title: Orthodontic soft-tissue parameters: a comparison of cone-beam computed tomography and the 3dMD imaging system.
abstract: BACKGROUND
  Orthodontists rely heavily on soft-tissue analysis to determine facial esthetics and treatment stability. The aim of this retrospective study was to determine the equivalence of soft-tissue measurements between the 3dMD imaging system (3dMD, Atlanta, Ga) and the segmented skin surface images derived from cone-beam computed tomography.
  
  
  METHODS
  Seventy preexisting 3dMD facial photographs and cone-beam computed tomography scans taken within minutes of each other for the same subjects were registered in 3 dimensions and superimposed using Vultus (3dMD) software. After reliability studies, 28 soft-tissue measurements were recorded with both imaging modalities and compared to analyze their equivalence. Intraclass correlation coefficients and Bland-Altman plots were used to assess interexaminer and intraexaminer repeatability and agreement. Summary statistics were calculated for all measurements. To demonstrate equivalence of the 2 methods, the difference needed a 95% confidence interval contained entirely within the equivalence limits defined by the repeatability results.
  
  
  RESULTS
  Statistically significant differences were reported for the vermilion height, mouth width, total facial width, mouth symmetry, soft-tissue lip thickness, and eye symmetry.
  
  
  CONCLUSIONS
  There are areas of nonequivalence between the 2 imaging methods; however, the differences are clinically acceptable from the orthodontic point of view.
authors.affiliation: Resident, Department of Orthodontics and Oral Facial Genetics, School of Dentistry, University of Indiana, Indianapolis, Ind.
authors.forename: Tasha E
authors.initials: TE
authors.lastname: Metzger
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Kula
authors.forename: George J
authors.initials: GJ
authors.lastname: Eckert
authors.forename: Ahmed A
authors.initials: AA
authors.lastname: Ghoneima
mesh_terms: D002508:Cephalometry / Q000706:statistics & numerical data; D002680:Chin / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D054893:Cone-Beam Computed Tomography / Q000706:statistics & numerical data*; D061827:Dimensional Measurement Accuracy; D005123:Eye / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D005145:Face / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000706:statistics & numerical data*; D021621:Imaging, Three-Dimensional / Q000706:statistics & numerical data*; D007180:Incisor / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008046:Lip / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008297:Male; D008334:Mandible / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D008437:Maxilla / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D009055:Mouth / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D009666:Nose / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D015588:Observer Variation; D010781:Photography / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012984:Software; D014716:Vertical Dimension; D055815:Young Adult