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Updated: Jan 26, 2026

Author Spotlight: Three-Dimensional Cephalometric Landmark Annotation Demonstration on Human Cone Beam Computed Tomography Scans
Published on: September 8, 2023
Three-dimensional skeletal and dental patterns obtained from cone-beam computer tomography of patients diagnosed as
Hamey Lee1, Hee Soo Oh2, Manuel O Lagravère1
1University of Alberta, Department of Dentistry, Edmonton, Canada.
Abstract:
The purpose of this study was to locate the landmarks both in traditionally-used two-dimensional (2D) lateral cephalogram images and newly suggested landmarks in three-dimensional (3D) cone-beam computer tomography (CBCT) images to determine possible relationships between them and determine if they could be used to classify patients of malocclusion Class I.
Material And Methods:
CBCT images from 30 patients with malocclusion Class I were selected from the university of Alberta Graduate Orthodontic Program database. The images were then reconstructed using the AVIZO® software platform to visualize and locate landmarks. There were a total of forty-two landmarks chosen for analysis, which included pre-existing landmarks used in 2D imaging as well as new landmarks suggested for 3D analysis. Descriptive statistics were also assessed using SPSS statistical package to determine any skeletal and dental relationships.
Results:
Descriptive statistics show that the linear and angular measurements used in 2D images did not correlate well with measurements in CBCT. The lowest standard deviation obtained was 0.04 for S-GoL/N-Me with a mean of 0.70mm. The highest standard deviation was 17.46 for FH-MPL with a mean of 41.53mm.
Conclusion:
The traditional landmarks used for 2D analysis of malocclusion did not show specific skeletal or dental patterns for analysing and classifying 3D images as malocclusion Class I.
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