Application of cone beam CT 3D images to cephalometric analysis

Orthodontic diagnosis is currently based primarily on two-dimensional (2D) measurements. The development of maxillofacial cone beam X-ray computed tomography (CBCT) has promoted the use of three-dimensional (3D) measurements for orthodontic diagnosis. This technology is also expected to generate new analytic methods aiming at establishing optimal occlusion according to the individual's maxillary shape and function. However, during the transitional stage from 2D to 3D measurements, it is necessary to relate 3D data to existing data analysis methods (e.g., lateral cephalogram) for the assessment of skeletal and dental relationship. Our objectives were to develop a new cephalometric analysis method based on 3D data obtained by CBCT from four aspects: (1) measurement of magnification of cephalogram, (2) assessment of the dimensional accuracy of CBCT images, (3) development of a method of cephalometric analysis using CBCT images and (4) comparison of cephalometric analytical values obtained from CBCT images with those obtained from existing cephalograms. The results demonstrated that our analytical method facilitated cephalometric analysis of CBCT images and therefore allowed direct comparison of CBCT images with existing cephalograms. Cephalometric analysis using CBCT images resulted in a smaller range of inter-operator measurement variability than that using conventional cephalograms.