontic software. This offers the freedom to analyse digital cephalograms within a clinical area at the same appointment as when the digital radiograph is taken.
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Affiliation(s)
- Sylvia S W Tan
- Department of Orthodontics, UCL Eastman Dental Institute, London, UK
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Singh P, Davies TI. A comparison of cephalometric measurements: a picture archiving and communication system versus the hand-tracing method--a preliminary study. Eur J Orthod 2010; 33:350-3. [PMID: 20923935 DOI: 10.1093/ejo/cjq087] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Traditionally, cephalometric analysis has been carried out using a hand-tracing manual method. In imaging, picture archiving and communication systems (PACS) are information management systems used for the capture and measurement of medical and dental radiographs. Although not customized for lateral cephalometry, this study aimed to evaluate the cephalometric measurements made on screen using PACS compared with the conventional hand-tracing method. Six angular and four liner parameters were measured on five radiographs of four females and one male with an age range of 14-20 years. Analysis was completed using the Wilcoxon rank-sum test. For the electronic method, SNB (P=0.04) and lower incisor angle (P=0.05) were the only parameters found to be significantly different between the two operators. There was no significant difference between operators 1 and 2 for the hand-tracing method for any measurement. All measurements were comparable between the two methods. This preliminary study would suggest that using PACS may be an acceptable method for obtaining cephalometric measurements for treatment planning; however, further evaluation is necessary with a larger sample size.
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Affiliation(s)
- Parmjit Singh
- Orthodontic Department, Ipswich Hospital, Suffolk, UK.
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