J Korean Assoc Oral Maxillofac Surg.  2010 Apr;36(2):78-86. 10.5125/jkaoms.2010.36.2.78.

Accuracy and reproducibility of landmark of cone beam computed tomography (CT) synthesized cephalograms

  • 1Department of Oral and Maxillofacial Surgery, School of Dentistry, Wonkwang University, Iksan, Korea.
  • 2Department of Oral and Maxillofacial Surgery, Samsung Medical Center, Sungkyunkwan University, Seoul, Korea. jypaeng@gmail.com


Cone beam computed tomography (CBCT) has various advantages and is used favorably in many fields in dentistry. Especially, CBCT is being used as basic diagnostic tool for 3-dimensional analysis in orthognathic patient. Two-dimensional cephalograms can be synthesized from CBCT digital imaging and communications in medicine (DICOM) data. In this study, conventional cephalograms and CBCT were taken simultaneously, and representative landmarks were located and analyzed in its accuracy and reproducibility.
Ten patients who had orthognathic surgery in Wonkwang University Daejeon Dental Hospital participated in this study. For each patient, CBCT and conventional cephalogram was taken. By using Ondemand (Cybermad, Korea), 2-dimensional cephalograms was established on CBCT. In addition, 19 landmarks were designated and measured by 3 orthodontists twice a week. After these landmarks were transferred to a coordinate, distance of landmark and axis, standard error, distribution degree were measured, compared and analyzed.
Comparing the CT ceph group and conventional cephalogram group, CT ceph group had shown shorter distance of landmark and axis in S, Hinge axis, Bpt, Ba, Or, Corpus left. Standard error of the mean shows that CT ceph group has better reproducibility in Or, Corpus left, Hinge axis at X axis and Na, U1R, U1T, Bpt, PNS, Ba Corpus left, Hinge axis at Y axis. In both groups, mean error was less than 1.00 mm, no significant difference were found between CT ceph group and conventional cephalogram group in all measurements. Furthermore, comparing two groups, each 17 landmarks out of 19 had its characteristic in distribution degree.
No significant difference were found between CBCT composed cephalographic radiograph and conventional cephalograghic radiograph, clinical application may be possible if improved.


Cone beam computed tomography (CBCT); Lateral cephalogram; Landmark
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