Abstract
Background: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients. Methods: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OBA, OBB, OBC). Statistical analysis was performed using descriptive and inferential statistics with paired t-tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A p-value less than 0.05 was considered as significant at a 95% confidence level. Results: When comparing, the plotting of points posterior nasal spine (PNS) (p < 0.05), anterior nasal spine (ANS) (p < 0.01), upper 1 root tip (p < 0.05), lower 1 root tip (p < 0.05), malare (p < 0.05), pyriforme (p < 0.05), porion (p < 0.01), and basion (p < 0.05) was statistically significant. Conclusion: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.
Highlights
Since its advent in 1931 [1], conventional cephalometry has been one of the essential diagnostic tools for analyzing orthodontic problems, maxillofacial deformities, evaluating growth, and planning treatment [2]
The synchronal literature in the past several years has emphasized the pivotal role of cone beam computed tomography (CBCT) to determine the reliability [19,20,21,22,23,24,25,26,27] of anatomic landmarks, there is a paucity of studies for the same, along with their reproducibility in cleft lip and palate (CLP) patients versus cephalometrics where the localization of anatomy is challenging
The mean distance of the digital and CBCT-derived cephalograms was recorded for all three observers along with the overall mean of the same
Summary
Since its advent in 1931 [1], conventional cephalometry has been one of the essential diagnostic tools for analyzing orthodontic problems, maxillofacial deformities, evaluating growth, and planning treatment [2]. The reliability and reproducibility of these anatomical landmarks are imperative, especially in patients with CLP where the identification of landmarks is highly challenging and, difficult to perceive and reproduce. The synchronal literature in the past several years has emphasized the pivotal role of CBCT to determine the reliability [19,20,21,22,23,24,25,26,27] of anatomic landmarks, there is a paucity of studies for the same, along with their reproducibility in CLP patients versus cephalometrics where the localization of anatomy is challenging. The present study was conducted to compare the reliability and reproducibility of landmark identification using two systems: CBCT-derived 3D cephalograms vis-a-vis digital lateral cephalograms in unilateral cleft lip and palate (UCLP) patients
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