Three-dimensional computed tomography cephalometric craniofacial analysis: experimental validation in vitro

The development of three-dimensional (3D) cephalometric analysis is essential for the computer-assisted planning of orthognathic surgery. The aim of this study was to transform and adapt Delaire's two-dimensional cephalometric analysis into the third dimension; this transposition was then validated. The comparative advantage of using 3D computed tomography (CT) surface renderings over profile X-rays was analysed. Comparison was made of inter- and intra-observer reproducibility of the cephalometric measurements done on profile X-rays and on 3D CT surface renderings on the same 26 dry skulls. The accuracy was also tested of the measurements done on 3D CT surface renderings (ACRO 3D©) in relation to those directly taken on dry skulls with the help of a 3D measuring instrument. Inter- and intra-observer reproducibility proved significantly superior (p < 0.0001) following the 3D CT method. There were no significant differences in the accuracy of measurements between the ACRO 3D software and the 3D measuring instrument. The ACRO 3D software was confirmed as being a reliable tool for developing 3D CT cephalometric analyses. Further research may entail clinical validation of the 3D CT craniofacial cephalometric method of analysis.