Comparison of Digital and Manual Methods Used in the Analysis of Cephalometric Radiographs
Yıl 2023,
Cilt: 2 Sayı: 3, 241 - 250, 26.01.2024
Ayla Yılmaz
Fethiye Çakmak Özlü
Öz
Aim: The purpose of this study was to evaluate the reliability and reproducibility of digital cephalometric tracing and conventional hand-tracing methods
Material and Method: Three hundred pretreatment lateral cephalometric radiographs were included in the study. Pretreatment digital cephalometric radiographs were traced using Nemoceph Dental Studio NX Pro 10.4.2 software programs and by hand tracing of the printouts. Twenty-four anatomic points were identified by the same investigator and 12 skeletal, 10 dental and 3 soft tissue parameters were measured. All measurements were repeated on the randomlyselected 75 radiographs by the same investigator after 1 month interval. For each method, Test-retest and intraclass correlation coefficient (ICC) were calculated to determine the consistence
of all measured values between intrainvestigator reliability and methods. The reproducibility between methods was calculated by paired t-test. The level of statistical significance was set at p<0.05.
Results: The intra-investigator reliability for all measurements were upon 0.90 ICC (strong correlation) for
both methods. Significant differences between the two methods were observed for all angular and linear measurements except for L1-NB angle (p=0,061) and Nasolabial angle (p=0,777). Among these methods, good consistence was observed in all measurements except for the Gonial angle (ICC = 0.751) and
Nasolabial angle(ICC = 0.780).
Conclusion: According to the results of this study, both
methods of digital and manuel methods are highly reliable.
Although there is a statistically significant difference between
the reproducibility of the two
Kaynakça
-
1. Phulari B. An atlas on cephalometric landmarks: JP
Medical Ltd; 2013.
-
2. Brennan J. An introduction to digital radiography in
dentistry. Journal of Orthodontics. 2002;29(1):66-9.
-
3. Carlos Quintero J, Trosien A, Hatcher D, Kapila
S. Craniofacial imaging in orthodontics: historical
perspective, current status, and future developments. The
Angle Orthodontist. 1999;69(6):491-506.
-
4. Näslund E, Kruger M, Petersson A, Hansen K. Analysis
of low-dose digital lateral cephalometric radiographs.
Dentomaxillofacial Radiology. 1998;27(3):136-9.
-
5. Houston W. The analysis of errors in orthodontic
measurements. American journal of orthodontics.
1983;83(5):382-90.
-
6. Midtgård J, Björk G, Linder-Aronson S. Reproducibility
of cephalometric landmarks and errors of measurements of
cephalometric cranial distances. The Angle Orthodontist.
1974;44(1):56-61.
-
7. Rudolph D, Sinclair P, Coggins J. Automatic computerized
radiographic identification of cephalometric landmarks.
American Journal of Orthodontics and Dentofacial
Orthopedics. 1998;113(2):173-9.
-
8. Gregston MD, Kula T, Hardman P, Glaros A, Kula
K, editors. A comparison of conventional and digital
radiographic methods and cephalometric analysis software:
I. hard tissue. Seminars in Orthodontics; 2004: Elsevier.
-
9. Macri V, Wenzel A. Reliability of landmark recording
on film and digital lateral cephalograms. The European
Journal of Orthodontics. 1993;15(2):137-48.
-
10. Nimkarn Y, Miles P. Reliability of computer-generated
cephalometrics. The International journal of adult
orthodontics and orthognathic surgery. 1995;10(1):43-52.
-
11. Ongkosuwito E, Katsaros C, Van’t Hof M, Bodegom J,
Kuijpers‐Jagtman A. The reproducibility of cephalometric
measurements: a comparison of analogue and digital
methods. The European Journal of Orthodontics.
2002;24(6):655-65.
-
12. Sayinsu K, Isik F, Trakyali G, Arun T. An evaluation of
the errors in cephalometric measurements on scanned
cephalometric images and conventional tracings. The
European Journal of Orthodontics. 2007;29(1):105-8.
-
13. Liu J-K, Chen Y-T, Cheng K-S. Accuracy of computerized
automatic identification of cephalometric landmarks.
American Journal of Orthodontics and Dentofacial
Orthopedics. 2000;118(5):535-40.
-
14. Chen Y-J, Chen S-K, Chung-Chen Yao J, Chang H-F. The
effects of differences in landmark identification on the
cephalometric measurements in traditional versus digitized
cephalometry. The Angle orthodontist. 2004;74(2):155-61.
-
15. Oliver RG. Cephalometric analysis comparing five different
methods. British Journal of orthodontics. 1991;18(4):277-
83.
-
16. Power G, Breckon J, Sherriff M, McDonald F. Dolphin
Imaging Software: an analysis of the accuracy of
cephalometric digitization and orthognathic prediction.
International journal of oral and maxillofacial surgery.
2005;34(6):619-26.
-
17. Kublashvili T, Kula K, Glaros A, Hardman P, Kula
T, editors. A comparison of conventional and digital
radiographic methods and cephalometric analysis software:
II. Soft tissue. Seminars in Orthodontics; 2004: Elsevier.
-
18. Celik E, Polat-Ozsoy O, Toygar Memikoglu TU.
Comparison of cephalometric measurements with digital
versus conventional cephalometric analysis. The European
Journal of Orthodontics. 2009;31(3):241-6.
-
19. Sandler P. Reproducibility of cephalometric measurements.
British journal of orthodontics. 1988;15(2):105-10.
-
20. Chen YJ, Chen SK, Chang HF, Chen KC. Comparison
of landmark identification in traditional versus computeraided
digital cephalometry. The Angle orthodontist.
2000;70(5):387-92.
-
21. Hagemann K, Vollmer D, Niegel T, Ehmer U, Reuter I.
Prospective study on the reproducibility of cephalometric
landmarks on conventional and digital lateral headfilms.
Journal of Orofacial Orthopedics/Fortschritte der
Kieferorthopädie. 2000;61(2):91-9.
-
22. Geelen W, Wenzel A, Gotfredsen E, Kruger M, Hansson
L. Reproducibility of cephalometric landmarks on
conventional film, hardcopy, and monitor-displayed images
obtained by the storage phosphor technique. The European
Journal of Orthodontics. 1998;20(3):331-40.
-
23. Naoumova J, Lindman R. A comparison of manual
traced images and corresponding scanned radiographs
digitally traced. The European Journal of Orthodontics.
2009;31(3):247-53.
-
24. Polat-Ozsoy O, Gokcelik A, Toygar Memikoglu TU.
Differences in cephalometric measurements: a comparison
of digital versus hand-tracing methods. The European
Journal of Orthodontics. 2009;31(3):254-9.
-
25. İşeri H, Açıkbaş A, Yılmaz O. Bilgisayar metodu ve
geleneksel metod ile yapılan sefalometrik ölçümlerin
hassasiyet, tekrarlanabilirlik ve zaman açısından
değerlendirilmesi. Türk Ortod Derg 1992;5: 1-6.
-
26. Sarı Z, Başçiftçi FA, Uysal T, Malkoç S. Üç farklı
sefalometrik film çizim yönteminde araştırıcılar
ve tekniklerin karşılaştırılması. Türk Ortod Derg
2002;15(2):99-107.
-
27. Baumrind S, Frantz RC. The reliability of head film
measurements: 1. Landmark identification. American
journal of orthodontics. 1971;60(2):111-27.
-
28. Sekiguchi T, Savara BS. Variability of cephalometric
landmarks used for face growth studies. American journal
of orthodontics. 1972;61(6):603-18.
-
29. Santoro M, Jarjoura K, Cangialosi TJ. Accuracy of digital
and analogue cephalometric measurements assessed with
the sandwich technique. American Journal of Orthodontics
and Dentofacial Orthopedics. 2006;129(3):345-51.
-
30. Bruntz LQ, Palomo JM, Baden S, Hans MG. A comparison
of scanned lateral cephalograms with corresponding
original radiographs. American Journal of Orthodontics
and Dentofacial Orthopedics. 2006;130(3):340-8.
-
31. Uysal T, Baysal A, Yagci A. Evaluation of speed,
repeatability, and reproducibility of digital radiography with
manual versus computer-assisted cephalometric analyses.
The European Journal of Orthodontics. 2009;31(5):523-8.
Sefalometrik Radyografilerin Analizlerinde Kullanılan Dijital ve Manuel Metotların Karşılaştırılması
Yıl 2023,
Cilt: 2 Sayı: 3, 241 - 250, 26.01.2024
Ayla Yılmaz
Fethiye Çakmak Özlü
Öz
Amaç: Bu çalışmanın amacı, dijital sefalometrik çizim ve konvansiyonel manuel çizim metotlarının, güvenilirlik ve tekrar edilebilirliğinin değerlendirilmesidir.
Gereç ve Yöntem: Üç yüz adet ortodontik tedavi öncesi dijital lateral sefalometrik radyograf çalışmaya dahil edilmiştir. Dijital çizim metodu Nemoceph Dental Studio NX Pro 10.4.2 çizim programı ile manuel çizim metodu ise dijital radyografların çıktıları üzerinde uygulanmıştır. Analiz için 24 anatomik nokta tanımlanmış ve 12 iskeletsel, 10 dişsel ve
3 yumuşak doku parametresi ölçülmüştür. Bütün ölçümler, rastgele seçilmiş 75 radyografi üzerinde, 1 ay aralıkla aynı araştırmacı tarafından tekrar yapılmıştır. Her bir metot için araştırmacı içi güvenilirlik ve metotlar arasında tüm ölçüm değerlerinin uyumunu belirlemek için Test-tekrar test ve sınıf
içi korelasyon katsayısı hesaplanmıştır. Metotlar arası tekrar edilebilirlik Paired Sample T testi kullanılarak hesaplanmıştır. İstatistiksel anlamlılık düzeyi p<0.05 olarak belirlenmiştir.
Bulgular: Her iki metot için araştırmacı içi güvenirlik tüm ölçümlerde sınıf içi korelasyon katsayısı 0,90’ın üzerindedir (güçlü korelasyon). L1-NB açısı (p=0,061) ve Nasolabial açı (p=0,777) haricinde açısal ve doğrusal ölçümlerin çoğunda istatistiksel olarak anlamlı farklılık bulunmuştur. Metotlar arasında, Gonial açı (SKK=0,751) ve Nasolabial açı (SKK=0,780) haricinde tüm ölçümlerde iyi bir uyum gözlenmiştir.
Sonuç: Çalışmamızın sonuçlarına göre, dijital ve manuel sefalometrik analiz metotlarının her ikisinde de
yüksek güvenilirlik bulunmuştur. İki metot arasında tekrar edilebilirlikler arasında istatistiksel olarak anlamlı farklılık görülmesine rağmen, farklılıkların çoğu klinik olarak anlamlı değildir.
Etik Beyan
Kocaeli Üniversitesi, Diş Hekimliği Fakültesi, Girişimsel Olmayan Klinik Araştırmalar Etik Kurulundan
11.05.2016 tarih ve 2016/141 sayılı etik kurul onayı alındı.
Kaynakça
-
1. Phulari B. An atlas on cephalometric landmarks: JP
Medical Ltd; 2013.
-
2. Brennan J. An introduction to digital radiography in
dentistry. Journal of Orthodontics. 2002;29(1):66-9.
-
3. Carlos Quintero J, Trosien A, Hatcher D, Kapila
S. Craniofacial imaging in orthodontics: historical
perspective, current status, and future developments. The
Angle Orthodontist. 1999;69(6):491-506.
-
4. Näslund E, Kruger M, Petersson A, Hansen K. Analysis
of low-dose digital lateral cephalometric radiographs.
Dentomaxillofacial Radiology. 1998;27(3):136-9.
-
5. Houston W. The analysis of errors in orthodontic
measurements. American journal of orthodontics.
1983;83(5):382-90.
-
6. Midtgård J, Björk G, Linder-Aronson S. Reproducibility
of cephalometric landmarks and errors of measurements of
cephalometric cranial distances. The Angle Orthodontist.
1974;44(1):56-61.
-
7. Rudolph D, Sinclair P, Coggins J. Automatic computerized
radiographic identification of cephalometric landmarks.
American Journal of Orthodontics and Dentofacial
Orthopedics. 1998;113(2):173-9.
-
8. Gregston MD, Kula T, Hardman P, Glaros A, Kula
K, editors. A comparison of conventional and digital
radiographic methods and cephalometric analysis software:
I. hard tissue. Seminars in Orthodontics; 2004: Elsevier.
-
9. Macri V, Wenzel A. Reliability of landmark recording
on film and digital lateral cephalograms. The European
Journal of Orthodontics. 1993;15(2):137-48.
-
10. Nimkarn Y, Miles P. Reliability of computer-generated
cephalometrics. The International journal of adult
orthodontics and orthognathic surgery. 1995;10(1):43-52.
-
11. Ongkosuwito E, Katsaros C, Van’t Hof M, Bodegom J,
Kuijpers‐Jagtman A. The reproducibility of cephalometric
measurements: a comparison of analogue and digital
methods. The European Journal of Orthodontics.
2002;24(6):655-65.
-
12. Sayinsu K, Isik F, Trakyali G, Arun T. An evaluation of
the errors in cephalometric measurements on scanned
cephalometric images and conventional tracings. The
European Journal of Orthodontics. 2007;29(1):105-8.
-
13. Liu J-K, Chen Y-T, Cheng K-S. Accuracy of computerized
automatic identification of cephalometric landmarks.
American Journal of Orthodontics and Dentofacial
Orthopedics. 2000;118(5):535-40.
-
14. Chen Y-J, Chen S-K, Chung-Chen Yao J, Chang H-F. The
effects of differences in landmark identification on the
cephalometric measurements in traditional versus digitized
cephalometry. The Angle orthodontist. 2004;74(2):155-61.
-
15. Oliver RG. Cephalometric analysis comparing five different
methods. British Journal of orthodontics. 1991;18(4):277-
83.
-
16. Power G, Breckon J, Sherriff M, McDonald F. Dolphin
Imaging Software: an analysis of the accuracy of
cephalometric digitization and orthognathic prediction.
International journal of oral and maxillofacial surgery.
2005;34(6):619-26.
-
17. Kublashvili T, Kula K, Glaros A, Hardman P, Kula
T, editors. A comparison of conventional and digital
radiographic methods and cephalometric analysis software:
II. Soft tissue. Seminars in Orthodontics; 2004: Elsevier.
-
18. Celik E, Polat-Ozsoy O, Toygar Memikoglu TU.
Comparison of cephalometric measurements with digital
versus conventional cephalometric analysis. The European
Journal of Orthodontics. 2009;31(3):241-6.
-
19. Sandler P. Reproducibility of cephalometric measurements.
British journal of orthodontics. 1988;15(2):105-10.
-
20. Chen YJ, Chen SK, Chang HF, Chen KC. Comparison
of landmark identification in traditional versus computeraided
digital cephalometry. The Angle orthodontist.
2000;70(5):387-92.
-
21. Hagemann K, Vollmer D, Niegel T, Ehmer U, Reuter I.
Prospective study on the reproducibility of cephalometric
landmarks on conventional and digital lateral headfilms.
Journal of Orofacial Orthopedics/Fortschritte der
Kieferorthopädie. 2000;61(2):91-9.
-
22. Geelen W, Wenzel A, Gotfredsen E, Kruger M, Hansson
L. Reproducibility of cephalometric landmarks on
conventional film, hardcopy, and monitor-displayed images
obtained by the storage phosphor technique. The European
Journal of Orthodontics. 1998;20(3):331-40.
-
23. Naoumova J, Lindman R. A comparison of manual
traced images and corresponding scanned radiographs
digitally traced. The European Journal of Orthodontics.
2009;31(3):247-53.
-
24. Polat-Ozsoy O, Gokcelik A, Toygar Memikoglu TU.
Differences in cephalometric measurements: a comparison
of digital versus hand-tracing methods. The European
Journal of Orthodontics. 2009;31(3):254-9.
-
25. İşeri H, Açıkbaş A, Yılmaz O. Bilgisayar metodu ve
geleneksel metod ile yapılan sefalometrik ölçümlerin
hassasiyet, tekrarlanabilirlik ve zaman açısından
değerlendirilmesi. Türk Ortod Derg 1992;5: 1-6.
-
26. Sarı Z, Başçiftçi FA, Uysal T, Malkoç S. Üç farklı
sefalometrik film çizim yönteminde araştırıcılar
ve tekniklerin karşılaştırılması. Türk Ortod Derg
2002;15(2):99-107.
-
27. Baumrind S, Frantz RC. The reliability of head film
measurements: 1. Landmark identification. American
journal of orthodontics. 1971;60(2):111-27.
-
28. Sekiguchi T, Savara BS. Variability of cephalometric
landmarks used for face growth studies. American journal
of orthodontics. 1972;61(6):603-18.
-
29. Santoro M, Jarjoura K, Cangialosi TJ. Accuracy of digital
and analogue cephalometric measurements assessed with
the sandwich technique. American Journal of Orthodontics
and Dentofacial Orthopedics. 2006;129(3):345-51.
-
30. Bruntz LQ, Palomo JM, Baden S, Hans MG. A comparison
of scanned lateral cephalograms with corresponding
original radiographs. American Journal of Orthodontics
and Dentofacial Orthopedics. 2006;130(3):340-8.
-
31. Uysal T, Baysal A, Yagci A. Evaluation of speed,
repeatability, and reproducibility of digital radiography with
manual versus computer-assisted cephalometric analyses.
The European Journal of Orthodontics. 2009;31(5):523-8.