Objectives: Cone Beam Computerized Tomography (CBCT) allows the possibility of modifying some of the diagnostic tools used in orthodontics, such as cephalometry. The first step must be to study the characteristics of these devices in terms of accuracy and reliability of the most commonly used landmarks. The aims were 1- To assess intra and inter-observer reliability in the location of anatomical landmarks belonging to hard tissues of the skull in images taken with a CBCT device, 2- To determine which of those landmarks are more vs. less reliable and 3- To introduce planes of reference so as to create cephalometric analyses appropriated to the 3D reality. Study design: Fifteen patients who had a CBCT (i-CAT®) as a diagnostic register were selected. To assess the reproducibility on landmark location and the differences in the measurements of two observers at different times, 41 landmarks were defined on the three spatial axes (X,Y,Z) and located. 3.690 measurements were taken and, as each determination has 3 coordinates, 11.070 data were processed with SPSS® statistical package. To discover the reproducibility of the method on landmark location, an ANOVA was undertaken using two variation factors: time (t1, t2 and t3) and observer (Ob1 and Ob2) for each axis (X, Y and Z) and landmark. The order of the CBCT scans submitted to the observers (Ob1, Ob2) at t1, t2, and t3, were different and randomly allocated. Multiple comparisons were undertaken using the Bonferroni test. The intra- and inter-examiner ICC´s were calculated. Results: Intra- and inter-examiner reliability was high, both being ICC ≥ 0.99, with the best frequency on axis Z. Conclusions: The most reliable landmarks were: Nasion, Sella, Basion, left Porion, point A, anterior nasal spine, Pogonion, Gnathion, Menton, frontozygomatic sutures, first lower molars and upper and lower incisors. Those with less reliability were the supraorbitals, right zygion and posterior nasal spine. Key words:Cone Beam Computed Tomography, cephalometry, landmark, orthodontics, reliability.
The aims of the study were to assess speed, reliability, accuracy, and reproducibility in measuring mesiodistal tooth sizes, bicanine widths, bimolar widths, and arch lengths (ALs) using cone beam computed tomography (CBCT) and to compare them with the same measurements obtained using a two-dimensional (2D) Digital Method. Plaster study models were made for 27 patients and then digitalized and measured using a 2D Digital Method. CBCTs were undertaken on the same 27 patients using the Dental Picasso Master 3D® and the images obtained were then analysed using the InVivoDental program. The correlation study of the two measuring methods, which were compared by determining the regression parameters and the values of one method as opposed to the other, show how both methods are comparable, although the mean and standard deviation of all the measurements analysed present statistically significant differences for the first upper right premolar, first upper left molar, first lower left premolar, and second lower right premolar, as well for the lower intercanine distance and lower AL. The differences, however, are less than 1 per cent. CBCT digital models are as accurate and reliable as the digital models obtained from plaster casts. The differences existing between both methods are clinically acceptable.
Objective: To assess whether the values of different measurements taken on three-dimensional (3D) reconstructions from cone-beam computed tomography (CBCT) are comparable with those taken on two-dimensional (2D) images from conventional lateral cephalometric radiographs (LCRs) and to examine if there are differences between the different types of CBCT software when taking those measurements. Material and Methods: Eight patients were selected who had both an LRC and a CBCT. The 3D reconstructions of each patient in the CBCT were evaluated using two different software packages, NemoCeph 3D and InVivo5. An observer took 10 angular and 3 linear measurements on each of the three types of record on two different occasions. Results: Intraobserver reliability was high except for the mandibular plane and facial cone (from the LCR), the Na-Ans distance (using NemoCeph 3D), and facial cone and the Ans-Me distance (using InVivo5). No statistically significant differences were found for the angular and linear measurements between the LCRs and the CBCTs for any measurement, and the correlation levels were high for all measurements. Conclusion: No statistically significant differences were found between the angular and linear measurements taken with the LCR and those taken with the CBCT. Neither were there any statistically significant differences between the angular or linear measurements using the two CBCT software packages. (Angle Orthod. 2011;81:856-864.)
The mandibular third molar (3M) is the tooth that is most often impacted, with lack of space being one of the reasons. In some orthodontic treatments, premolars are extracted in order to create space. The aims of our study are: firstly, to assess the changes in the angulation and position of the 3M in cases treated either with or without extraction of the first or second premolars; secondly, to analyse the variation in the gonial angle and the degree of inclusion of the 3M; and lastly, to establish a predictive impaction model for 3M. This study included 88 patients: 28 patients treated with extractions of first premolars, 30 with second premolars and 30 without. The initial and final orthopantomography was analysed and the angulation of the 3M was measured, a new variable being created to determine the degree of 3M inclusion in the mandibular ramus. The results show that the angulation of 3M improves with time, regardless of treatment, and presents a greater disinclusion in cases treated with extractions. The gonial angle tends to diminish with age in all cases. The conclusions suggest that other factors may influence the angulation and position of 3M and that it is not possible to establish a predictive impaction model.
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