Abstract
The study aimed to evaluate the reliability and reproducibility and compare the outcomes of two 3D voxel-based superimposition techniques for craniofacial CBCT images, using anterior cranial base areas of different extent as references. Fifteen preexisting pairs of serial CBCTs (initial age: 11.7 ± 0.6 years; interval: 1.7 ± 0.4 years) were superimposed on total anterior cranial base (TACB) or middle anterior cranial base (MACB) structures through the Dolphin 3D software. The overlap of the reference structures was assessed visually to indicate reliability. All superimpositions were repeated by the same investigator. Outcomes were compared to assess the agreement between the two methods. Reliability was perfect for the TACB and moderate for the MACB method (p = 0.044). Both areas showed good overall reproducibility, though in individual cases there were notable differences for MACB superimpositions, ranging from −1.84 to 1.64 mm (TACB range: −0.48 to 0.31 mm). The overall agreement in the detected T0/T1 changes was also good, though it was significantly reduced for individual measurements (median < 0.01 mm, IQR: 0.46 mm, range: −2.81 to 0.73 mm). In conclusion, the voxel-based superimposition on TACB was more reliable and showed higher reproducibility than the superimposition on MACB. Thus, the extended anterior cranial base area is recommended for the assessment of craniofacial changes.
Highlights
Craniofacial growth assessment and treatment outcome analysis is essential in several fields, such as orthodontics and maxillofacial or plastic surgery
The popularity of cone-beam computed tomography (CBCT) in diagnostics has increased over the years
When the areawas wasapplied, applied, adequate overlap ofanterior the anterior cranial base structures was visually observed in all cases, in all three planes that were cranial base structures was visually observed in all 15 cases, in all three planes that were visualized in the views of the software
Summary
Craniofacial growth assessment and treatment outcome analysis is essential in several fields, such as orthodontics and maxillofacial or plastic surgery. The most commonly used method for this is the superimposition of serial 2D cephalometric images on stable areas of the anterior cranial base [1]. The radiographic source of information is in two dimensions, which has limitations, such as image distortion and lack of precision in landmark identification. These are mainly related to the compression of a 3D object into a the popularity of cone-beam computed tomography (CBCT) in diagnostics has increased over the years. There is an increased interest in the use of serial CBCT superimpositions to evaluate craniofacial changes [5]. The anterior cranial base structures remain stable after an early age [6,7]. Due to their being centrally located in the cranium, superimposition on these structures is the standard reference, applicable in 2D as well as in
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