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Title Preliminary Evidence Suggests CBCT Is Accurate For Identifying Orthodontic Landmarks
Clinical Question How accurate is CBCT in identifying orthodontic landmarks for growth analysis?
Clinical Bottom Line CBCT has a high degree of accuracy and reproducibility in measurements, but more evidence is required to determine anatomical landmarks accuracy of CBCT. (See Comments on the CAT below)
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 21898195Medelnik/20111 Cadaver HeadClinical Trial
Key resultsHigh accuracy and reproducibility of measurements in ventral/dorsal direction and lateral direction. CBCT was less accurate than multi-slice spiral CT in the anterior/posterior direction but still within acceptable limits clinically.
#2) 21640864Leonelli/201110 Dry Human SkullsComparative Study
Key results2D imaging had poor agreement with physical measurements (kappa = 0.0609).CBCT had excellent agreement with physical measurements (kappa = 0.92). Author concludes that CBCT can better evaluate craniofacial morphology compared with 2D images.
#3) 21803252El-Beialy/20111 Dry Human SkullClinical Study
Key resultsConcordance correlation and Pearson correlation coefficients values were almost 0.9999. Very high agreement between physical skull and CBCT measurements.
Evidence Search “cone beam CT" AND landmarks
Comments on
The Evidence
No description of lighting conditions for readings and whether readings were performed by trained radiologists. Studies have no mention whether data is randomized or not, could indicate bias. Very small sample sizes in two of the studies. All the studies were performed on ex vivo samples of adults. No samples on children.
Applicability Human, Adult
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (Orthodontics)
Keywords CBCT, cone beam CT, orthodontic landmarks
ID# 2141
Date of submission: 09/23/2011spacer
E-mail hashem@uthscsa.edu
Author Mohannad Hashem
Co-author(s) e-mail
Faculty mentor/Co-author Marcel Noujeim, DDS
Faculty mentor/Co-author e-mail Noujeim@uthscsa.edu
Basic Science Rationale
(Mechanisms that may account for and/or explain the clinical question, i.e. is the answer to the clinical question consistent with basic biological, physical and/or behavioral science principles, laws and research?)
post a rationale
None available
Comments and Evidence-Based Updates on the CAT
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by Muhannad Kaaki (San Antonio, TX) on 07/10/2012
Another laboratory study published in June 2012 (European Journal of Orthodontics) has proven the reliability of CBCT in term of repeatability and reproducibility of cephalometric landmarks which further strengthen the conclusion of this CAT. (PMID: 21566086)

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