title: Accuracy of linear measurements using three imaging modalities: two lateral cephalograms and one 3D model from CBCT data.
abstract: BACKGROUND
  The aim of this study was to evaluate the accuracy of linear measurements on three imaging modalities: lateral cephalograms from a cephalometric machine with a 3 m source-to-mid-sagittal-plane distance (SMD), from a machine with 1.5 m SMD and 3D models from cone-beam computed tomography (CBCT) data.
  
  
  METHODS
  Twenty-one dry human skulls were used. Lateral cephalograms were taken, using two cephalometric devices: one with a 3 m SMD and one with a 1.5 m SMD. CBCT scans were taken by 3D Accuitomo® 170, and 3D surface models were created in Maxilim® software. Thirteen linear measurements were completed twice by two observers with a 4 week interval. Direct physical measurements by a digital calliper were defined as the gold standard. Statistical analysis was performed.
  
  
  RESULTS
  Nasion-Point A was significantly different from the gold standard in all methods. More statistically significant differences were found on the measurements of the 3 m SMD cephalograms in comparison to the other methods. Intra- and inter-observer agreement based on 3D measurements was slightly better than others.
  
  
  CONCLUSIONS
  Dry human skulls without soft tissues were used. Therefore, the results have to be interpreted with caution, as they do not fully represent clinical conditions.
  
  
  CONCLUSIONS
  3D measurements resulted in a better observer agreement. The accuracy of the measurements based on CBCT and 1.5 m SMD cephalogram was better than a 3 m SMD cephalogram. These findings demonstrated the linear measurements accuracy and reliability of 3D measurements based on CBCT data when compared to 2D techniques. Future studies should focus on the implementation of 3D cephalometry in clinical practice.
authors.affiliation: *OIC, OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium, Department of Radiology, Faculty of Dentistry, Chulalongkorn University, Bangkok, Thailand, p.pittayapat@gmail.com.
authors.forename: Pisha
authors.initials: P
authors.lastname: Pittayapat
authors.affiliation: *OIC, OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium, Department of Oral Surgery and Stomatology, School of Dental Medicine, University of Bern, Bern, Switzerland.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Bornstein
authors.affiliation: Department of Stomatology, Bauru School of Dentistry, University of São Paulo (FOB/USP), São Paulo, Brazil.
authors.forename: Thaís Sumie Nozu
authors.initials: TS
authors.lastname: Imada
authors.affiliation: Department of Clinical Biology, Scientific Institute of Public Health, Brussels, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Coucke
authors.affiliation: Biomedical Research Institute, Laboratory of Morphology, Hasselt University, Campus Diepenbeek, Diepenbeek, Belgium.
authors.forename: Ivo
authors.initials: I
authors.lastname: Lambrichts
authors.affiliation: *OIC, OMFS IMPATH Research Group, Department of Imaging & Pathology, Faculty of Medicine, University of Leuven and Oral & Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.
authors.forename: Reinhilde
authors.initials: R
authors.lastname: Jacobs
mesh_terms: D002508:Cephalometry / Q000379:methods*; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D015588:Observer Variation; D009971:Orthodontics, Corrective / Q000379:methods; D015203:Reproducibility of Results; D012886:Skull / Q000033:anatomy & histology / Q000000981:diagnostic imaging*; D012984:Software