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Reproducibility of osseous landmarks used for computed tomography based three-dimensional cephalometric analyses.

Authors
  • Olszewski, Raphael1
  • Tanesy, Olivier
  • Cosnard, Guy
  • Zech, Francis
  • Reychler, Hervé
  • 1 Department of Oral and Maxillofacial Surgery, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, 10 Av. Hippocrate, 1200 Brussels, Belgium. [email protected] , (Belgium)
Type
Published Article
Journal
Journal of cranio-maxillo-facial surgery : official publication of the European Association for Cranio-Maxillo-Facial Surgery
Publication Date
Apr 01, 2010
Volume
38
Issue
3
Pages
214–221
Identifiers
DOI: 10.1016/j.jcms.2009.05.005
PMID: 19574058
Source
Medline
Language
English
License
Unknown

Abstract

The aim of this paper was to measure the reproducibility of osseous landmark identification from two recently described three-dimensional (3D) cephalometric analyses: 3D-ACRO and 3D-Swennen analyses. The study population consisted of 13 patients examined with spiral 3D computed tomography (CT). We used a previously validated low-dose CT protocol. For each analysis, 22 cephalometric reference landmarks were identified on 3D CT surface renderings. Forty-four reference landmarks were identified per patient. Two series of identifications were performed by two independent observers. In total, 3432 imaging measurements were completed. The intra-observer reconstructed mean log was 1.210+/-1.042mm for the 3D-ACRO analysis, and 1.311+/-1.042mm for 3D-Swennen analysis (comparison: p=0.17 NS). The inter-observer reconstructed mean log was 1.799+/-1.037mm for the 3D-ACRO analysis, and 2.465+/-1.036mm for 3D-Swennen analysis (comparison: p=0.000000002). The difference between the intra- and inter-observer reconstructed mean logs were 1.486+/-1.057mm for 3D-ACRO and 1.880+/-1.056mm for 3D-Swennen analysis. In conclusions: 3D-ACRO analysis was significantly more reproducible than 3D-Swennen analysis (p=0.0027) due to the use of a majority of highly reproducible cephalometric landmarks. Finally, we propose a classification scheme and exclusion criteria for reference landmarks used in 3D cephalometrics, based on inter-observer reproducibility and anatomical reality.

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