ABSTRACT
The purpose of this study was to redefine the cephalometric landmarks in three-dimensional (3D) images, which are used in orthodontic cephalometric radiography, and to evaluate the reproducibility of each landmark for 3D cephalometric analysis. Eighteen CT scans were taken at the Department of Diagnostic Radiology at Seoul National University Dental Hospital and manipulated with V works 4.0 (Cybermed Inc., Seoul, Korea). The coordinate system was established using 7 reference points, with no more than 4 points on the same plane. These 7 points were generated as a volume model, the voxel size of which was 4 by 4 by 2 (threshold value = 639). The cephalometric landmarks were selected at the multiplanar reformation (MPR) window on the volume mode of V works 4.0. The selected landmarks were exported to V surgery (Cybermed Inc., Seoul, Korea) for the calculation of coordinate values. All the data were taken twice with a lapse of 2 weeks by one investigator. The reproducibility of each landmark was 0.17 ~ 1.21 mm in the x axis, 0.30 ~ 1.53 mm in the y axis, and 0.27 ~ 1.81 mm in the z axis. In all three axes, the range of error was similar. These error ranges were acceptable with regards to the pixel space and slice thickness. The most reproducible points were I points which were selected on the basis of the volume model. The least reproducible points were J points that were defined by sutures.