• The korean journal of orthodontics
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• v.32 no.2 s.91
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• pp.79-89
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• 2002

The purpose of this study is to evaluate the reproducibility and errors in landmark identification of conventional lateral cephalometric radiography and digital lateral cephalometric radiography. Fifteen conventional lateral cephalometric radiographs and fifteen digital lateral cephalometric radiographs were selected in adults with no considerations on sex and craniofacial forms. Each landmark was identified and expressed as the coordinate (x, y). The landmarks were classified into 3 groups. The landmarks of the first identification was T1, identification after one week was T2, and identification after one month was T3. The mean and standard deviation of identification errors between replicates were calculated according to the x and y coordinates. The errors between first identification and second identification were expressed as T2-T1(x), T2-T1(y) and those between first identification and third identification were expressed as T3-T1(x), T2-T1(y). Each was divided into conventional lateral cephalometric radiography and digital lateral cephalometric radiography. The independent t- test was used for statistical analysis of identification errors for the evaluation of reproducibility. The results of this study were as follows ; 1. Generally, the mean and standard deviation of landmark identification errors in digital lateral cephalometric radiography was smaller than those of conventional lateral cephalometric radiography. 2. Only a few landmarks showed statistically significant difference in identification error between conventional lateral cephalometric radiography and digital lateral cephalometric radiography. 3. The enhancement of image quality didn't guarantee decrease in landmark identification error and didn't affect tendency of landmark identification error.

• The korean journal of orthodontics
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• v.37 no.6
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• pp.391-399
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• 2007

Three-dimensional approaches for the diagnosis and analysis of the dentofacial area are becoming more popular in accordance with the development of cone-beam CT (CBCT). The purposes of this study were to evaluate the reliability of cephalometric measurements of lateral cephalograms generated from a CBCT image by making comparisons with the traditional digital lateral cephalogram, and to evaluate the possibility of the clinical application of CBCT generated cephalogram images. Methods: Twenty patients whose external auditory meatus could be identified in the CBCT image were selected, and both CBCT and digital cephalograms were taken. Differences between the measurements of both cephalograms were tested by paired t-test. Results: Among the 22 measurements used, only U1-FH, Mx6 to PTV, and maxillomandibular difference showed statistically significant differences between the CBCT generated cephalogram and the digital cephalogram. Conclusions: The results suggest that the CBCT generated cephalogram can be used for some cephalometric measurements not requiring porion, PTV, condylion as a landmark (SNA, SNB, U1 to SN, IMPA, interincisal angle, etc.).

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.543-552
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• 2000

The purposes of this study were to evaluate the reproducibility of posteroanterior(PA) cephalograms obtained by two methods, the Head Posture Aligner(HPA) method in natural head posture and the conventional method(operator-guided method), and to compare the vertical rotational differences of the head Posture between lateral and PA cephalograms according to the method. The sample was consisted of 30 adults. At first day, a PA cephalogram and a lateral cephalogram were obtained from each subject by two methods to investigate the difference of vertical rotational posture between lateral and PA cephalograms. Two weeks later, another PA cephalogram was obtained using each method to evaluate the reproducibility of head posture. Five height measurements and nine width measurements were used in the paired t-test to compare the reproducibility of the PA cephalometric measurements between two methods. The differences of vertical rotational posture between lateral and PA cephalograms were calculated from a computer program and compared according to the method used, and following results were obtained. 1. Height measurements obtained by operator-guided method showed significant differences according to the time interval and revealed low reproducibility. 2. Height measurements obtained by HPA method did not show significant differences according to the time interval and presented high reproducibility. 3. In the comparison of width measurement, two methods did not show distinct differences in reproducibility. 4. The difference of vertical rotational posture between lateral and PA cephalograms showed $0.8^{\circ}$ in the HPA method, more less than $2.5^{\circ}$ in the operator-guided method. The results of the present study suggest that the HPA may be helpful in the PA cephalometric radiography in terms of reproducibility.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.21 no.2
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• pp.174-188
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• 1999

The purpose of this study is to evaluate the precision and accuracy of a three dimensional cephalogram constructed by using the frontal and lateral cephalogram of twelve human dry skulls. After achieving the three dimensional image reconstruction program, we tried to apply this program to two dentofacial deformity patients. 1. Conventional nasion relator in cephalostat was used to reproduce the same head position for the same dry skull. The mean difference of the three dimensional cephalogram for the same dry skull was $0.34{\pm}0.33mm$. Closeness of repeated measures to each skull reveals the precision of this method for the three dimensional cephalogram. 2. Concerning the accuracy, the mean difference between the three dimensional reconstruction data and actual lineal measurements was $1.47{\pm}1.45mm$ and the mean magnification ratio was $100.24{\pm}4.68%$. This Diffrerence is attributed mainly to the ill defined cephalometric landmarks, not to the positional change of the dry skull. 3. Cephalometric measurement of lateral and frontal radiographs had no consecutive magnification ratio because of the different focus-object distance. The mean difference between the frontal and lateral cephalogram to the actual lineal measurements was $4.72{\pm}2.01mm$ and $-5.22{\pm}3.36mm$. Vertical measurements were slightly more accurate than horizontal measurements. 4. Applying to the actual patient analysis, it is recommendable to use this program for analyzing the asymmetry or spatial change after operation. The orthodontic bracket would be a favorable cephalometric landmark for constructing the three dimensional images.

• The korean journal of orthodontics
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• v.36 no.1 s.114
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• pp.74-83
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• 2006

Analysis of lateral cephalometric radiograph (cephalogram) has been used routinely to evaluate skeletal and dental relationships, but analysis of the lateral facial photograph has not been used frequently for evaluation of skeletal relationships. As concerns about harm of X-ray irradiation increases, this study was planned to evaluate the possibility of substituting analysis of the lateral cephalogram with analysis of the lateral facial photograph by comparing these two analyses. According to the ANB values from cephalometric analysis, subjects were divided into three groups: Class I malocclusion group (n=32). Class II malocclusion group (n=32), and Class III malocclusion group (n=31). After measurements of angles indicating horizontal and vertical relationships of the maxilla and mandible on the lateral cephalograms and photographs, differences between Class I, II and III groups were evaluated. To evaluate the similarity between two similar values in the cephalograms and photographs, t-test using standardized variable Z and correlation analysis were performed in the Class I malocclusion group. The results showed that 1) SnN'Pg' on the photograph can be used to evaluate the antero-posterior relationship of the maxilla and mandible (ANB), 2) N'-Sn/Sn-Pg' on the photograph can be used to evaluate facial convexity (NA/APg), 3) Sn-Tra-Me' on the photograph can be used as a measurement similar to FMA. In conclusion, partly substituting lateral cephalogram analysis with lateral facial photograph analysis was possible in the evaluation of the maxilla and mandible.

• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.75-83
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• 1998

This study was done to recognize the importance of errors in measurements of cephalometric radiograph and to find the anatomical structures those need special care to select as a reference points through the detection of the systematic errors and estimation of random errors. For this purose, 100 cephalometric radiographs were prepared by usual manner and 61 reference points, and 130 measurement variables were established. Measurement errors were detected and estimated by the comparison of the 25 randomly-selected samples for repeated measurements with the main sample. The following results were obtained : 1. In comparison of the repeated measurements, there were statistical significant differences in 24 variables which were 18.4% of 130 total variables. 2. The frequency of the difference in identification of the reference points between the repeated measurements was very high in the root apex of upper incisor(as), the most posterior wall of maxilla(tu), soft tissue nasion(n'), soft tissue frontal eminence(ft), and ad3 in airway. 3. After correction of reference points marking until the level of below 5% significance, the range of random errors were from 0.67 to 1.71 degree or mm. 4. The variable shown the largest random error was the interincisal angle(ILs-ILi). 5. Measurement errors were mainly caused by the lack of precision in anatomic definitions and obscure radiographic image. From the above results, the author could find the high possibility of errors in cephalometric measurements and from this point, we should include error analysis in all the studies concerning measurments. In is essential to have a concept of error analysis not only for the investigator but also for a reader of other articles.

• The korean journal of orthodontics
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• v.27 no.1
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• pp.129-140
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• 1997

Conventional cephalometrics have inherent errors because their evaluation is performed in two-dimension for threedimensional object. To compensate these errors, three-dimensional cephalograms - derivation of three-dimensional data from conventional lateral and postero-anterior cephalograms - were developed. In this study, the accuracy and precision of three dimensional cephalograms were determined by means of 10 linear and 12 angular measurements on 36 acrylic skull models and by the comparison of conventional lateral cephalograms. The results were as follows 1. Mean difference between three-dimensional cephalograms and actual models in linear measurements was $0.94{\pm}0.62mm$ and mean rate of magnification of three-dimensional cephalograms was $100.31{\pm}0.91%$. There were no statistically significant differences between three-dimensional cephalograms and actual models in linear measurements(${\alpha}=0.1$). 2. Mean difference between conventional lateral cephalograms and actual models in linear measurements was $6.44{\pm}1.48mm$ and mean rate of magnification of lateral cephalograms was $106.99{\pm}1.45%$. There were statistically significant differences between lateral cephalograms and actual models in linear measurements(P<0.005). 3. Mean difference between three-dimensional cephalograms and actual models in angular measurements was $1.22{\pm}0.82^{\circ}$ and mean rate of magnification of three-dimensional cephalograms was $105.71{\pm}12.07%$. There were no statistically significant differences between three-dimensional cephalograms and actual models in angular measurements(${\alpha}=0.1$). 4. Mean difference between conventional lateral cephalograms and actual models in angular measurements was $1.70{\pm}0.94^{\circ}$ and mean rate of magnification of lateral cephalograms was $106.35{\pm}15.70%$. There were no statistically significant differences between lateral cephalograms and actual models in angular measurements(${\alpha}=0.1$). There were similarity between three-dimensional and lateral cephalograms in angular measurements.

• The korean journal of orthodontics
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• v.40 no.2
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• pp.77-86
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• 2010

Objective: The purposes of this study were to evaluate the reproducibility and reliability of head posture obtained by registering outer canthus as a soft tissue landmark with the Outer Canthus Indicator (OCI). Methods: Twenty-one adults with normal facial morphology were enrolled in this study (mean age $27.5\;{\pm}\;1.72$ years). To register initial head posture, height of the outer canthus from the ear rod plane was measured using OCI. Head posture was reproduced by moving the head upwards and downwards until the outer canthus was in a straight line with the indicator set at a registered height. After the head posture is reproduced by two operators after two days, lateral photographs were taken. Computerized photometric analyses of the photographs were performed. Results: The head rotations around the transverse axis were $0.69\;{\pm}\;0.43^{\circ}$, $0.98\;{\pm}\;0.65^{\circ}$ from each of the two operators. Standard errors were $0.09^{\circ}$ and $0.14^{\circ}$ each, which were similar to results from past research findings. There were no significant differences between the data from the two operators (p > 0.05). There were no correlations between the head rotation around the horizontal and vertical axes (p > 0.05). Conclusions: The present study suggests that OCI-registered head posture may minimize errors from vertical head rotation in cephalometry and photometry.

• The korean journal of orthodontics
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• v.34 no.5 s.106
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• pp.448-457
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• 2004

As computer Programs for cephalometric analysis were developed in diagnosis & treatment planning, digital imaging of film-based cephalograms came to be needed. When a digital camera is used, a problem encountered the image distortion produced according to the focal length, which causes errors in indentifying landmarks. In addition, changes in the image size and compression ratio will inevitably produce a low quality image, causing errors in identifying landmarks. Hence. we have found the focal length producing the least image distortion when digital imaging the film-based cephalograms and the minimal digital camera setting which helps to identify the correct landmarks using the COOLPIX4500 digital camera (Nikon, Japan). The results were as follows The image distortion was minimized at a focal length of 16.4mm (79.4mm when converted into a 35mm film camera) when digital imaging the film-based cephalograms. When wide imaging, with a focal length of under IS.4mm, barrel distortion was found and when tole imaging. with a focal length of over 15.4mm pincushion distortion was found. The minimal digital camera setting was $2272{\times}1704$ pixel at normal (1/8) compression from which we can identify the correct landmarks at the same level as tracing the film-based cephalograms manually. As a result. when digital imaging the film-based cephalograms, using a COOLPIX4500 digital camera (Nikon, Japan), the focal length should be 16.4mm the pixel image size over $2272{\times}1704$, and the compression ratio over normal (1/8).

• The korean journal of orthodontics
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• v.38 no.6
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• pp.427-436
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• 2008

Objective: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. Methods: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of land-marks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. Results: The difference was from $-0.14{\pm}0.65$ to $-2.12{\pm}2.89\;mm$ in X axis, from $0.34{\pm}0.78$ to $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition.