a Original lateral cephalogram (lat ceph) gets downsampled by a factor of 3. 1 Schematic of the overall detection framework. Greater variability of certain landmarks in the mediolateral direction is probably related to inadequate definition of the landmarks in the third dimension. landmark k, B k, conducted a forward-propagation with Fig. More precise location of condylion, gonion, and orbitale overcomes the problem of superimposition of these bilateral landmarks seen in Ceph. The MPR displays of CBCT volume images provide generally more precise identification of traditional cephalometric landmarks. Mediolateral variability was statistically greater than anteroposterior or caudal-cranial variability for 5 landmarks in the MPR views. All bilateral landmarks had increased precision when identified in the MPR views. The overall correlation of 1920 paired ODM and DEO measurements was excellent at 0.972. DEO calculations of observer variability were consistently greater than ODM. Radiographic modality and landmark were significant at P <0.0001 for DEO and ODM calculations. ANOVA and paired t tests were used to analyze variability differences. The absolute difference of each observer from any other observer was averaged as a second measure of variability (DEO). Absolute differences between each observer's plot and the mean of all observers were averaged as 1 measure of variability (ODM). Five observers plotted 24 landmarks using computer displays of multi-planer reconstruction (MPR) CBCT and Ceph views during separate sessions. Twenty presurgical orthodontic patients were radiographed with conventional Ceph and CBCT techniques. In this study, we compared the precision of landmark identification using displays of multi-planar cone-beam computed tomographic (CBCT) volumes and conventional lateral cephalograms (Ceph).

Lateral ceph landmarks