title: The evaluation of a novel haptic-enabled virtual reality approach for computer-aided cephalometry.
abstract: OBJECTIVE
  In oral and maxillofacial surgery, conventional radiographic cephalometry is one of the standard auxiliary tools for diagnosis and surgical planning. While contemporary computer-assisted cephalometric systems and methodologies support cephalometric analysis, they tend neither to be practical nor intuitive for practitioners. This is particularly the case for 3D methods since the associated landmarking process is difficult and time consuming. In addition to this, there are no 3D cephalometry norms or standards defined; therefore new landmark selection methods are required which will help facilitate their establishment. This paper presents and evaluates a novel haptic-enabled landmarking approach to overcome some of the difficulties and disadvantages of the current landmarking processes used in 2D and 3D cephalometry.
  
  
  METHODS
  In order to evaluate this new system's feasibility and performance, 21 dental surgeons (comprising 7 Novices, 7 Semi-experts and 7 Experts) performed a range of case studies using a haptic-enabled 2D, 2½D and 3D digital cephalometric analyses.
  
  
  RESULTS
  The results compared the 2D, 2½D and 3D cephalometric values, errors and standard deviations for each case study and associated group of participants and revealed that 3D cephalometry significantly reduced landmarking errors and variability compared to 2D methods.
  
  
  CONCLUSIONS
  Through enhancing the process by providing a sense of touch, the haptic-enabled 3D digital cephalometric approach was found to be feasible and more intuitive than its counterparts as well effective at reducing errors, the variability of the measurements taken and associated task completion times.
authors.affiliation: Facultad de Ingeniería, Universidad Autónoma de San Luis Potosí, Av. Manuel Nava No. 8, Zona Universitaria, 78290 San Luis Potosí, S.L.P., Mexico. Electronic address: hugoivanmc@uaslp.mx.
authors.forename: H I
authors.initials: HI
authors.lastname: Medellín-Castillo
authors.affiliation: Facultad de Ingeniería, Universidad Autónoma de San Luis Potosí, Av. Manuel Nava No. 8, Zona Universitaria, 78290 San Luis Potosí, S.L.P., Mexico. Electronic address: ederhazael@hotmail.com.
authors.forename: E H
authors.initials: EH
authors.lastname: Govea-Valladares
authors.affiliation: Asociación Mexicana de Ortodoncia, Mexico. Electronic address: cyntia.p08@gmail.com.
authors.forename: C N
authors.initials: CN
authors.lastname: Pérez-Guerrero
authors.affiliation: Asociación Mexicana de Implantología Oral, Mexico. Electronic address: josegilvalladares@hotmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Gil-Valladares
authors.affiliation: Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Riccarton, EH14 4AS Edinburgh, UK. Electronic address: T.Lim@hw.ac.uk.
authors.forename: Theodore
authors.initials: T
authors.lastname: Lim
authors.affiliation: Institute of Mechanical, Process and Energy Engineering, School of Engineering and Physical Sciences, Heriot-Watt University, Riccarton, EH14 4AS Edinburgh, UK. Electronic address: J.M.Ritchie@hw.ac.uk.
authors.forename: James M
authors.initials: JM
authors.lastname: Ritchie
mesh_terms: D000328:Adult; D002508:Cephalometry / Q000379:methods*; D003198:Computer Simulation; D006801:Humans; D008875:Middle Aged; D014584:User-Computer Interface; D055815:Young Adult
keywords: Cephalometric values; Cephalometry; Haptic technologies; Landmark selection; Task completion time (TCT)