Abstract
The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.
Highlights
Introduction distributed under the terms andThe first photograph used in the medical field dated back to 1845 [1]
The standardized facial photographs require special types of equipment, precise stepwise technique, and more time than that required for 3D stereophotogrammetry [11,12,13]
The concordance correlation coefficients (CCC) showed that most of the soft tissue linear and angular measurements of maxillary and mandibular anteroposterior and vertical parameters were of high reliability (CCC ranged between 0.91 and 0.998), except for four soft tissue measurements which were unreliable: the posterior gonial angle (0.085 and 0.11 for wrapped and direct Cone Beam Computed Tomography (CBCT) soft tissue, respectively), the mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), the posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively), and the total soft tissue facial convexity (0.52 for both the wrapped and direct CBCT soft tissue, Table 3)
Summary
The first photograph used in the medical field dated back to 1845 [1]. Thereafter, several advances in this practice were developed. Another recent method for recording the soft tissue profile is “stereophotogrammetry” This method is almost accurate in representing the facial soft tissue compared to the direct anthropometric and the 2D standardized photogrammetric measurements, it needs expensive equipment, is time consuming, and takes considerable clinical workspace [11,12,13]. For their part, the standardized facial photographs require special types of equipment, precise stepwise technique, and more time than that required for 3D stereophotogrammetry [11,12,13]. There is a need to replace the expensive, and time- and space-consuming methods—
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