Reliability of three-dimensional anterior cranial base superimposition methods for assessment of overall hard tissue...

The purpose of this systematic review was to synthesize the available literature concerning the reliability of three-dimensional superimposition methods when assessing changes in craniofacial hard tissues.

Four electronic databases were searched. Two authors independently reviewed potentially relevant articles for eligibility. Clinical trials, cohort, case-control, and cross-sectional studies that evaluated the reliability of three-dimensional superimposition methods on the anterior cranial base were included.

Six studies fulfilled the inclusion criteria. Four studies used the voxel-based registration method, one used the landmark-based method and one used the surface-based method. Regarding reliability, the voxel-based studies showed on average a difference of 0.5 mm or less between images. The optimized analysis using a six-point correction algorithm in the landmark-based method showed 1.24 mm magnitude of error between images.

Although reliability appears to be adequate, the small sample size and high risk of bias among studies make available evidence still insufficient to draw strong conclusions.