Related Experiment Video
Updated: Jun 21, 2026
Three-Dimensional Cephalometric Landmark Annotation Demonstration on Human Cone Beam Computed Tomography Scans
Published on: September 8, 2023
Accuracy and reliability of linear cephalometric measurements from cone-beam computed tomography scans of a dry human
Mauricio Berco1, Paul H Rigali, R Matthew Miner
1Department of Developmental Biology, Harvard School of Dental Medicine, Harvard University, Boston, Mass, USA.
Introduction:
The purpose of this study was to determine the accuracy and reliability of 3-dimensional craniofacial measurements obtained from cone-beam computed tomography (CBCT) scans of a dry human skull.
Methods:
Seventeen landmarks were identified on the skull. CBCT scans were then obtained, with 2 skull orientations during scanning. Twenty-nine interlandmark linear measurements were made directly on the skull and compared with the same measurements made on the CBCT scans. All measurements were made by 2 operators on 4 separate occasions.
Results:
The method errors were 0.19, 0.21, and 0.19 mm in the x-, y- and z-axes, respectively. Repeated measures analysis of variance (ANOVA) showed no significant intraoperator or interoperator differences. The mean measurement error was -0.01 mm (SD, 0.129 mm). Five measurement errors were found to be statistically significantly different; however, all measurement errors were below the known voxel size and clinically insignificant. No differences were found in the measurements from the 2 CBCT scan orientations of the skull.
Conclusions:
CBCT allows for clinically accurate and reliable 3-dimensional linear measurements of the craniofacial complex. Moreover, skull orientation during CBCT scanning does not affect the accuracy or the reliability of these measurements.
