Measurement error and reliability of three available 3D superimposition methods in growing patients
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(2020) 16:1
RESEARCH
Open Access
Measurement error and reliability of three available 3D superimposition methods in growing patients Cecilia Ponce-Garcia1*, Antonio Carlos de Oliveira Ruellas2, Lucia Helena Soares Cevidanes3, Carlos Flores-Mir4, Jason P. Carey5 and Manuel Lagravere-Vich6
Abstract Introduction: Cone-Beam Computed Tomography (CBCT) images can be superimposed, allowing threedimensional (3D) evaluation of craniofacial growth/treatment effects. Limitations of 3D superimposition techniques are related to imaging quality, software/hardware performance, reference areas chosen, and landmark points/ volumes identification errors. The aims of this research are to determine/compare the intra-rater reliability generated by three 3D superimposition methods using CBCT images, and compare the changes observed in treated cases by these methods. Methods: Thirty-six growing individuals (11–14 years old) were selected from patients that received orthodontic treatment. Before and after treatment (average 24 months apart) CBCTs were analyzed using three superimposition methods. The superimposed scans with the two voxel-based methods were used to construct surface models and quantify differences using SlicerCMF software, while distances in the landmark-derived method were calculated using Excel. 3D linear measurements of the models superimposed with each method were then compared. Results: Repeated measurements with each method separately presented good to excellent intraclass correlation coefficient (ICC ≥ 0.825). ICC values were the lowest when comparing the landmark-based method and both voxelbased methods. Moderate to excellent agreement was observed when comparing the voxel-based methods against each other. The landmark-based method generated the highest measurement error. Conclusions: Findings indicate good to excellent intra-examiner reliability of the three 3D superimposition methods when assessed individually. However, when assessing reliability among the three methods, ICC demonstrated less powerful agreement. The measurements with two of the three methods (CMFreg/Slicer and Dolphin) showed similar mean differences; however, the accuracy of the results could not be determined. Keywords: Three-dimensional superimposition, Cone beam computed tomography
Introduction Monitoring treatment progress and outcomes is pivotal to patient care [1]. Therefore, an important part of orthodontic treatment involves the study of longitudinal changes induced by growth and treatment in the dentofacial complex in individual patients [2–5]. Superimposing tracings of serial lateral cephalograms has facilitated knowledge about normal craniofacial growth and * Correspondence: [email protected] 1 Division of Orthodontics, School of Dentistry, University of Alberta, Edmonton, Canada Full list of author information is available at the end of the article
development as well as knowledge about the treatment effects produced by various orthodontic, orthopedic, and surgical procedures [3, 6]. A reference system is required for a supe
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