Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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Comparison of the observer reliability of cranial anatomic landmarks based on cephalometric radiograph and three-dimensional computed tomography scans

삼차원 전산화단층촬영사진과 측모두부 방사선규격사진의 계측자에 따른 계측오차에 대한 비교분석

  • Kim, Jae-Young (Department of Oral and Maxillofacial Surgery, Sun Dental Hospital) ;
  • Lee, Dong-Keun (Department of Oral and Maxillofacial Surgery, Sun Dental Hospital) ;
  • Lee, Sang-Han (Department of Oral and Maxillofacial Surgery, School of Dentistry, Kyungpook National University)
  • 김재영 (대전선치과병원 구강악안면외과) ;
  • 이동근 (대전선치과병원 구강악안면외과) ;
  • 이상한 (경북대학교 치의학전문대학원 구강악안면외과학교실)
  • Received : 2009.12.28
  • Accepted : 2010.05.11
  • Published : 2010.08.31
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Abstract

Introduction: Accurate diagnosis and treatment planning are very important for orthognathic surgery. A small error in diagnosis can cause postoperative functional and esthetic problems. Pre-existing 2-dimensional (D) chephalogram analysis has a high likelihood of error due to its intrinsic and extrinsic problems. A cephalogram can also be inaccurate due to the limited anatomic points, superimposition of the image, and the considerable time and effort required. Recently, an improvement in technology and popularization of computed tomography (CT) provides patients with 3-D computer based cephalometric analysis, which complements traditional analysis in many ways. However, the results are affected by the experience and the subject of the investigator. Materials and Methods: The effects of the sources human error in 2-D cephalogram analysis and 3-D computerized tomography cephalometric analysis were compared using Simplant CMF program. From 2008 Jan to 2009 June, patients who had undergone CT, cephalo AP, lat were investigated. Results: 1. In the 3 D and 2 D images, 10 out of 93 variables (10.4%) and 11 out 44 variables (25%), respectively, showed a significant difference. 2. Landmarks that showed a significant difference in the 2 D image were the points frequently superimposed anatomically. 3. Go Po Orb landmarks, which showed a significant difference in the 3 D images, were found to be the artificial points for analysis in the 2 D image, and in the current definition, these points cannot be used for reproducibility in the 3 D image. Conclusion: Generally, 3-D CT images provide more precise identification of the traditional cephalometric landmark. Greater variability of certain landmarks in the mediolateral direction is probably related to the inadequate definition of the landmarks in the third dimension.

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References

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