Validity of Three-dimensional Facial Scan Taken with Facial Scanner and Digital Photo Wrapping on the Cone-beam Computed Tomography: Comparison of Soft Tissue Parameters

Purpose: The purpose of the study was to assess the validity of three-dimensional (3D) facial scan taken with facial scanner and digital photo wrapping on the cone-beam computed tomography (CBCT). Materials and Methods: Twenty-five patients had their CBCT scan, two-dimensional (2D) standardized frontal photographs and 3D facial scan obtained on the same day. The facial scans were taken with a facial scanner in an upright position. The 2D standardized frontal photographs were taken at a fixed distance from patients using a camera fixed to a cephalometric apparatus. The 2D integrated facial models were created using digital photo wrapping of frontal photographs on the corresponding CBCT images. The 3D integrated facial models were created using the integration process of 3D facial scans on the CBCT images. On the integrated facial models, sixteen soft tissue landmarks were identified, and the vertical, horizontal, oblique and angular distances between soft tissue landmarks were compared among the 2D facial models and 3D facial models, and CBCT images. Result: The results showed no significant differences of linear and angular measurements among CBCT images, 2D and 3D facial models except for Se-Sn vertical linear measurement which showed significant difference for the 3D facial models. The Bland-Altman plots showed that all measurements were within the limit of agreement. For 3D facial model, all Bland-Altman plots showed that systematic bias was less than 2.0 mm and 2.0° except for Se-Sn linear vertical measurement. For 2D facial model, the Bland-Altman plots of 6 out of 11 of the angular measurements showed systematic bias of more than 2.0°. Conclusion: The facial scan taken with facial scanner showed a clinically acceptable performance. The digital 2D photo wrapping has limitations in clinical use compared to 3D facial scans.