Use of an anatomical mid-sagittal plane for 3-dimensional cephalometry: A preliminary study
Vernucci Roberto Antonio, Aghazada Huseynagha, Gardini Kelly, Fegatelli Danilo Alunni, Barbato Ersilia, Galluccio Gabriella, Silvestri Alessandro,
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( Vernucci Roberto Antonio ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
( Aghazada Huseynagha ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
( Gardini Kelly ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
( Fegatelli Danilo Alunni ) - Sapienza University of Rome Department of Public Health and Infectious Diseases
( Barbato Ersilia ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
( Galluccio Gabriella ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
( Silvestri Alessandro ) - Sapienza University of Rome School of Dentistry Department of Oral and Maxillofacial Sciences
Abstract
Purpose: Cone-beam computed tomography (CBCT) is widely used for 3-dimensional assessments of cranio-maxillofacial relationships, especially in patients undergoing orthognathic surgery. We have introduced, for reference in CBCT cephalometry, an anatomical mid-sagittal plane (MSP) identified by the nasion, the midpoint between the posterior clinoid processes of the sella turcica, and the basion. The MSP is an updated version of the median plane previously used at our institution for 2D posterior-anterior cephalometry. This study was conducted to test the accuracy of the CBCT measures compared to those obtained using standard posterior-anterior cephalometry.
Materials and Methods: Two operators measured the inter-zygomatic distance on 15 CBCT scans using the MSP as a reference plane, and the CBCT measurements were compared with measurements made on patients' posterior-anterior cephalograms. The statistical analysis evaluated the absolute and percentage differences between the 3D and 2D measurements.
Results: As demonstrated by the absolute mean difference (roughly 1 mm) and the percentage difference (less than 3%), the MSP showed good accuracy on CBCT compared to the 2D plane, especially for measurements of the left side. However, the CBCT measurements showed a high standard deviation, indicating major variability and low precision.
Conclusion: The anatomical MSP can be used as a reliable reference plane for transverse measurements in 3D cephalometry in cases of symmetrical or asymmetrical malocclusion. In patients who suffer from distortions of the skull base, the identification of landmarks might be difficult and the MSP could be unreliable. Becoming familiar with the relevant software could reduce errors and improve reliability.
키워드
Cephalometry; Cone-Beam Computed Tomography; Dimensional Measurement Accuracy
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