Comparison of Conventional and Automated Cephalometric Analysis Using Cone-Beam Computed Tomography PDF Download
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Author: Andrew Paige
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Since its advent in 1931, analysis of lateral cephalometric radiographs has been an important aspect of orthodontic diagnosis and treatment planning. This type of orthodontic analysis provides a quantitative evaluation of the positions of various anatomical structures of the face, including skeletal, dental, and soft tissue features. Cephalometric analysis, however, is a time-consuming process and is not always performed in clinical practice. Cephalometric analysis from Cone-Beam Computed Tomography (CBCT) imaging is particularly cumbersome, requiring both reconstruction of a two-dimensional lateral cephalogram as well as subsequent computer-assisted tracing analysis using a program such as Dolphin. As the use of CBCT continues to become more prominent in orthodontics, methodologies to expedite cephalometric analysis may be valuable in facilitating their use by clinicians. Several different commercially available (e.g. CephX) and proprietary products have been created to analyze cephalometric radiographs using automated artificial intelligence (AI), but the accuracy of these products remains incompletely established. Our study examined the accuracy and workflow impacts of CephX's ABO analysis directly from CBCT compared to manual reconstruction and tracing by human examiners on 40 CBCT volumes. We hypothesized that automatically generated cephalometric analyses from CBCT volumes would differ significantly from those generated by human examiners, and that workflow time would be statistically significantly decreased in the automated analysis. In contrast, overall workflow time was found to be significantly greater for the CephX software than for the human examiners. Furthermore, our study showed that seven of the eleven measurements in the ABO analysis differed statistically significantly from the human examiners: SNB, ANB, SN-MP, L1-NB, L1-MP, LL to E-Plane, and UL to E-Plane. Nine of the eleven measurements showed average measurement error within clinically acceptable limits, while two showed greater average error than is clinically acceptable - U1-SN and L1-MP were the least accurate measurement in our study. Bland-Altman plots were constructed showing that FMA may show a slight tendency towards greater accuracy at high values, while LL to E-Plane may display a slight tendency to underestimate more frequently at low values and overestimate more frequently at high values. Only one measurement (ANB) showed limits of agreement within the maximum allowed difference; ten out of the eleven variables exceeded the maximum allowed difference. Overall, CephX may offer clinically acceptable performance for most variables in the ABO analysis, but needs further improvement overall, particularly with the inclination of the upper and lower incisors (U1-SN and L1-MP).
Author: Andrew Paige
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
Since its advent in 1931, analysis of lateral cephalometric radiographs has been an important aspect of orthodontic diagnosis and treatment planning. This type of orthodontic analysis provides a quantitative evaluation of the positions of various anatomical structures of the face, including skeletal, dental, and soft tissue features. Cephalometric analysis, however, is a time-consuming process and is not always performed in clinical practice. Cephalometric analysis from Cone-Beam Computed Tomography (CBCT) imaging is particularly cumbersome, requiring both reconstruction of a two-dimensional lateral cephalogram as well as subsequent computer-assisted tracing analysis using a program such as Dolphin. As the use of CBCT continues to become more prominent in orthodontics, methodologies to expedite cephalometric analysis may be valuable in facilitating their use by clinicians. Several different commercially available (e.g. CephX) and proprietary products have been created to analyze cephalometric radiographs using automated artificial intelligence (AI), but the accuracy of these products remains incompletely established. Our study examined the accuracy and workflow impacts of CephX's ABO analysis directly from CBCT compared to manual reconstruction and tracing by human examiners on 40 CBCT volumes. We hypothesized that automatically generated cephalometric analyses from CBCT volumes would differ significantly from those generated by human examiners, and that workflow time would be statistically significantly decreased in the automated analysis. In contrast, overall workflow time was found to be significantly greater for the CephX software than for the human examiners. Furthermore, our study showed that seven of the eleven measurements in the ABO analysis differed statistically significantly from the human examiners: SNB, ANB, SN-MP, L1-NB, L1-MP, LL to E-Plane, and UL to E-Plane. Nine of the eleven measurements showed average measurement error within clinically acceptable limits, while two showed greater average error than is clinically acceptable - U1-SN and L1-MP were the least accurate measurement in our study. Bland-Altman plots were constructed showing that FMA may show a slight tendency towards greater accuracy at high values, while LL to E-Plane may display a slight tendency to underestimate more frequently at low values and overestimate more frequently at high values. Only one measurement (ANB) showed limits of agreement within the maximum allowed difference; ten out of the eleven variables exceeded the maximum allowed difference. Overall, CephX may offer clinically acceptable performance for most variables in the ABO analysis, but needs further improvement overall, particularly with the inclination of the upper and lower incisors (U1-SN and L1-MP).
Author: Wesley J. Chladny
Publisher:
ISBN:
Category : Cephalometry
Languages : en
Pages : 168
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Author: Loren W. Jolley
Publisher:
ISBN:
Category :
Languages : en
Pages : 138
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Author: Mazyar Moshiri
Publisher:
ISBN:
Category : Teeth
Languages : en
Pages : 168
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Book Description
The purpose of this project was to compare the accuracy and precision of linear measurements made on conventional lateral cephalograms (LC) and simulated LC using cone-beam computed tomography (CBCT) to direct measurements on dentate skulls. The linear distances for 5 mid-sagittal and 4 bilateral measurements between anatomical landmarks on 22 skulls were measured by two observers. The skulls were imaged using a CBCT scanner at 4 scan settings: high resolution (0.2mm) and normal resolution (0.4mm) at 20-sec (306 projections) and 40-sec scans (612 projections). Three simulated LC were generated: Ray sum image reconstructions of the maximum thickness mid-sagittal multiplanar projections, a single frame basis projection, and the scout image. LCs were acquired using a storage phosphor system. Projection images were exported into a cephalometric analysis program and linear measurements determined. Analyses were repeated three times and statistically compared to measured anatomic truth using repeated measures general linear model (p [less than or equal to] 0.05). The mean absolute error was used as an index of precision. While there were statistical differences between skull and modality measurements for 6 of the nine measurements, there were no overall differences between LC and CBCT derived image measurements irrespective of method of construction. CBCT imaging provides clinically reliable 2D simulation images however, dose considerations demand that evidence-based selection criteria should be developed for CBCT in orthodontics that take into account the ALARA principle.
Author: Brian M. Mannari
Publisher:
ISBN:
Category : Dental care
Languages : en
Pages : 152
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Book Description
The purpose of this project was to compare the accuracy and reliability of linear measurements on posterior-anterior (PA) cephalograms made conventionally using photostimulable storage phosphor imaging plates (PSP) and simulated PA cephalometric images from ray sum reconstruction of cone beam computed tomographic (CBCT) volumetric datasets of the same anatomic specimens. The sample consisted of 19 dried dentate human skulls which were imaged using PA cephalometry using PSP imaging plates and three CBCT datasets at 10 s., 20 s. and 40 s. scanning times from which ray sum simulated PA images were produced. Various anatomic landmarks were identified and truth measurements of 13 selected cephalometric linear dimensions were measured directly on the skulls using a high precision caliper. CBCT datasets were imported into a reconstruction program (Dolphin 3D Software) from which ray sum PA images were constructed. Linear cephalometric measurements on PSP and CBCT simulated PA images were performed by one observer using Dolphin Imaging Software. Intraobserver reliability was determined by calculating and comparing Intraclass correlation coefficient. Mean absolute and percentage errors were calculated for each dimension and modality to quantify the reliability error. Mean modality measurements were compared. All other groups were compared using one-way ANOVA with Tukey post hoc comparisons (p [less than or equal to] 0.05). While the ICC was high, PSP cephalometric absolute error was greater than anatomic distances and CBCT image measurements for 8 for 13 measurements. We found that for most measurements, simulated PA images produced from reconstructed CBCT volumetric dataset were accurate and compared well to PSP cephalometric images except for Z-Ag. We also found that PSP cephalometric images consistently underestimated MO-MO dimensions. Measurements on CBCT simulated PA images are more reliabile and as accuracte as PSP cephalometric measurements. The number of projections comprising the reconstructed simulated PA image did not influence reliability or accuracy. Therefore in accordance with ALARA, when CBCT imaging is used to generate simulated PA images, the lowest number of projections are recommended.
Author: Sunil D. Kapila
Publisher: John Wiley & Sons
ISBN: 1118646592
Category : Medical
Languages : en
Pages : 880
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Book Description
Since its introduction to dentistry, cone beam computed tomography (CBCT) has undergone a rapid evolution and considerable integration into orthodontics. However, despite the increasing popularity of CBCT and progress in applying it to clinical orthodontics, the profession has lacked a cohesive, comprehensive and objective reference that provides clinicians with the background needed to utilize this technology optimally for treating their patients. Cone Beam Computed Tomography in Orthodontics provides timely, impartial, and state-of-the-art information on the indications and protocols for CBCT imaging in orthodontics, clinical insights gained from these images, and innovations driven by these insights. As such, it is the most current and authoritative textbook on CBCT in orthodontics. Cone Beam Computed Tomography in Orthodontics is organized to progress sequentially through specific topics so as to build the knowledgebase logically in this important and rapidly evolving field. Part I provides the foundational information on CBCT technology, including radiation exposure and risks, and future evolutions in computed tomography. Part II presents the Principles and Protocols for CBCT Imaging in Orthodontics, focusing on developing evidence-based criteria for CBCT imaging, the medico-legal implications of CBCT to the professional and the protocols and integration of this technology in orthodontic practice. Part III provides critical information on CBCT-based Diagnosis and Treatment Planning that includes how to interpret CBCT scans, identify incidental pathologies and the possible other uses of this technology. Part IV covers practical aspects of CBCT’s Clinical Applications and Treatment Outcomes that encompasses a range of topics, including root morphology and position, treatment of impacted teeth, virtual surgical treatment planning and outcomes, and more.
Author: Dr. SHREYA SHARMA
Publisher: Book Rivers
ISBN: 9355151470
Category : Antiques & Collectibles
Languages : en
Pages : 214
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Author: Llon Hurst Clendenen
Publisher:
ISBN:
Category :
Languages : en
Pages : 84
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Book Description
The purpose of this study was to compare examiner reliability of cephalometric measurements from cone beam computed tomography (CBCT) and conventional digital cephalograms. Three imaging modalities were compared: CBCT using maximum intensity projection and ray-sum algorithms, and conventional digital cephalograms. Blinded examiners were calibrated, and intra- and inter-examiner reliability were assessed. Data were collected on a convenience sample of seven subjects. Examiners obtained linear and angular measures on each of the subjects' images, and rater consistency among the three methods were assessed using repeated measures analysis of variance of intraclass correlation coefficient ratios. A statistically significantly greater level of consistency for linear measurements was seen with the CBCT images. For the conventional digital images, linear measurements showed less consistency than angular measurements. This statistical significance unlikely correlates to a clinical significance. For orthodontic diagnosis, treatment planning, and treatment evaluation, CBCT generated cephalograms are equally effective to conventional digital cephalograms.
Author: Ryann Christensen
Publisher:
ISBN:
Category :
Languages : en
Pages : 51
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Book Description
Objectives: The increased use of 3-dimensional (3D) cone-beam computed tomography (CBCT) in orthodontic and orthognathic cases has provided a clear understanding of its benefits compared to 2-dimensional (2D) cephalometric radiographs. However, current "3D hard tissue analyses" continue to rely on 2D linear and angular measurements and do not take advantage of the vast amount of information that can be derived from CBCTs. The long-term objective is to establish a user-friendly true 3D skeletal and dental analysis including quantifiable subnorms with respect to age, gender, and ethnicity. In order to eventually create a comprehensive and effective 3D analysis, it is necessary to first develop a true 3D description of the craniofacial structure that is both accurate and practical for the user. The specific objective of this study is to develop an approach for automatic point acquisition for 3D hard tissue analysis. Materials and Methods: The skeletal boundaries of the maxilla/palate, cranial base/zygoma, and mandible of 24 patient samples were manually plotted in a previous study conducted at UCLA. The same strict inclusion and exclusion criteria was used in both studies, including requirements for patients to be 18+ years old, have a class I skeletal relationship, and mesocephalic pattern and omitting patients with significant craniofacial defects, gross skeletal asymmetry or deformity, or history of orthognathic surgery. An extended form to the Active Shape Model (ASM) was further extended to function in 3D. Using ASM, automatic point acquisition along the boundaries of the maxilla/palate, cranial base/zygoma, and mandible was trained and implemented. A general Procrustes alignment was performed and elliptical-fourier descriptors were computed on both the points automatically plotted ("estimated landmarks") and points manually plotted ("ground-truth landmarks"), which were later compared. Results: An approach for automatic point acquisition on normative 3D CBCT images of the adult craniofacial complex was created. Conclusion: The development of an approach for automatic point acquisition on 3D CBCT images is an essential step towards establishing a true 3D skeletal and dental analysis. While this approach improves practicality by eliminating the need for a user to plot a great number of points thereby eliminating several hours of the user's time, further development of this method is needed to improve its accuracy.
Author: Alexander Jacobson
Publisher: Quintessence Publishing (IL)
ISBN:
Category : Medical
Languages : en
Pages : 326
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Book Description
Accompanying CD-ROM contains ... "an 'average' template and larger and smaller 'normal' templates ... Also provided are instructions for the digital application of the templates to accommodate skulls of all sizes."--Page ix.
