Voxel-based superimposition of serial craniofacial CBCTs: Reliability, reproducibility and segmentation effect on hard-tissue outcomes.

Häner, Simeon T.; Kanavakis, Georgios; Matthey, François; Gkantidis, Nikolaos (2020). Voxel-based superimposition of serial craniofacial CBCTs: Reliability, reproducibility and segmentation effect on hard-tissue outcomes. Orthodontics & craniofacial research, 23(1), pp. 92-101. Wiley 10.1111/ocr.12347

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OBJECTIVES To test the reliability and reproducibility of a fast and user-friendly voxel-based 3D superimposition method and the effect of bone segmentation on its outcomes. SETTING AND SAMPLE POPULATION This prospective methodological study assessed 15 pairs of pre-existing serial CBCT images (interval: 1.69 ± 0.37 years) obtained from growing patients (initial age: 11.75 ± 0.59 years). MATERIALS AND METHODS Volumes were superimposed on the anterior cranial base using Dolphin 3D software. Reliability was assessed visually, by inspecting the overlap of the superimposition reference structures. Reproducibility was tested with intra- and inter-operator comparisons of superimposition outcomes. RESULTS The method presented good reliability in all cases. The median differences between intra- and inter-operator comparisons at various tested areas ranged from 0.06 to 0.16 mm and from 0.15 to 0.24 mm, respectively. In few individual cases, differences exceeded 0.5 mm. There was no evidence that the error increased upon increase in the magnitude of the detected T0-T1 changes. However, the superimposition error increased when the distance between the measurement area and the superimposition reference also increased. For a single image, the median error of bone surface segmentation ranged in different areas between 0.05 and 0.12 mm, with few exceptions where it slightly exceeded 0.25 mm. CONCLUSIONS The tested voxel-based superimposition method presented good efficiency, cranial base matching and reproducibility in a growing patient sample. Segmentation error was considered minimal. The total error reached clinically relevant levels in very few cases. Thus, this technique is considered appropriate for clinical use, when 3D assessment of craniofacial changes is required.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Orthodontics

UniBE Contributor:

Häner, Simeon Thomas and Gkantidis, Nikolaos


600 Technology > 610 Medicine & health








Renate Imhof-Etter

Date Deposited:

24 Oct 2019 13:38

Last Modified:

18 Jan 2020 01:31

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

craniofacial CBCT hard-tissue segmentation three-dimensional imaging voxel-based superimposition





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