Accuracy of linear measurements using three imaging modalities: two lateral cephalograms and one 3D model from CBCT data

Pittayapat, Pisha; Bornstein, Michael; Imada, Thaís Sumie Nozu; Coucke, Wim; Lambrichts, Ivo; Jacobs, Reinhilde (2015). Accuracy of linear measurements using three imaging modalities: two lateral cephalograms and one 3D model from CBCT data. European journal of orthodontics, 37(2), pp. 202-208. Oxford University Press 10.1093/ejo/cju036

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BACKGROUND The aim of this study was to evaluate the accuracy of linear measurements on three imaging modalities: lateral cephalograms from a cephalometric machine with a 3 m source-to-mid-sagittal-plane distance (SMD), from a machine with 1.5 m SMD and 3D models from cone-beam computed tomography (CBCT) data. METHODS Twenty-one dry human skulls were used. Lateral cephalograms were taken, using two cephalometric devices: one with a 3 m SMD and one with a 1.5 m SMD. CBCT scans were taken by 3D Accuitomo® 170, and 3D surface models were created in Maxilim® software. Thirteen linear measurements were completed twice by two observers with a 4 week interval. Direct physical measurements by a digital calliper were defined as the gold standard. Statistical analysis was performed. RESULTS Nasion-Point A was significantly different from the gold standard in all methods. More statistically significant differences were found on the measurements of the 3 m SMD cephalograms in comparison to the other methods. Intra- and inter-observer agreement based on 3D measurements was slightly better than others. LIMITATIONS Dry human skulls without soft tissues were used. Therefore, the results have to be interpreted with caution, as they do not fully represent clinical conditions. CONCLUSIONS 3D measurements resulted in a better observer agreement. The accuracy of the measurements based on CBCT and 1.5 m SMD cephalogram was better than a 3 m SMD cephalogram. These findings demonstrated the linear measurements accuracy and reliability of 3D measurements based on CBCT data when compared to 2D techniques. Future studies should focus on the implementation of 3D cephalometry in clinical practice.

Item Type:

Journal Article (Original Article)


04 Faculty of Medicine > School of Dental Medicine > Department of Oral Surgery and Stomatology

UniBE Contributor:

Bornstein, Michael


600 Technology > 610 Medicine & health




Oxford University Press




Eveline Carmen Schuler

Date Deposited:

29 Mar 2016 11:28

Last Modified:

25 Oct 2019 01:21

Publisher DOI:


PubMed ID:





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