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The Reliability of Two- and Three-Dimensional Cephalometric Measurements: A CBCT Study. Diagnostics (Basel) 2021; 11:diagnostics11122292. [PMID: 34943528 PMCID: PMC8700671 DOI: 10.3390/diagnostics11122292] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 11/21/2021] [Accepted: 12/03/2021] [Indexed: 11/16/2022] Open
Abstract
Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed tomography (CBCT) images not only allow three-dimensional (3D) analysis, but also enable the extraction of two-dimensional (2D) images without magnification. To evaluate the most reliable cephalometric analysis method, we extracted 2D lateral cephalometric images with and without magnification from twenty full-cranium CBCT datasets; images were extracted with magnification to mimic traditional lateral cephalograms. Cephalometric tracings were performed on the two types of extracted 2D lateral cephalograms and on the reconstructed 3D full cranium images by two examiners. The intra- and inter-examiner intraclass correlation coefficients (ICC) were compared between linear and angular parameters, as well as between CBCT datasets of adults and children. Our results showed that overall, tracing on 2D cephalometric images without magnification increased intra- and inter-examiner reliability, while 3D tracing reduced inter-examiner reliability. Angular parameters and children's images had the lowest inter- and intra-examiner ICCs compared with adult samples and linear parameters. In summary, using lateral cephalograms extracted from CBCT without magnification for tracing/analysis increased reliability. Special attention is needed when analyzing young patients' images and measuring angular parameters.
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Kerbrat A, Rivals I, Dupuy P, Dot G, Berg BI, Attali V, Schouman T. Biplanar Low-Dose Radiograph Is Suitable for Cephalometric Analysis in Patients Requiring 3D Evaluation of the Whole Skeleton. J Clin Med 2021; 10:5477. [PMID: 34884179 PMCID: PMC8658104 DOI: 10.3390/jcm10235477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Revised: 11/20/2021] [Accepted: 11/22/2021] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The biplanar 2D/3D X-ray technology (BPXR) is a 2D/3D imaging system allowing simultaneous stereo-corresponding posteroanterior (PA) and lateral 2D views of the whole body. The aim of our study was to assess the feasibility of cephalometric analysis based on the BPXR lateral skull view to accurately characterize facial morphology. METHOD A total of 17 landmarks and 11 angles were placed and/or calculated on lateral BPXR and lateral cephalograms of 13 patients by three investigators. Five methods of angle identification were performed: the direct construction of straight lines on lateral cephalograms (LC-A) and on BPXR (BPXR-A), as well as the calculation of angles based on landmark identification on lateral cephalograms (LA-L) and on BPXR with the PA image (BPXR-LPA) or without (BPXR-L). Intra- and interoperator reliability of landmark identification and angle measurement of each method were calculated. To determine the most reliable method among the BPXR-based methods, their concordance with the reference method, LC-A, was evaluated. RESULTS Both imaging techniques had excellent intra- and interoperator reliability for landmark identification. On lateral BPXR, BPXR-A presented the best concordance with the reference method and a good intra- and interoperator reliability. CONCLUSION BPXR provides a lateral view of the skull suitable for cephalometric analysis with good reliability.
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Affiliation(s)
- Adeline Kerbrat
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
| | - Isabelle Rivals
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
- Equipe de Statistique Appliquée, ESPCI Paris, PSL Research University, 75231 Paris, France
| | - Pauline Dupuy
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
| | - Gauthier Dot
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
| | - Britt-Isabelle Berg
- Department of Cranio-Maxillofacial Surgery, University Hospital Basel, CH-4031 Basel, Switzerland;
| | - Valérie Attali
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
- Sorbonne Université, Inserm, UMRS1158 Neurophysiologie Respiratoire Expérimentale et Clinique, 75005 Paris, France;
- Service des Pathologies du Sommeil, Département R3S, Hôpital Pitié-Salpêtrière, AP-HP. Sorbonne Université, 75013 Paris, France
| | - Thomas Schouman
- Service de Chirurgie Maxillo-Faciale, Hôpital Pitié-Salpêtrière, AP-HP Sorbonne Université, 75013 Paris, France; (P.D.); (T.S.)
- Arts et Metiers ParisTech, LBM/Institut de Biomécanique Humaine Georges Charpak, 75013 Paris, France; (G.D.); (V.A.)
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