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Updated: Oct 7, 2025

Author Spotlight: Three-Dimensional Cephalometric Landmark Annotation Demonstration on Human Cone Beam Computed Tomography Scans
Published on: September 8, 2023
Accuracy of virtual 3-dimensional cephalometric images constructed with 2-dimensional cephalograms using the biplanar
Jae-Seo Lee1, Sang-Rok Kim2, Hyeon-Shik Hwang2
1Department of Oral and Maxillofacial Radiology, School of Dentistry, Chonnam National University, Gwangju, Korea.
Purpose:
The purpose of this study was to evaluate the accuracy of virtual 3-dimensional (3D) cephalograms constructed using the principle of biplanar radiography by comparing them with cone-beam computed tomography(CBCT) images.
Materials And Methods:
Thirty orthodontic patients were enrolled in this study. Frontal and lateral cephalograms were obtained with the use of a head posture aligner and reconstructed into 3D cephalograms using biplanar radiography software. Thirty-four measurements representing the height, width, depth, and oblique distance were computed in 3 dimensions, and compared with the measurements from the 3D images obtained by CBCT, using the paired t-test and Bland-Altman analysis.
Results:
Comparison of height, width, depth, and oblique measurements showed no statistically significant differences between the measurements obtained from 3D cephalograms and those from CBCT images (P>0.05). Bland-Altman plots also showed high agreement between the 3D cephalograms and CBCT images.
Conclusion:
Accurate 3D cephalograms can be constructed using the principle of biplanar radiography if frontal and lateral cephalograms can be obtained with a head posture aligner. Three-dimensional cephalograms generated using biplanar radiography can replace CBCT images taken for diagnostic purposes.

