title: Methods to quantify soft-tissue based facial growth and treatment outcomes in children: a systematic review.
abstract: BACKGROUND
  Technological advancements have led craniofacial researchers and clinicians into the era of three-dimensional digital imaging for quantitative evaluation of craniofacial growth and treatment outcomes.
  
  
  OBJECTIVE
  To give an overview of soft-tissue based methods for quantitative longitudinal assessment of facial dimensions in children until six years of age and to assess the reliability of these methods in studies with good methodological quality.
  
  
  METHODS
  PubMed, EMBASE, Cochrane Library, Web of Science, Scopus and CINAHL were searched. A hand search was performed to check for additional relevant studies.
  
  
  METHODS
  Primary publications on facial growth and treatment outcomes in children younger than six years of age were included.
  
  
  METHODS
  Independent data extraction by two observers. A quality assessment instrument was used to determine the methodological quality. Methods, used in studies with good methodological quality, were assessed for reliability expressed as the magnitude of the measurement error and the correlation coefficient between repeated measurements.
  
  
  RESULTS
  In total, 47 studies were included describing 4 methods: 2D x-ray cephalometry; 2D photography; anthropometry; 3D imaging techniques (surface laser scanning, stereophotogrammetry and cone beam computed tomography). In general the measurement error was below 1 mm and 1° and correlation coefficients range from 0.65 to 1.0.
  
  
  CONCLUSIONS
  Various methods have shown to be reliable. However, at present stereophotogrammetry seems to be the best 3D method for quantitative longitudinal assessment of facial dimensions in children until six years of age due to its millisecond fast image capture, archival capabilities, high resolution and no exposure to ionizing radiation.
authors.affiliation: Department of Orthodontics and Craniofacial Biology, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands. orthodontics@dent.umcn.nl
authors.forename: Sander
authors.initials: S
authors.lastname: Brons
authors.forename: Machteld E
authors.initials: ME
authors.lastname: van Beusichem
authors.forename: Ewald M
authors.initials: EM
authors.lastname: Bronkhorst
authors.forename: Jos
authors.initials: J
authors.lastname: Draaisma
authors.forename: Stefaan J
authors.initials: SJ
authors.lastname: Bergé
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Maal
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Kuijpers-Jagtman
mesh_terms: D002508:Cephalometry / Q000379:methods*; D002648:Child; D005145:Face / Q000033:anatomy & histology; D006801:Humans; D008445:Maxillofacial Development / Q000502:physiology*; D011785:Quality Assurance, Health Care; D015203:Reproducibility of Results; D016896:Treatment Outcome