RESUMO
AIM: The aim of this study was to compare four different three-dimensional digitalization methods on the basis of the complex anatomical surface of a cleft lip and palate plaster cast, and to ascertain their accuracy when positioning 3D landmarks. MATERIAL AND METHODS: A cleft lip and palate plaster cast was digitalized with the SCAN3D photo-optical scanner, the OPTIX 400S laser-optical scanner, the Somatom Sensation 64 computed tomography system and the MicroScribe MLX 3-axis articulated-arm digitizer. First, four examiners appraised by individual visual inspection the surface detail reproduction of the three non-tactile digitalization methods in comparison to the reference plaster cast. The four examiners then localized the landmarks five times at intervals of 2 weeks. This involved simply copying, or spatially tracing, the landmarks from a reference plaster cast to each model digitally reproduced by each digitalization method. Statistical analysis of the landmark distribution specific to each method was performed based on the 3D coordinates of the positioned landmarks. RESULTS: Visual evaluation of surface detail conformity assigned the photo-optical digitalization method an average score of 1.5, the highest subjectively-determined conformity (surpassing computer tomographic and laser-optical methods). The tactile scanning method revealed the lowest degree of 3D landmark scatter, 0.12 mm, and at 1.01 mm the lowest maximum 3D landmark scatter; this was followed by the computer tomographic, photo-optical and laser-optical methods (in that order). CONCLUSIONS: This study demonstrates that the landmarks' precision and reproducibility are determined by the complexity of the reference-model surface as well as the digital surface quality and individual ability of each evaluator to capture 3D spatial relationships. The differences in the 3D-landmark scatter values and lowest maximum 3D-landmark scatter between the best and the worst methods showed minor differences. The measurement results in this study reveal that it is not the method's precision but rather the complexity of the object analysis being planned that should determine which method is ultimately employed.
