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Orthodontics and Dentofacial Orthopaedics, requires a cautious acquisition and interpretation of a large amount of information to achieve a correct diagnosis and treatment planning. Manual techniques are time consuming and tedious. The digital technology is advantageous but the affordability remains obstacle. Objectives: The main aim of this study was to compare the linear and angular measures between the two methods, Ceph Ninja and Nemoceph. No significant difference between the two methods will result in that Ceph Ninja can be used as an alternative. Methods: This study was conducted on 100 digital lateral cephalogram taken from the same machine. The samples were collected by non-probability convenience sampling procedures. These images were analyzed for Steiner’s Cephalometric Analysis using the two software. Results: The results of this study showed the skeletal and dental values had no statistical significant difference in the majority, except for the linear values of Lower Incisor and Upper Incisor with N-A and N-B respectively. Conclusion: It seems that the two software can be used interchangeably with high confidence.
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INTRODUÇÃO: a hipertrofia de adenoide é uma das principais causas da respiração bucal. Entre os métodos utilizados para o diagnóstico dessa condição, os mais precisos são a endoscopia nasal e a ressonância magnética. No entanto, o método mais utilizado, em Odontologia, é a radiografia cefalométrica lateral. OBJETIVO: determinar a eficácia dessa radiografia no diagnóstico da hipertrofia de adenoide, pela sua comparação com a endoscopia nasal. MÉTODOS: foram avaliados 30 indivíduos (7 a 12 anos). Todos fizeram exame de endoscopia nasal e radiografia cefalométrica lateral. Nas endoscopias, foi registrada a porcentagem de obstrução da nasofaringe e, nas radiografias, a menor dimensão anteroposterior livre da nasofaringe. RESULTADOS: os exames se mostraram fortemente correlacionados (r = - 0,793, p-valor < 0,01). Considerou-se portadores de hipertrofia severa de adenoide os pacientes que apresentaram, na endoscopia, obstrução da nasofaringe igual ou superior a 75 por cento e, nas radiografias, o menor diâmetro anteroposterior da nasofaringe igual ou inferior a 5mm; o exame radiográfico teve uma sensibilidade de 75 por cento, especificidade de 86,3 por cento, valor preditivo positivo de 66,7 por cento, valor preditivo negativo de 90,4 por cento e exatidão de 83,3 por cento. CONCLUSÃO: a radiografia cefalométrica lateral se mostrou um exame eficiente para o diagnóstico da hipertrofia de adenoide.
INTRODUCTION: One of the most usual causes of mouth breathing is adenoids hypertrophy with reduction of the nasopharyngeal space. The most precise diagnostic methods are magnetic resonance and nasal endoscopy, because they make possible a three dimension image of the nasopharynx. However, in Dentistry, cephalometric radiography is the method used in the majority of cases. That is why it is so important the evaluation of the efficacy of this diagnostic method. AIM: The aim of this paper is to determine the efficacy of the lateral cephalometric radiography in diagnosing adenoids hypertrophy, comparing this method to the nasal endoscopy. METHODS: Thirty patients (7 to 12 years), with no history of otolaryngological surgery, were evaluated. All of them were submitted to a nasal endoscopy and a lateral cephalometric radiography. In the endoscopic exams it was registered the percentage of nasopharyngeal obstruction and in the radiographic exams it was registered the minor nasopharyngeal dimension. RESULTS: The results of the exams showed a strong correlation with each other (r = - 0.793, p-value < 0.01). After that, reliability tests to the radiographic diagnose were performed, assuming that 75 percent (endoscopic exams) and 5mm (radiographic exams) were the limit values to the determination of the diagnose of severe adenoids hypertrophy. The radiographic exam showed a sensibility of 75 percent, specificity of 86.3 percent, positive predictive value of 66.7 percent, negative predictive value of 90.4 percent and an exactness of 83.3 percent. Therefore, lateral cephalometric radiography is an efficient method of adenoids hypertrophy diagnose. It was proved by the strong correlation of its results with the results of the nasal endoscopy, that is considered a method of excellence for diagnosing this condition.
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Humanos , Masculino , Femenino , Niño , Tonsila Faríngea , Cefalometría , Radiografía , Endoscopía , Respiración por la BocaRESUMEN
OBJETIVOS: avaliar, por meio do traçado cefalométrico e medidas cefalométricas, a dificuldade na localização das estruturas e dos pontos, tanto na radiografia convencional quanto na digital. METODOLOGIA: a amostra constituiu-se de 30 telerradiografias em norma lateral, sendo 15 convencionais e 15 digitais. Essas radiografias foram obtidas de 15 indivíduos brasileiros, adultos, sendo que de cada paciente obteve-se uma radiografia convencional e uma digital. RESULTADOS: com base nos dados obtidos, observou-se que não houve diferença estatisticamente significativa quando comparados os dois métodos de estudo. CONCLUSÕES: sendo assim, concluiu-se que, independentemente do método aplicado, o indivíduo que realiza o traçado, seja manual ou por meio de programas de computador, tanto na radiografia convencional quanto na digital, deve estar treinado e calibrado para a execução do mesmo.
AIM: This study aimed to evaluate, by cephalometric tracing and measurements, the difficulty in the localization of structures and points on both conventional and digital lateral cephalograms. METHODS: The sample comprised 30 lateral cephalograms, being 15 conventional and 15 digital. These radiographs were taken from 15 Brazilian adult subjects, with achievement of one conventional and one digital cephalogram for each subject. RESULTS: The obtained data revealed no statistically significant difference between the two study methods. CONCLUSION: Thus, it was concluded that, regardless of the utilized method, the professional performing the cephalometric tracing, either manually or with a computer software, should be well trained and calibrated for that.
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Humanos , Adulto , Cefalometría , Radiografía Dental/historia , Radiografía Dental/tendencias , Radiografía Dental , Estudios de Evaluación como AsuntoRESUMEN
OBJECTIVE: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. METHODS: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of landmarks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. RESULTS: The difference was from -0.14 +/- 0.65 to -2.12 +/- 2.89 mm in X axis, from 0.34 +/- 0.78 to -2.36 +/- 2.55 mm (6.79 +/- 3.04 mm) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition. CONCLUSIONS: This study revealed innate shortcomings of radiography. For the development of 3D cephalometry, more study was needed.
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Humanos , Vértebra Cervical Axis , Cefalometría , Cabeza , Máscaras , Hueso Occipital , PrognatismoRESUMEN
Um estudo cefalométrico longitudinal e retrospectivo foi desenvolvido com o propósito de estabelecer um cefalograma para a maxila, encontrar pontos cefalométricos estáveis na telerradiografia em norma de 45 graus, e ainda avaliar se as imagens obtidas de um lado da radiografia oblíqua são compatíveis com o outro lado. Foram selecionadas telerradiografias em norma de 45 graus de 25 indivíduos, com faixa etária entre 12 e 17 anos, apresentando maloclusões de Classe I e Classe II de Angle. Todos os indivíduos possuíam radiografias oblíquas iniciais e finais dos lados direito e esquerdo tomadas em um mesmo aparelho de raios X, com um intervalo de 8 a 16 meses. O principal critério de inclusão era a presença de implantes metálicos em todas as telerradiografias , para sobreposições dos traçados cefalométricos. Após estudos em crânio seco e inspeção visual foi sugerido um cefalograma para a maxila constituído das seguintes estruturas anatômicas: contorno da órbita, uma linha da base do crânio, a região do processo zigomático, limites de seio maxilar, a maxila, o processo zigomático da maxila do lado oposto, o osso zigomático do lado oposto e a órbita do lado oposto. Os pontos cefalométricos sugeridos para servir de parâmetro na sobreposição parcial da maxila, em telerradiografias em norma de 45 graus, foram divididos de acordo com o sentido analisado. No sentido vertical os pontos mais estáveis foram: OS, PZI, ENP e PZMO. No sentido horizontal os pontos sugeridos foram: PZP, PZPI, PZI, ENA e A. As alterações anatômicas ocorridas em todos os pontos cefalométricos do lado esquerdo foram iguais as do lado direito, não havendo diferença entre os lados da tomada radiográfica para telerradiografias em norma de 45 graus
A longitudinal and retrospective cephalometric study was developed in order to establish a maxillary cephalogram, to identify stable cephalometric landmarks on 45° radiographs, as well as to evaluate if the obtained images from one side are compatible with the ones from the other side. Forty-five degrees cephalometric radiographs of 25 persons, aged between 12 and 17 years, presenting Angle malocclusion: Class I and Class II were selected. All the persons had pre and post right and left oblique radiographs obtained from the same X ray device, with an interval of eight to sixteen months. The primary inclusion criterion was the presence of metallic implants in all radiographs, to obtain the cephalometric tracings superimpositions. After studies in dried skulls and visual inspection, a maxillary cephalogram was suggested using the following anatomical structures: the orbital contour, a cranial base line, the zigomatic process area, maxillary sinus boundaries, the maxilla; the maxillary zygomatic process, zigomatic bone and orbit of the counter side. The cephalometric landmarks suggested to work parameter for maxillary superimposition in 45º cephalometric radiographs were separated in accordance with the evaluated plane. It can be suggested the use of OS, PZI, PNS and PZMO on vertical planes and PZP, PZPI, PZI, ANS and A on horizontal plane considered the points more stable and reproducible in the sample. The anatomical changes observed in all the cephalometric points of the left side were equivalent to the ones of the right side, with no differences between the sides on 45º cephalometric radiographs
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Humanos , Masculino , Femenino , Adolescente , Cefalometría , Telerradiología , Maloclusión Clase I de Angle , Maloclusión Clase II de Angle , Maxilar , Radiografía Dental , Ortodoncia CorrectivaRESUMEN
The purpose of this study is to evaluate the reproducibility and errors in landmark identification of conventional lateral cephalometric radiography and digital lateral cephalometric radiography. Fifteen conventional lateral cephalometric radiographs and fifteen digital lateral cephalometric radiographs were selected in adults with no considerations on sex and craniofacial forms. Each landmark was identified and expressed as the coordinate (x, y). The landmarks were classified into 3 groups. The landmarks of the first identification was T1, identification after one week was T2, and identification after one month was T3. The mean and standard deviation of identification errors between replicates were calculated according to the x and y coordinates. The errors between first identification and second identification were expressed as T2-T1(x), T2-T1(y) and those between first identification and third identification were expressed as T3-T1(x), T2-T1(y). Each was divided into conventional lateral cephalometric radiography and digital lateral cephalometric radiography. The independent t-test was used for statistical analysis of identification errors for the evaluation of reproducibility. The results of this study were as follows; 1. Generally, the mean and standard deviation of landmark identification errors in digital lateral cephalometric radiography was smaller than those of conventional lateral cephalometric radiography. 2. Only a few landmarks showed statistically significant difference in identification error between conventional lateral cephalometric radiography and digital lateral cephalometric radiography. 3. The enhancement of image quality didn't guarantee decrease in landmark identification error and didn't affect tendency of landmark identification error.