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Title CBCT Is More Accurate For Craniometric Measurements Than Standard Cephalometric Imaging
Clinical Question Is Cone-Beam Computed Tomography (CBCT) more accurate than cephalometric radiography for skull measurements?
Clinical Bottom Line The accuracy of CBCT is equal to, or greater than, cephalometric radiography for various craniometric and cephalometric measurements, using craniometry as a gold standard. (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) 20936951Gribel/ 201125 skullsLab Study
Key resultsThe difference between the craniometric and cephalometric measurements was statistically significant, Turkey test P<0.05 and some measurements in the standard cephalometric imaging were larger and other smaller; but this difference was not statistically significant (ANOVA) P>0.05. The mean difference was 0.01mm and all the measurements were no more than 0.03 mm different from the gold standard.
#2) 20936949Yitschaky/201110 skullsLab Study
Key resultsThere was no difference for linear measurements between the two types of images the only measurement that showed significant difference was the AO-BO with a P value of 0.054. There was no difference for most of the angular cephalometric measurements except the ones that depend of the sella turcica such as SNA.
#3) 20044238Vlijmen/ 200940 skullsLab Study
Key resultsA statistically significant difference was found for: ANB,SNB,NL/ML,NSL/BOP,NSL/NL,NSL/ML. The average difference was between -3.11 to 0.82. For most measurements the difference was smaller than the standard deviation.
Evidence Search Search ("Orthodontics"[Mesh]) AND "Cone-Beam Computed Tomography"[Mesh]Search ("Orthodontics"[Mesh]) AND "Cone-Beam Computed Tomography"[Mesh] Limits: Comparative Study, Controlled Clinical Trial
Comments on
The Evidence
In the article by Gribel the gold standard was acceptable, but it was not blind to target test, the gold standard was used for the skulls and there were not competing interests. In the article by Yitschaky the gold standard was acceptable, there was no competing interest and the gold standard was applied to all the skulls. In the article by Vlijmen there was not competing interests, the gold standard was not measured blind to the target test and it was used in all the skulls.
Applicability As these comparisons were performed on dry skulls rather than patients, we have the benefit of a good standard but less-than-desired generalizability.
Specialty/Discipline (Oral Medicine/Pathology/Radiology) (General Dentistry) (Orthodontics)
Keywords Cone Beam Computer Tomography
ID# 774
Date of submission: 03/15/2011spacer
E-mail lanternier@livemail.uthscsa.edu
Author Margarita Lanternier
Co-author(s) e-mail
Faculty mentor/Co-author S. Thomas Deahl, II, DMD, PhD
Faculty mentor/Co-author e-mail DEAHL@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 on the CAT
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by Brian Schweers, Suzzane Horani, Linh Quach (San Antonio, TX) on 01/06/2014
A PubMed search was conducted in Jan 2014 which found more recent articles such as PMID: 24262417 (Silva 2013) and 23785942 (Cheung 2013). These and other articles further validated that CBCT is a more reliable measurement tool. Silva 2013 used live patients as subjects instead of dry skulls used in this CAT.

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