Plane orientation for standardization in 3-dimensional cephalometric analysis with computerized tomography imaging

Introduction: The purpose of this study was to propose certain landmarks and planes to standardize 3-dimensional image orientation. Methods: Cone-beam computerized tomographic images were obtained from 10 adolescent patients and analyzed with AMIRA software (AMIRA, Mercury Computer Systems, Berlin, Germany). Results: Four points (ELSA, right superior external auditory meatus, left superior external auditory meatus, and mid-dorsum foramen magnum) were located on each image. The axial-horizontal plane (x-y plane) was then determined by using both superior external auditory meatus and ELSA; the sagittal-vertical plane (z-y plane) was formed by ELSA and mid-dorsum foramen magnum perpendicular to the x-y plane. Conclusions: All points had high intrareliability and were adequate for standardizing the orientation of 3-dimensional images.