The purpose of this study was to determine the accuracy and repeatability of linear anthropometric measurements on the soft tissue surface model generated from cone beam computed tomography scans.
Materials and Methods
The study sample consisted of seven cadaver heads. The accuracy and repeatability were assessed by means of a series of 21 standardized, linear facial measurements derived from 11 landmarks taken both directly on the face with a set of digital calipers and indirectly from a three-dimensional soft tissue surface model generated from a cone beam computed tomography scan of the heads using SimPlant® Ortho Pro software. The landmarks and measurements were chosen to cover various regions of the face with an emphasis on the oral-nasal region. The cone beam computed tomography measurements were compared with the physical measurements. Statistical analysis for the repeatability was done by means of the intraclass coefficient. Accuracy was determined by means of the absolute error and absolute percentage error.
Results
The cone beam computed tomography measurements were very accurate when compared with the physical measurements (0.962 to 0.999). Except for one measurement, between point tragion (t) and nasion (n) (mean, 1.52 mm), all the measurements had a mean absolute error of less than 1.5 mm.
Conclusions
The three-dimensional surface models derived from cone beam computed tomography images are sufficiently precise and accurate for the anthropometric measurements.
Al-OmariI., MillettD.T., AyoubA.F.Methods of assessment of cleft-related facial deformity: a review. Cleft Palate Craniofac J.2005; 42: 145–156.
2.
ArridgeS.R., MossJ.P., LinneyA.D., JamesD.R.Three-dimensional digitization of the face and skull. J Maxillofac Surg.1985; 13: 136–143.
3.
AungS.C., NgimR.C.K., LeeS.T.Evaluation of the laser surface scanner as a measuring tool and its accuracy compared with direct facial anthropometric measurements. Br J Plast Surg.1995; 48: 551–558.
4.
AyoubA.F., SiebertP., MoosK.F., WrayD., UrquhartC., NiblettT.B.A vision based three-dimensional capture system for maxillofacial assessment and surgical planning. Br J Oral Maxillofac Surg.1998; 36: 353–357.
5.
BacjaD.B., DeutschC.K., D'AgostinoR.B.Correspondence between direct anthropometry and structured light digital measurement. In: FarkasL.G., ed. Anthropometry of the Head and Face.New York: Raven Press;1994: 235–238.
6.
BurkeP.H., BanksP., BeardL.F.H., TeeJ.E., HughesC.Stereo-photography measurement of change in soft tissue following surgery. Br J Oral Surg.1983; 21: 237–245.
7.
BurkeP.H., BeardL.F.H.Stereophotogrammetry of the face. A preliminary investigation into the accuracy of a simplified system evolved for contour mapping by photography. Am J Orthod.1967; 53: 769–782.
8.
BushK., AntonyshynO.Three-dimensional facial anthropometry using a laser surface scanner: validation of the technique. Plast Reconstr Surg.1996; 98: 226–235.
9.
CavalcantiM.G., VannierM.W.Quantitative analysis of spiral computed tomography for craniofacial clinical applications. Dentomaxillofac Radiol.1998; 27: 344–350.
10.
DamstraJ., FourieZ., Huddleston SlaterJ.J.R., RenY.Accuracy of linear measurements from cone-beam computed tomography-derived surface models of different voxel sizes. Am J Orthod Dentofacial Orthop.2010; 137: 16.e1–16.e6.
11.
DanforthR.A., DusI., MahJ.3-D volume imaging for dentistry: a new dimension. J Calif Dent Assoc.2003; 31: 817–823.
12.
DeutschC.K., MullikenJ.B.Discussion of surface anatomy of the face in Down's syndrome: anthropometric indices in the craniofacial regions. J Craniofac Surg.2008; 12: 525–526.
13.
DouglasT.S.Image processing for craniofacial landmark identification and measurement: a review of photogrammetry and cephalometry. Comput Med Imaging Graph.2004; 28: 401–409.
14.
EnomotoK., NishimuraH., InoharaH., MurataJ., HoriiA., DoiK.A rare case of a glass foreign body in the parapharyngeal space: pre-operative assessment by contrast-enhanced CT and three-dimensional CT images. Dentomaxillofac Radiol.2009; 38: 112–115.
15.
FarkasL.G.Accuracy of anthropometric measurements: past, present and future. Cleft Palate Craniofac J.1996; 33: 10–18.
16.
FarkasL.G.Anthropometry of the Head and Face.New York: Raven Press;1994.
17.
FarkasL.G., BrysonW., KlotzJ.Is photogrammetry of the face reliable?Plast Reconstr Surg.1980; 66: 346–355.
18.
ForsythD.B., DavisD.N.Assessment of an automated cephalometric analysis system. Eur J Orthod.1996; 18: 471–478.
19.
FourieZ., DamstraJ., GerritsP.O., RenY.Accuracy and reliability of facial soft tissue depth measurements using cone beam computer tomography. Forensic Sci Int.2010; 199: 9–14.
20.
GraysonB., CuttingC., BooksteinF.L., KimH., McCarthyJ.G.The three-dimensional cephalogram: theory, technique and clinical application. Am J Orthod Dentofacial Orthop.1988; 94: 327–337.
21.
HilgersM.L., ScarfeW.C., ScheetzJ.P., FarmanA.G.Accuracy of linear TM J measurements with cone beam computed tomography and digital cephalometric radiography. Am J Orthod Dentofacial Orthop.2005; 128: 803–811.
22.
JamesonP.L., WardR.E.Brief communication: measurement size, precision, and reliability in craniofacial anthropometry: bigger is better. Am J Phys Anthropol.1993; 90: 495–500.
23.
KawaiT., NatsumeN., ShibataH., YamamotoT.Three-dimensional analysis of facial morphology using moiré stripes. Part I. Method. Int J Oral Maxillofac Surg.1990; 19: 356–358.
24.
KawanoY.Three-dimensional analysis of the face in respect of zygomatic fractures and evaluation of the surgery with the aid of moire topography. J Craniomaxillofac Surg.1987; 15: 68–74.
25.
KobayashiK., ShimodaS., NakagawaY., YamamotoA.Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants.2004; 19: 228–231.
26.
KobayashiT., UedaK., HonmaK., SasakuraH., HanadaK., NakauimaT.Three-dimensional analysis of facial morphology before and after orthognathic surgery. J Craniomaxillofac Surg.1990; 18: 68–73.
27.
LascalaC.A., PanellaJ., MarquesM.M.Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-NewTom). Dentomaxillofac Radiol.2004; 33: 291–294.
28.
LudlowJ.B., Davies-LudlowL.E., BrooksS.L., HowertonW.B.Dosimetry of 3 CBCT devices for oral and maxillofacial radiology: CB Mercuray, NewTom 3G and i-CAT. Dentomaxillofac Radiol.2006; 35: 219–226.
29.
McCanceA.M., MossJ.P., WrightW.R., LinneyA.D., JamesD.R.A three-dimensional soft tissue analysis of 16 skeletal class III patients following bimaxillary surgery. Br J Oral Maxillofac Surg.1992; 30: 221–232.
30.
MeintjesE.M., DouglasT.S., MartinezF., VaughanC.L., AdamsL.P., StekhovenA., ViljoenD.A stereo-photogrammetric method to measure the facial dysmorphology of children in the diagnosis of fetal alcohol syndrome. Med Eng Phys.2002; 24: 683–689.
31.
MischkowskiR.A., PulsfortR., RitterL., NeugebauerJ., BrochhagenH.G., KeeveE., ZöllerJ.E.Geometric accuracy of a newly developed cone-beam device for maxillofacial imaging. Oral Surg Oral Med Oral Pathol Oral Radiol Endod.2007; 104: 551–559.
32.
MossJ.P., LinneyA.D., GrindrodS.R., ArridgeS.R., CliftonJ.S.Three-dimensional visualization of the face and skull using computerized tomography and laser scanning techniques. Eur J Orthod.1987; 9: 247–253.
33.
MossJ.P., LinneyA.D., GrindrodS.R., MosseC.A.A laser scanning system for the measurement of facial surface morphology. Opt Lasers Eng.1989; 10: 179–190.
34.
MotoyoshiM., NamuraS., AraiH.Y.A three-dimensional measuring system for the human face using three-directional photography. Am J Orthod Dentofacial Orthop.1992; 101: 431–440.
PeriagoD.R., ScarfeW.C., MoshiricM., ScheetzJ.P., SilveiraA.M., FarmanA.G.Linear accuracy and reliability of cone beam CT derived 3-dimensional images constructed using an orthodontic volumetric rendering program. Angle Orthod.2008; 78: 387–395.
37.
PosnickJ.C., FarkasL.G.The application of anthropometric surface measurements in craniomaxillofacial surgery. In: FarkasL.G., ed. Anthropometry of the Head and Face.New York: Raven Press;1994: 125–138.
38.
RakosiT.An Atlas of Cephalometric Radiography. London: Wolfe Medical Publications; 1982. Richardson A. A comparison of traditional and computerized methods of cephalometric analysis. Eur J Orthod.1981; 3: 15–20.
39.
ShanerD.J., BamforthJ.S., PetersenA.E., BeattieO.B.Facial measurements in clinical genetics: how important are the instruments we use?Am J Med Genet.1998; 77: 384–390.
40.
StratemannS.A., HuangJ.C., MakiK., MillerA.J., HatcherD.C.Comparison of cone beam computed tomography imaging with physical measures. Dentomaxillofac Radiol.2008; 37: 80–93.
WardR.E., JamisonP.L.Measurement precision and reliability in craniofacial anthropometry: implications and suggestions for clinical applications. J Craniofac Genet Dev Biol.1991; 11: 156–164.
43.
WeinbergS.M., KolarJ.C.Three-dimensional surface imaging: limitations and considerations from the anthropometric perspective. J Craniofac Surg.2005; 16: 847–851.
44.
WeinbergS.M., ScottN.M., NeiswangerK., BrandonC.A., MarazitaM.L.Digital three-dimensional photogrammetry: evaluation of anthropometric precision and accuracy using a Genex 3D camera system. Cleft Palate Craniofac J.2004; 41: 507–518.
45.
WongJ.Y., OhA.K., OhtaE., HuntA.T., RogersG.F., MullikenJ.B., DeutschC.K.Validity and reliability of 3D craniofacial anthropometric measurements. Cleft Palate Craniofac J.2008; 45: 232–239.
