Two-dimensional vs 3-dimensional comparison of alveolar bone over maxillary incisors with A-point as a reference

Theodore J. Kula, Ahmed Ghoneima, George Eckert, Edwin T. Parks, Achint Utreja, Katherine Kula

Research output: Contribution to journalArticle

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Abstract

Introduction Our objectives were to compare, relative to A-point, (1) bone thickness over the most forward maxillary incisor (MFMI) in 2 dimensions vs 3 dimensions, and (2) bone thickness and inclination of each maxillary incisor in 3 dimensions. Methods Thirty-four cone-beam computed tomography (CBCT) images were coded, and 2-dimensional (2D) cephalograms were derived from each image using Dolphin software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). A-point and the MFMI crown were located. After reliability tests, alveolar bone buccal to 3 points on the MFMI root, bone to reference line Frankfort horizontal (FH)–A-point, and incisor inclination were measured. This procedure was repeated on the 3-dimensional (3D) CBCT images comparing MFMI with all maxillary incisors. The 2D and 3D measurements were compared using paired t tests, and 3D measurements were compared with analysis of variance. A 5% significance level was used for all tests. Results The MFMI's buccal bone thickness at the root apices and the distance between buccal bone and FH–A-point line at 2 root points were significantly greater in 2 dimensions than in 3 dimensions. In 3 dimensions, bone thickness at MFMI's root apex and the distance from FH–A-point line at all root points were significantly greater than those of the lateral incisors. Bone buccal to MFMI was significantly smaller than at the lateral incisors 3 mm from the cementoenamel junction. Conclusions Evaluation of 2D CBCT derivations can result in overestimation of alveolar bone buccal to the maxillary incisor root apices compared with 3D evaluations. The anterior nasal spine obscures bone measurements over the maxillary incisors in 2 dimensions.

Original languageEnglish (US)
Pages (from-to)836-847.e2
JournalAmerican Journal of Orthodontics and Dentofacial Orthopedics
Volume152
Issue number6
DOIs
StatePublished - Dec 1 2017

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Maxilla
Incisor
Bone and Bones
Cone-Beam Computed Tomography
Cheek
Zygoma
Dolphins
Tooth Cervix
Crowns
Nose
Analysis of Variance
Spine
Software

ASJC Scopus subject areas

  • Orthodontics

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Two-dimensional vs 3-dimensional comparison of alveolar bone over maxillary incisors with A-point as a reference. / Kula, Theodore J.; Ghoneima, Ahmed; Eckert, George; Parks, Edwin T.; Utreja, Achint; Kula, Katherine.

In: American Journal of Orthodontics and Dentofacial Orthopedics, Vol. 152, No. 6, 01.12.2017, p. 836-847.e2.

Research output: Contribution to journalArticle

Kula, Theodore J. ; Ghoneima, Ahmed ; Eckert, George ; Parks, Edwin T. ; Utreja, Achint ; Kula, Katherine. / Two-dimensional vs 3-dimensional comparison of alveolar bone over maxillary incisors with A-point as a reference. In: American Journal of Orthodontics and Dentofacial Orthopedics. 2017 ; Vol. 152, No. 6. pp. 836-847.e2.
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AB - Introduction Our objectives were to compare, relative to A-point, (1) bone thickness over the most forward maxillary incisor (MFMI) in 2 dimensions vs 3 dimensions, and (2) bone thickness and inclination of each maxillary incisor in 3 dimensions. Methods Thirty-four cone-beam computed tomography (CBCT) images were coded, and 2-dimensional (2D) cephalograms were derived from each image using Dolphin software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). A-point and the MFMI crown were located. After reliability tests, alveolar bone buccal to 3 points on the MFMI root, bone to reference line Frankfort horizontal (FH)–A-point, and incisor inclination were measured. This procedure was repeated on the 3-dimensional (3D) CBCT images comparing MFMI with all maxillary incisors. The 2D and 3D measurements were compared using paired t tests, and 3D measurements were compared with analysis of variance. A 5% significance level was used for all tests. Results The MFMI's buccal bone thickness at the root apices and the distance between buccal bone and FH–A-point line at 2 root points were significantly greater in 2 dimensions than in 3 dimensions. In 3 dimensions, bone thickness at MFMI's root apex and the distance from FH–A-point line at all root points were significantly greater than those of the lateral incisors. Bone buccal to MFMI was significantly smaller than at the lateral incisors 3 mm from the cementoenamel junction. Conclusions Evaluation of 2D CBCT derivations can result in overestimation of alveolar bone buccal to the maxillary incisor root apices compared with 3D evaluations. The anterior nasal spine obscures bone measurements over the maxillary incisors in 2 dimensions.

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