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

PubMed ID	Author / Year	Patient Group	Study type (level of evidence)
21898195	Medelnik/2011	1 Cadaver Head	Clinical Trial
Key results	High 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.
21640864	Leonelli/2011	10 Dry Human Skulls	Comparative Study
Key results	2D 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.
21803252	El-Beialy/2011	1 Dry Human Skull	Clinical Study
Key results	Concordance 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

(Oral Medicine/Pathology/Radiology) (Orthodontics)

Keywords

CBCT, cone beam CT, orthodontic landmarks

ID#

2141

Date of submission

09/23/2011

E-mail

hashem@uthscsa.edu

Author

Mohannad Hashem

Co-author(s)

Co-author(s) e-mail

Faculty mentor

Marcel Noujeim, DDS

Faculty mentor 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?)

None available

Comments and Evidence-Based Updates on the CAT
(FOR PRACTICING DENTISTS', FACULTY, RESIDENTS and/or STUDENTS COMMENTS ON PUBLISHED CATs)

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)