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Study on the reproducibility of the Frankfort horizontal plane based on CBCT 3D reconstruction and comparative
Zhiwen Li1, Liuli Jin2, Xueyang Zhang1,2
1Department of Stomatology, The Eighth Affiliated Hospital of Southern Medical University (The First People's Hospital of Shunde), Foshan, China.
Objective:
To investigate the reproducibility of the Frankfort horizontal plane (FHP) established using CBCT-based three-dimensional reconstruction and to evaluate reproducibility errors generated by CBCT and lateral cephalometric reference-construction workflows in patients with facial deformities.
Methods:
A total of 27 patients with facial deformities were enrolled. All subjects underwent both CBCT scanning and lateral cephalometric radiography. For the CBCT data, three-dimensional craniofacial models were reconstructed using Mimics 21.0 and Geomagic Studio 2014, and the FHP was established accordingly. For lateral cephalometric radiographs, bilateral orbitale and porion landmarks were manually identified using Adobe Photoshop 2024. Two experienced orthodontists independently performed landmark identification twice. Landmark positional errors and plane angular errors were calculated. Intra-class correlation coefficients (ICCs) were used to assess reproducibility, Bland-Altman analysis was applied to evaluate agreement, and paired t tests were performed to evaluate differences in reproducibility errors generated by the CBCT and lateral cephalometric workflows.
Results:
The CBCT 3D reconstruction method demonstrated good reproducibility for all landmarks and planes when establishing FHP, while lateral cephalometric measurements exhibited larger reproducibility errors than the CBCT workflow (p < 0.05).
Conclusion:
CBCT-based three-dimensional reconstruction demonstrated high reproducibility for Frankfort horizontal plane construction. This technique may provide a reliable reference framework for the diagnosis and treatment planning of patients with facial deformities.

