Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)

Abstract Objective The commonly used lateral cephalometric radiographs, including traditional lateral cephalometric radiographs and CBCT-synthesized lateral cephalometric radiographs, have the problem of overlapping anatomical structures, which interferes with the identification of landmarks. Theref...

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Main Authors: Chuan Cai, Hongkun Li, Haodong Zhang, Na Huo, Jing Wang, Tianqi Li, Nuo Xu, Tong Zhang
Format: Article
Language:English
Published: BMC 2025-05-01
Series:BMC Oral Health
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Online Access:https://doi.org/10.1186/s12903-025-06258-x
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author Chuan Cai
Hongkun Li
Haodong Zhang
Na Huo
Jing Wang
Tianqi Li
Nuo Xu
Tong Zhang
author_facet Chuan Cai
Hongkun Li
Haodong Zhang
Na Huo
Jing Wang
Tianqi Li
Nuo Xu
Tong Zhang
author_sort Chuan Cai
collection DOAJ
description Abstract Objective The commonly used lateral cephalometric radiographs, including traditional lateral cephalometric radiographs and CBCT-synthesized lateral cephalometric radiographs, have the problem of overlapping anatomical structures, which interferes with the identification of landmarks. Therefore, we proposed a new method called CBCT-based locally reconstructed lateral cephalometric radiographs and evaluated its precision and reproducibility. Materials and methods CBCT and lateral cephalometric radiographs were obtained from five orthodontic patients. Twenty-six cephalometric landmarks were identified using three methods by ten orthodontists. The landmarks on each image were recorded as (X, Y), and the absolute values of the differences between each measurement and the average values of the X and Y coordinates were calculated (ΔX and ΔY). Additionally, the distance between each located point and the centroid was calculated (ΔD). The differences in ΔX, ΔY, and ΔD among the groups were compared through analysis of variance (ANOVA). Bonferroni post hoc correction was used for pairwise comparisons. p < 0.05 was considered statistically significant. Results The reproducibility of 14 landmarks in the CBCT-based locally reconstructed lateral cephalometric radiographs was better than that of the other methods in at least one direction (p < 0.05). Among these landmarks, the precision of the CBCT local reconstruction group was greater in all directions for five landmarks than that of the other two groups (p < 0.05). Conclusion The CBCT locally reconstructed lateral cephalometric radiographs proposed in this study enhanced the precision and reproducibility of cephalometric landmark identification.
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spelling doaj-art-95644a8d2d264e599d81b86ad643ae212025-08-20T01:59:57ZengBMCBMC Oral Health1472-68312025-05-0125111110.1186/s12903-025-06258-xEvaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)Chuan Cai0Hongkun Li1Haodong Zhang2Na Huo3Jing Wang4Tianqi Li5Nuo Xu6Tong Zhang7Department of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalDepartment of Stomatology, The First Medical Center, Chinese PLA General HospitalAbstract Objective The commonly used lateral cephalometric radiographs, including traditional lateral cephalometric radiographs and CBCT-synthesized lateral cephalometric radiographs, have the problem of overlapping anatomical structures, which interferes with the identification of landmarks. Therefore, we proposed a new method called CBCT-based locally reconstructed lateral cephalometric radiographs and evaluated its precision and reproducibility. Materials and methods CBCT and lateral cephalometric radiographs were obtained from five orthodontic patients. Twenty-six cephalometric landmarks were identified using three methods by ten orthodontists. The landmarks on each image were recorded as (X, Y), and the absolute values of the differences between each measurement and the average values of the X and Y coordinates were calculated (ΔX and ΔY). Additionally, the distance between each located point and the centroid was calculated (ΔD). The differences in ΔX, ΔY, and ΔD among the groups were compared through analysis of variance (ANOVA). Bonferroni post hoc correction was used for pairwise comparisons. p < 0.05 was considered statistically significant. Results The reproducibility of 14 landmarks in the CBCT-based locally reconstructed lateral cephalometric radiographs was better than that of the other methods in at least one direction (p < 0.05). Among these landmarks, the precision of the CBCT local reconstruction group was greater in all directions for five landmarks than that of the other two groups (p < 0.05). Conclusion The CBCT locally reconstructed lateral cephalometric radiographs proposed in this study enhanced the precision and reproducibility of cephalometric landmark identification.https://doi.org/10.1186/s12903-025-06258-xCephalometric analysisCephalometric landmarksCone beam computed tomographyPrecision and reproducibility
spellingShingle Chuan Cai
Hongkun Li
Haodong Zhang
Na Huo
Jing Wang
Tianqi Li
Nuo Xu
Tong Zhang
Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
BMC Oral Health
Cephalometric analysis
Cephalometric landmarks
Cone beam computed tomography
Precision and reproducibility
title Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
title_full Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
title_fullStr Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
title_full_unstemmed Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
title_short Evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography (CBCT)
title_sort evaluating the precision and reproducibility of cephalometric landmarks in locally reconstructed lateral cephalometric radiographs from cone beam computed tomography cbct
topic Cephalometric analysis
Cephalometric landmarks
Cone beam computed tomography
Precision and reproducibility
url https://doi.org/10.1186/s12903-025-06258-x
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