Aim: To investigate the accuracy of measurements in vertical and horizontal direction using an extra-oral calibration object placed in different positions on the panoramic radiograph in JPEG and DICOM image format. Methods: Digital panoramic radiographs of a purpose made model with 32 removable teeth replaced with metal balls were taken. The measurements of metal balls were performed with and without the calibration object placed in the middle or on the side of the radiograph in JPEG and DICOM image formats. Results: One sample t-test was used for the analyses of accuracy of measurements in vertical and horizontal direction. The most accurate vertical measurements were achieved in canine group in JPEG (6.02±0.04 mm, P=0.144) and DICOM (6.03±0.07 mm, P=0.104) formats using calibration object placed in the middle of the radiograph. The mean values of measurements in horizontal direction differed significantly from the real values (P<0.05) in all teeth groups regardless of the image format. Conclusion: The most accurate measurements in vertical direction were achieved by placing the metal scale ruler extra-orally in the middle of panoramic radiograph independent of the image format. Reliable clinical accuracy for measurements in horizontal direction was achieved only in canine region (G2) in both image formats.
The cephalogram is a radiological image used in orthodontics. Cephalometric analysis includes the interconnection of reference points which allows analyses and measurements of various planes and angles, which serve as an aid in finding the correct treatment of teeth. The standard cephalogram is recorded in two projections – LL and PA. The combination of LL and PA recordings once made up a 3D display up to the appearance of the CBCT device. Since the introduction of cephalometric analyses, numerous authors have pointed out the need for the development of new methods of analysis and measurement to correct the shortcomings of reference points, lines, and angles. The aim of this paper is to present a reliability assessment of cephalometric analysis and measurement on three types of cephalograms: conventional, digital 2D, and 3D CBCT cephalograms. Furthermore, the article presents the methodology and results of several scientific studies. The results of the reviewed studies show that all tested methods are reliable and practical for scientific research, with clinically acceptable differences between manually and digitally analyzed cephalograms. 3D CBCT shows a slightly higher degree of reliability in terms of taking measurements, but it is thought that new ways of producing more accurate measurements as well as better ways of displaying certain reference points should be devised. Finally, 2D cephalometric measurements should not be abandoned because the transition to 3D technology requires more additional research.
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