Linear Mandibular Measurements: Comparison between Orthopantomograms and Lateral Cephalograms

Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. Conclusion: An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).

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Reproducibility of measurements in tablet-assisted, PC-aided, and manual cephalometric analysis

The Angle Orthodontist ◽

10.2319/061513-451.1 ◽

2013 ◽

Vol 84 (3) ◽

pp. 437-442 ◽

Cited By ~ 2

Author(s):

Cecilia Goracci ◽

Marco Ferrari

Keyword(s):

Intraclass Correlation ◽

Occlusal Plane ◽

Cephalometric Analysis ◽

Linear Measurements ◽

High Agreement ◽

Landmark Identification ◽

Lateral Cephalograms ◽

Angular Measurements ◽

Cephalometric Measurements ◽

Good Agreement

ABSTRACT Objective: To assess the reproducibility of cephalometric measurements performed with software for a tablet, with a program for personal computers (PCs), and manually. Materials and Methods: The pretreatment lateral cephalograms of 20 patients that were acquired using the same digital cephalometer were collected. Tracings were performed with NemoCeph for Windows (Nemotec), with SmileCeph for iPad (Glace Software), and by hand. Landmark identification was carried out with a mouse-driven cursor using NemoCeph and with a stylus pen on the iPad screen using SmileCeph. Hand tracings were performed on printouts of the cephalograms, using a 0.3-mm 2H pencil and a protractor. Cephalometric landmarks and linear and angular measurements were recorded. All the tracings were done by the same investigator. To evaluate reproducibility, for each cephalometric measurement the agreement between the value derived from NemoCeph, that given by SmileCeph and that measured manually was assessed with the intraclass correlation coefficient (ICC). Agreement was rated as low for an ICC ≤0.75, and an ICC > 0.75 was considered indicative of good agreement. Also, differences in measurements between each software and manual tracing were statistically evaluated (P < .05). Results: All the measurements had ICC >0.8, indicative of a high agreement among the tracing methods. Relatively lower ICCs occurred for linear measurements related to the occlusal plane and to N perpendicular to the Frankfurt plane. Differences in measurements between both software programs and hand tracing were not statistically significant for any of the cephalometric parameters. Conclusion: Tablet-assisted, PC-aided, and manual cephalometric tracings showed good agreement.

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Evaluation of radiographic magnification in lateral cephalograms obtained with different X-ray devices: experimental study in human dry skull

Dental Press Journal of Orthodontics ◽

10.1590/s2176-94512013000200005 ◽

2013 ◽

Vol 18 (2) ◽

pp. 17e1-17e7 ◽

Cited By ~ 1

Author(s):

José Rino Neto ◽

João Batista de Paiva ◽

Gilberto Vilanova Queiroz ◽

Miguel Ferragut Attizzani ◽

Hiroshi Miasiro Junior

Keyword(s):

Pearson Correlation ◽

Great Influence ◽

Magnification Factor ◽

Linear Measurements ◽

High Positive Correlation ◽

Lateral Cephalograms ◽

Pearson Correlation Test ◽

Radiographic Magnification ◽

Cephalometric Measurements ◽

The Relationship

OBJECTIVE: The purpose of this study was to evaluate the influence of the magnification factor of the radiographic image in angular, linear and proportional measurements. METHODS: From a dried human skull where metallic spheres with predetermined size were fixed (1.0 mm), 14 radiographs were obtained in devices of three different manufacturers: Panoura, Instrumentarium and Tomeceph. The Pearson correlation test was used to investigate the relationship between the rate of radiographic magnification and the cephalometric measurements assessed. RESULTS: According to the results, the linear measurements showed a high positive correlation, pointing out great influence of the magnification factor, while the angular and proportional measurements did not correlate. CONCLUSIONS: Comparisons between linear cephalometric measurements obtained with different devices from the same manufacturer showed maximum rates of expansion of 0.6%, 1.25% and 2.3%, respectively, for the devices from Instrumentarium (OP-100, Instrumentarium, Finland), Panoura (10CSU, Yoshida, Japan) and Satelec/Tomeceph (XMind, Satelec/Tomeceph Orion Corporation, Finland).

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The Reliability of Two- and Three-Dimensional Cephalometric Measurements: A CBCT Study

Diagnostics ◽

10.3390/diagnostics11122292 ◽

2021 ◽

Vol 11 (12) ◽

pp. 2292

Author(s):

Chenshuang Li ◽

Hellen Teixeira ◽

Nipul Tanna ◽

Zhong Zheng ◽

Stephanie Hsiang Yi Chen ◽

...

Keyword(s):

Intraclass Correlation ◽

Three Dimensional ◽

Young Patients ◽

Correlation Coefficients ◽

3D Analysis ◽

Intraclass Correlation Coefficients ◽

Lateral Cephalograms ◽

Adults And Children ◽

Left And Right ◽

Cephalometric Measurements

Cephalometry is a standard diagnostic tool in orthodontic and orthognathic surgery fields. However, built-in magnification from the cephalometric machine produces double images from left- and right-side craniofacial structures on the film, which poses difficulty for accurate cephalometric tracing and measurements. The cone-beam computed tomography (CBCT) images not only allow three-dimensional (3D) analysis, but also enable the extraction of two-dimensional (2D) images without magnification. To evaluate the most reliable cephalometric analysis method, we extracted 2D lateral cephalometric images with and without magnification from twenty full-cranium CBCT datasets; images were extracted with magnification to mimic traditional lateral cephalograms. Cephalometric tracings were performed on the two types of extracted 2D lateral cephalograms and on the reconstructed 3D full cranium images by two examiners. The intra- and inter-examiner intraclass correlation coefficients (ICC) were compared between linear and angular parameters, as well as between CBCT datasets of adults and children. Our results showed that overall, tracing on 2D cephalometric images without magnification increased intra- and inter-examiner reliability, while 3D tracing reduced inter-examiner reliability. Angular parameters and children’s images had the lowest inter- and intra-examiner ICCs compared with adult samples and linear parameters. In summary, using lateral cephalograms extracted from CBCT without magnification for tracing/analysis increased reliability. Special attention is needed when analyzing young patients’ images and measuring angular parameters.

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A novel, reproducible, and objective method for volumetric magnetic resonance imaging assessment of enhancing glioblastoma

Journal of Neurosurgery ◽

10.3171/2014.4.jns121952 ◽

2014 ◽

Vol 121 (3) ◽

pp. 536-542 ◽

Cited By ~ 16

Author(s):

Charles W. Kanaly ◽

Ankit I. Mehta ◽

Dale Ding ◽

Jenny K. Hoang ◽

Peter G. Kranz ◽

...

Keyword(s):

Interobserver Variability ◽

Intraclass Correlation ◽

Evaluation Criteria ◽

Correlation Coefficients ◽

Response Assessment ◽

Volumetric Method ◽

Kappa Statistics ◽

Macdonald Criteria ◽

Automated Method ◽

Radiological Response

Object Robust methodology that allows objective, automated, and observer-independent measurements of brain tumor volume, especially after resection, is lacking. Thus, determination of tumor response and progression in neurooncology is unreliable. The objective of this study was to determine if a semi-automated volumetric method for quantifying enhancing tissue would perform with high reproducibility and low interobserver variability. Methods Fifty-seven MR images from 13 patients with glioblastoma were assessed using our method, by 2 neuroradiologists, 1 neurosurgeon, 1 neurosurgical resident, 1 nurse practitioner, and 1 medical student. The 2 neuroradiologists also performed traditional 1-dimensional (1D) and 2-dimensional (2D) measurements. Intraclass correlation coefficients (ICCs) assessed interobserver variability between measurements. Radiological response was determined using Response Evaluation Criteria In Solid Tumors (RECIST) guidelines and Macdonald criteria. Kappa statistics described interobserver variability of volumetric radiological response determinations. Results There was strong agreement for 1D (RECIST) and 2D (Macdonald) measurements between neuroradiologists (ICC = 0.42 and 0.61, respectively), but the agreement using the authors' novel automated approach was significantly stronger (ICC = 0.97). The volumetric method had the strongest agreement with regard to radiological response (κ = 0.96) when compared with 2D (κ = 0.54) or 1D (κ = 0.46) methods. Despite diverse levels of experience of the users of the volumetric method, measurements using the volumetric program remained remarkably consistent in all users (0.94). Conclusions Interobserver variability using this new semi-automated method is less than the variability with traditional methods of tumor measurement. This new method is objective, quick, and highly reproducible among operators with varying levels of expertise. This approach should be further evaluated as a potential standard for response assessment based on contrast enhancement in brain tumors.

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Reliability of lateral cephalometric radiographs in the assessment of the upper airway: a systematic review

Эндодонтия Today ◽

10.36377/1683-2981-2021-19-2-126-131 ◽

2021 ◽

Vol 19 (2) ◽

pp. 126-131

Author(s):

M. E. Balashova ◽

Z. S. Khabadze ◽

I. A. Voronov ◽

I. N. Bagdasarova ◽

N. N. Fedotova

Keyword(s):

Screening Method ◽

Upper Airway ◽

Cost Effective ◽

Publication Date ◽

Upper Respiratory Tract ◽

Linear Measurements ◽

Lateral Cephalogram ◽

Airway Patency ◽

Electronic Search ◽

Lateral Cephalograms

Relevance. The problem of respiratory diseases has been studied for a long time by many specialists and remains relevant to this day. This problem has been of interest to researchers for many years due to several factors. In many studies, it was demonstrated, that a signifcant relationship exist between the upper airway condition and jaw growth, craniofacial skeleton and TMJ dysfunction. Lateral cephalometric radiographs (LCRs) have been used to assess skull parameters, jaw bones and teeth, the morphology of the upper airway, the severity of airways obstruction and adenoid size. The present study aimed to determine the reliability of LCRs compared to CBCT in the assessment of the upper respiratory tract in order to determine which variables are reliable for potential use in clinical diagnosis.Aim. To analyze the literature on the effectiveness of the using Lateral Cephalogram in the assessment of the upper airway.Materials and methods. Electronic search of articles was carried out using search engines and databases: Cyberleninka, eLIBRARY, Google Scholar, Pub Med, SCOPUS. The publication date criterion was selected from January 2010 to January 2021. The electronic search was conducted using the following keywords: lateral cephalogram, upper airway, cone-beam computed tomography. A total of 10 studies from the literature met the selection criteria.Results. CBCT provides a good estimate of the transverse dimensions and volumetric measurement of the airway space. Linear measurements of CBCT and LCRs were quite reliable and reproducible. The most diffcult to study and differentiate area is the oropharynx, the variability of the pharyngeal segment cannot be predicted by LCs. LCRs method is advisable for adenoid pathology diagnosis due to its fnancial acceptability and availability. The cephalometric headflm provides a good general overall indicator for nasopharyngeal airway patency, adenoidal hypertrophy.Conclusions. The traditional lateral cephalogram remains not only a standard, reproducible and cost-effective diagnostic method in orthodontics, but also a reliable initial tool for screening upper airway obstruction, studying the nasopharyngeal morphology and assessment of adenoid size. Based on our results, the measurement of the nasopharyngeal space on lateral cephalograms can be used as an initial screening method to estimate the nasopharynx volumes. The results demonstrate that a lateral cephalogram can provide valuable information about the severe limitations and nasopharyngeal morphology

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Photographic assessment of cephalometric measurements

The Angle Orthodontist ◽

10.2319/120712-925.1 ◽

2013 ◽

Vol 83 (6) ◽

pp. 1049-1058 ◽

Cited By ~ 6

Author(s):

Liliane de Carvalho Rosas Gomes ◽

Karla Orfelina Carpio Horta ◽

Luiz Gonzaga Gandini ◽

Marcelo Gonçalves ◽

João Roberto Gonçalves

Keyword(s):

Low Cost ◽

Pearson Correlation ◽

Intraclass Correlation ◽

Correlation Coefficients ◽

Facial Profile ◽

Intraclass Correlation Coefficients ◽

Standardized Protocol ◽

Lateral Cephalograms ◽

Cephalometric Measurements ◽

The Relationship

ABSTRACT Objective: To investigate the relationship between craniofacial measurements obtained from cephalometric radiographs and analogous measurements from profile photographs. Materials and Methods: Lateral cephalograms and standardized facial profile photographs were obtained from a sample of 123 subjects (65 girls, 58 boys; age 7–12 years). Intraclass correlation coefficients (ICCs) were calculated from repeated photographic measurements to evaluate method reliability. Analogous cephalometric and photographic measurements were compared to assess Pearson correlation coefficients. Linear regression analyses were conducted between the measurements that achieved correlation coefficients greater than r = 0.7. Results: The reliability of the photographic technique was satisfactory. Most measurements showed ICCs above 0.80 and highly significant correlations (P ≤ .001) with cephalometric variables. Among all measurements used, the A'N'B' angle was the most effective in explaining the variability of its analogous cephalometric, mainly for female subjects (r2 = 0.80). The FMA' angle showed the best results for vertical assessment (r2 = 0.65). Conclusions: The photographic method has proven to be a repeatable and reproducible tool provided that a standardized protocol is followed. Therefore, it may be considered a feasible and practical diagnostic alternative, particularly if there is a need for a low-cost and noninvasive method.

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Twin study—genetic comparison of matrix versus intramatrix rotation in the mandible and three different occlusal planes

Progress in Orthodontics ◽

10.1186/s40510-020-00344-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Jin Hyeong Kim ◽

Young Ho Kim ◽

Soo Jin Kim ◽

Joohon Sung ◽

Yun-Mi Song ◽

...

Keyword(s):

Treatment Plan ◽

Intraclass Correlation ◽

Genetic Effect ◽

Occlusal Plane ◽

Group 13 ◽

Mean Values ◽

Lateral Cephalograms ◽

Plane Change ◽

High Heritability ◽

Cephalometric Measurements

Abstract Background The purpose of this study is to investigate the heritability of total rotation, matrix rotation, and intramatrix rotation of the mandible in Korean monozygotic (MZ) twins, dizygotic (DZ) twins, and their siblings. Materials and methods The samples consisted of 75 pairs of Korean twins (39.7 + 9.26 years; MZ group, 36 pairs; DZ group, 13 pairs; sibling group, 26 pairs). Lateral cephalograms were taken, and 13 variables related to internal and external mandible rotation were measured. Three types of occlusal planes (bisected occlusal plane, functional occlusal plane, and the MM bisector occlusal plane) were used to evaluate genetic influence on the occlusal plane. Heritability (h2) was calculated by using the intraclass correlation coefficient (ICC) and Falconer’s method. Results With regard to mandibular rotation, the MZ twin group showed significantly higher ICC values compared to the DZ twin and sibling groups. The ICC mean values for 13 cephalometric measurements were 0.85 (MZ), 0.62 (DZ), and 0.52 (siblings) respectively. The heritability of the total rotation (0.48) and matrix rotation (0.5) between the MZ and DZ groups was higher than that of the intramatrix rotation (− 0.14). All of the three types of occlusal plane showed high heritability, and among the three types, the functional occlusal plane showed the highest heritability (h2 = 0.76). Conclusion Based on these findings that showed a strong genetic effect on total rotation and matrix rotation, maintaining these rotations should be carefully considered in the orthodontic treatment plan, while the lower border of the mandible may be responsive to various treatments. Occlusal plane change, especially with regard to the functional occlusal plane, may not be stable due to strong genetic influences.

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Panoramic radiographs for investigating skeletal patternsA comparative study

International Journal of Dentistry Research ◽

10.31254/dentistry.2019.4207 ◽

2019 ◽

Vol 4 (2) ◽

pp. 66-78

Author(s):

Taruna Puri ◽

Keyword(s):

Class I ◽

Regression Equations ◽

Linear Measurements ◽

Lateral Cephalogram ◽

Panoramic Radiographs ◽

Lateral Cephalograms ◽

Angular Measurements ◽

Group A ◽

Group B ◽

Age Range

Introduction: The most commonly used diagnostic aids in orthodontics are lateral cephalograms and panoramic radiographs (OPG). The OPG forms an indispensible orthodontic screening tool in providing information about the teeth, their root length, axial inclinations, morphology and structure, eruption sequence and spatial relationships [1] which is mostly qualitative in nature. The purpose of this study was to evaluate whether the use of OPG could be extended for evaluating skeletal patterns and dentofacial characteristics which are routinely measured on lateral cephalograms. Materials and Methods: A total of 80 subjects were chosen, they were divided into two groups: Group A and Group B. Group A included 40 skeletal Class I, dental Class I adults with age range of 18-27 years. Group B included 40 skeletal ClassII, dental Class II Div 1 children with age range of 10 -15 years. The lateral cephalogram and OPG were taken under standard conditions using skeletal cephalostat and various parameters were measured and compared. Results and Conclusion: From this study it was concluded that angular measurements on OPG can be used to predict the corresponding angular measurements from the lateral cephalograms, both for the dental and skeletal parameters but the vertical linear measurements cannot be predicted accurately from OPG. The regression equations obtained from this study showed that the Go-Gn/S-N, ANS-PNS/Go-Me (palatal plane/mandibular plane), and Co-Go/Go-Me parameters could be predicted from OPG within statistically significant levels, and their predictability levels were 20.47%, 31.7%, and 10.88%, respectively for group A and 32.0%.22.08% and 52.36% respectively for group B.

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Concurrent validity and reliability of cephalometric analysis using smartphone apps and computer software

The Angle Orthodontist ◽

10.2319/021919-124.1 ◽

2019 ◽

Vol 89 (6) ◽

pp. 889-896 ◽

Cited By ~ 5

Author(s):

Christos Livas ◽

Konstantina Delli ◽

Frederik K. L. Spijkervet ◽

Arjan Vissink ◽

Pieter U. Dijkstra

Keyword(s):

Intraclass Correlation ◽

Computer Software ◽

Correlation Coefficients ◽

Cephalometric Analysis ◽

Smartphone Apps ◽

Validity And Reliability ◽

Linear Measurements ◽

Intraclass Correlation Coefficients ◽

Lateral Cephalograms ◽

Orthodontic Patients

ABSTRACTObjectives:To assess the diagnostic accuracy of two smartphone cephalometric analysis apps compared with Viewbox software.Materials and Methods:Pretreatment digital lateral cephalograms of 50 consecutive orthodontic patients (20 males, 30 females; mean age, 19.1 years; SD, 11.7) were traced twice using two apps (ie, CephNinja and OneCeph), with Viewbox used as the gold standard computer software program. Seven angular and two linear measurements, originally derived from Steiner cephalometric analysis, were performed.Results:Regarding validity, intraclass correlation coefficients (ICCs) ranged from .903–.983 and .786–.978 for OneCeph vs Viewbox and CephNinja vs Viewbox, respectively. The ICC values for intratool reliability ranged from .647–.993. None of the CephNinja measurements was below the recommended cutoff values of ICCs for reliability.Conclusions:OneCeph has a high validity compared with Viewbox, while CephNinja is the best alternative to Viewbox regarding reliability. Smartphone apps may have a great potential in supplementing traditional cephalometric analysis.

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Precision of orthodontic cephalometric measurements on ultra low dose-low dose CBCT reconstructed cephalograms

Clinical Oral Investigations ◽

10.1007/s00784-021-04127-9 ◽

2021 ◽

Author(s):

R. H. van Bunningen ◽

P. U. Dijkstra ◽

A. Dieters ◽

W. J. van der Meer ◽

A. M. Kuijpers-Jagtman ◽

...

Keyword(s):

Low Dose ◽

Standard Dose ◽

Cone Beam ◽

Lateral Cephalogram ◽

Lower Radiation Dose ◽

Lateral Cephalograms ◽

Significant Difference ◽

Image Set ◽

Human Skulls ◽

Cephalometric Measurements

Abstract Objectives To analyze differences in variation of orthodontic diagnostic measurements on lateral cephalograms reconstructed from ultra low dose-low dose (ULD-LD) cone beam computed tomography (CBCT) scans (RLC) as compared to variation of measurements on standard lateral cephalograms (SLC), and to determine if it is justifiable to replace a traditional orthodontic image set for an ULD-LD CBCT with a reconstructed lateral cephalogram. Material and methods ULD-LD CBCT images and SLCs were made of forty-three dry human skulls. From the ULD-LD CBCT dataset, a lateral cephalogram was reconstructed (RLC). Cephalometric landmarks (13 skeletal and 7 dental) were identified on both SLC and RLC twice in two sessions by two calibrated observers. Thirteen cephalometric variables were calculated. Variations of measurements, expressed as standard deviations of the 4 measurements on SLC and RLC, were analyzed using a paired sample t-test. Differences in the number of observations deviating ≥ 2.0 mm or degrees from the grand mean between SLC and RLC were analyzed using a McNemar test. Results Mean SDs for 7 out of 13 variables were significantly smaller for SLCs than those for RLCs, but differences were small. For 9 out of 13 variables, there was no significant difference between SLC and RLC for the number of measurements outside the range of 2 mm or degrees. Conclusions Based on the lower radiation dose and the small differences in variation in cephalometric measurements on reconstructed LC compared to standard dose LC, ULD-LD CBCT with reconstructed LC should be considered for orthodontic diagnostic purposes. Clinical relevance ULD-LD CBCT with reconstructed LC should be considered for orthodontic purposes.

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