Orthodontic soft-tissue parameters: A comparison of cone-beam computed tomography and the 3dMD imaging system

Tasha E. Metzger, Katherine S. Kula, George J. Eckert, Ahmed A. Ghoneima

Research output: Contribution to journalArticle

19 Scopus citations


Introduction Orthodontists rely heavily on soft-tissue analysis to determine facial esthetics and treatment stability. The aim of this retrospective study was to determine the equivalence of soft-tissue measurements between the 3dMD imaging system (3dMD, Atlanta, Ga) and the segmented skin surface images derived from cone-beam computed tomography. Methods Seventy preexisting 3dMD facial photographs and cone-beam computed tomography scans taken within minutes of each other for the same subjects were registered in 3 dimensions and superimposed using Vultus (3dMD) software. After reliability studies, 28 soft-tissue measurements were recorded with both imaging modalities and compared to analyze their equivalence. Intraclass correlation coefficients and Bland-Altman plots were used to assess interexaminer and intraexaminer repeatability and agreement. Summary statistics were calculated for all measurements. To demonstrate equivalence of the 2 methods, the difference needed a 95% confidence interval contained entirely within the equivalence limits defined by the repeatability results. Results Statistically significant differences were reported for the vermilion height, mouth width, total facial width, mouth symmetry, soft-tissue lip thickness, and eye symmetry. Conclusions There are areas of nonequivalence between the 2 imaging methods; however, the differences are clinically acceptable from the orthodontic point of view.

Original languageEnglish (US)
Pages (from-to)672-681
Number of pages10
JournalAmerican Journal of Orthodontics and Dentofacial Orthopedics
Issue number5
StatePublished - Nov 1 2013

ASJC Scopus subject areas

  • Orthodontics

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