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Murtazaev Saidazim Saidagzamovich, Ph.D., Tashkent State dental institute senior lecturer, of Prosthodontics and Orthodontics department
E-mail: dr.saidazim@mail.ru Nasimov Elbek Elhonovich, assistant, of Prosthodontics and Orthodontics department
Tashkent State dental institute E-mail: dr.nasimov@gmail.com Voidov Giyos Gulom uglu, student, of the faculty of dentistry Tashkent State dental institute E-mail: giyosvokhidov@mail.ru Aminov Elmurod Komiljonovich, student, of the faculty of dentistry Tashkent State dental institute E-mail: Aminove@gmail.com
Murtazaev Saidmurodkhon Saidaloevich, DMD, Tashkent State dental institute Head of Pediatric dentistry department E-mail: Saidmurodtma@mail.ru
COMPARISON OF THE RESULTS OF SUPERIMPOSITION AS WELL AS MANUAL AND COMPUTER SOFTWARE OF CEPHALOMETRIC IMAGERY
Abstract: 43 pairs of cephalograms were analyzed after pretreatment (T1) and after treatment (T2), 21 men of 22 women. the average value of T2 LD for manual and digital overlays is not zero. However, the differences were small (<1 mm) and could be considered clinically insignificant. Thus, the digital imposition method can accurately duplicate and replace the traditional imposition method for both the cranial base and regional overlays.
Keywords: Computer program, manual tracing, cephalometric analysis.
Introduction. Practitioner orthodontists switch to alogs and superimpositions for orthodontic diagnosis, paperless offices and obtain digital records. This transi- the accuracy of computer tracking software should be tion was partly due to advances in the field of new tech- established by comparing them with manual trace on nologies, which led to the creation of advanced tubeless acetate paper based on the gold standard. There are no cephalometric radiology equipment. Digital radiology differences in the definition of cephalometric reference has several advantages over X-ray film-based systems. points on traditional films or on digital cephalometric The imposition of cephalometric radiographs on specific radiographs. With the help of cephalometric analysis anatomical structures is a method used by clinicians to using the most popular computer programs it is pos-visualize changes in growth and effects of orthodontic sible to create linear and angular measurements, as in treatment on the jaws and teeth. manual measurement. However, only a few studies have
As a basic measure for clinical orthodontic studies, examined cephalometric superimpositions created by regular use is made of superimposition - the imposi- these programs. We did not find any information about tion. Considering the importance of cephalometric an- using a special oriented function for creating digital
settings in V-ceph. As digital radiography becomes more common, manual superimpositions become less attractive. However, many of the problems that exist in the current digital software and they are not controlled by the operator. The purpose of this study was to determine the ability of the operator to produce comparable superimpositions using digital V-ceph and manual methods (gold standard), and to assess the differences between digital imposition of cranium bases and digital SN imposition techniques.
Materials and methods
All patients received complex orthodontic treatment, only radiographs of excellent quality were selected.
- 43 pairs of radiographs were selected after pretreat-ment (T1) and after treatment (T2). X-ray photographs of 22 women and 21 men were used.
Traditional cephalometric reference points (Table 1) were identified on all radiographs using a 0.5 mm pencil. The orthogonal axis was drawn with a pencil on T1 films. Radiographs are scanned and installed into the V-ceph software. Orthogonal axes served to determine the location of reference points between the methods of superimposition for the same object. For the superposition of cranial bases, the horizontal axis was drawn through the Sella-Nasion with the vertical axis through Sella (Figure 1).
Figure 1. The horizontal axis is drawn through the Sella-Nasion points and the vertical axis through Sella
Figure 2. In the maxillary region, the horizontal axis was drawn through the anterior nasal-SNA and posterior nasal-SNP
Figure 3. The horizontal axis was drawn through the front point - Menton
and the back point - Gonion
In the maxillary region, the horizontal axis was drawn through the anterior nasal-SNA and posterior nasal-SNP and the vertical axis through the posterior nasal-SNP (Figure 2).
On the lower jaw, the horizontal axis was drawn through the front point - Menton and the back point - Gonion with a vertical axis through the Gonion (Figure 3).
Each X-ray image was calculated using a manual, digital method and standard cephalometric measurements (SN-FH, SN-MP, SNA, SNB, ANB, U1-SN, L1-MP). Manual drawing was done on acetate paper in a darkened room on a negatoscope. Trace T1 on acetate with superimposition on the film X-ray film using a mechanical pencil with a diameter of 0.3. This trace best suited directly to the T2-X-ray, then depicted in red on the same acetate. Digital superimpositions were completed using V-ceph. All the standard anatomical structures were outlined using software. The peeling was carried out independently of each other. The cranial plane was held on the front of the sella turcica and the inner contour of the frontal bone. Maxillary superimposition is performed along the lower border of the sky and the inner cortical layer of the upper jaw. Mandibular superimposition was performed along the inner contour of the mandibular symphysis.
For the manual and digital method, identical layering methods were used. For the digital method, the function of imposing specially prepared anatomically repeating template structures was applied. Digital cranial base superimpositions are specially prepared anatomically re-
petitive template structures embedded in the software. T2 to trace T1 anywhere.
Using the methods described earlier, digital superpositions based on the best matching of the skull were compared to the digital overlay S-N. In 3 of the 43 x-ray diffraction patterns, the difference between the manual and digital best-placed cranial superimposition was greater (> 1 mm). Thus, 40 X-ray images of patients with a treatment period from 6 months to 5.5 years were collected. These X-rays were divided into three groups, depending on the duration ofthe period T1-T2. Group 1 is patients with a treatment period of 0-2 years, in the second group of patients with a treatment period of 2-3 years, in the third group of patients with a treatment period of more than 3 years.
Discussion
The principal novelty of our study is that the average value of T2 LD for manual and digital superimpositions is not zero. However, the differences were small (< 1 mm) and could be considered clinically insignificant. Thus, the digital imposition method can accurately duplicate and replace the traditional imposition method for both the cranial base and regional superimpositions. When comparing manual and digital superimpositions, the upper limit of 95% confidence in the mean was less than 1 mm for all variables, except for the tip and root (1.09 mm).
In order to prevent the error of identifying the reference point between the manual and digital samples, all the reference points were identified on the original
radiographs from which the manual and digital tracing were created and, thus, this source of errors was significantly reduced or eliminated. Another source of error will be related to superimposition. Data on the range of errors of the cranial base and regional overlap in the literature vary. The method errors found in this study are analogous to the errors found in the literature for the re-producibility of superimpositions. However, it is difficult to quantitatively compare examples of imposition errors due to the many different methods used to calculate and describe errors. Few studies have reported the accuracy of digital superimpositions. The results of the other two studies coincide with the data obtained by us that the digital superimpositions created by computer programs are similar to those obtained manually.
Conclusion
1. There are no differences between the cranial base and the regional superimpositions obtained by V-ceph and the method performed by hand.
2. Given that the differences were within the measurement error, accurate interpretation of the growth and changes resulting from orthodontic treatment is possible.
3. There is some difference in the clinical consistency between the best-placed cranial base and the superposition of S-N. However, since treatment time is longer than 3 years in growing patients, the application of S-N can provide a less accurate idea of growth.
4. This study provides support for the transition from manual to digital superimposition methods.
References:
1.
Арсеньева А. В., Трезубов В. Н., Фабеев Р. А., Особенности получение прямых телеренгенограмм головы для их качественной оценки // Матер. IX Междунар. Конф. Челюстно-лицевых хирургов и стоматологов. СПб., - 25-27 мая. - 2004. - 24 с.
Хорошилкина Ф. Я. Новые возможности определения функциональных нарушений в зубо- челюстно-лице-вой области на основании изучения телерентгенограмм головы // Матер. VIII Междунар. конф. челюстно-лицевых хирургов и стоматологов.- СПб.,- 2003.- С. 175-176.
Хорошилкина Ф. Я. Рентгенологические исследования в ортодонтии: дополнительные возможности улучшения качества диагностики и лечения // Стоматология для всех.- 1999.- № 2-3.- С. 44-46. Хорошилкина Ф. Я. Ортодонтия.- М.: Медицина,- 2006.- 541 с.
Хорошилкина Ф. Я., Малыгин Ю. М., Биллинг В. А. и др. Сравнительный телерентгенологический анализ строения лицевого скелета в период сменного и постоянного прикуса в норме // Науч. тр. Центр, ин-та усоверш. врачей.- М.,- 1989.- Т. 228.- С. 121-125.
Keim R. G., Gottlieb E. L., Nelson A. H., Vogels D. S. JCO orthodontic practice study. part 1: trends. J Clin Or-thod.- 2005.- 39.- P. 641-650.
Chen Y. J., Chen S. K., Yao J. C.C., Chamg H. F. The effects of differences in landmark identification on the cepha-lometric measurements in traditional versus digitized cephalometry. Angle Orthod.- 2004.- 74.- P. 155-161.
8. Mc Clure S. R., Sadowaky P. L., Ferreira A., Jacobson A. Reliability of digital versus conventional cephalometric radiology: a comparative evaluation of landmark identification error. Semin Orthod.- 2005.- 11.- P. 98-110.
9. Ongkosuwito E. M., Katsaros C., van't Hof M. A., Bodegom J. C., Kuijpers-Jagtman A. M. The reproducibility ofcepha-lometric measurements: a comparison of analogue and digital methods. Eur J Orthod.- 2002.- 24.- P. 655-665.
10. Dana J. M., Goldstein M., Burch J. G., Hardigan P. C. Comparative study of manual and computerized cephalometric analyses. J Clin Orthod.- 2004.- 5.- P. 293-296.
11. Gutierrez A. Accuracy of Cephalometric Analysis Using Imaging Software versus Conventional Hand Tracing [thesis]. Bronx, NY: Saint Barnabas Hospital; - 2006.
12. Roden-Johnson D. D. Comparison of Hand-traced and Computerized Cephalograms: Landmark Identification, Measurement and Superimposition Accuracy [thesis]. Houston: The University of Texas Health Science Center at Houston; - 2006.
13. Bruntz L. Q Plomo J. M., Baden S., Hans M. G. A comparison of scanned lateral cephalograms with corresponding original radiographs. Am J Orthod Dentofacial Orthop.- 2006.- 130.- P. 340-348.
2.
6.
7.
14. Santoro M., Jarjoura K., Cangialosi T. J. Accuracy of digital and analogue cephalometric measurements assessed with the sandwich technique. Am J Orthod Dentofacial Orthop.- 2006.- 129.- P. 345-351.
15. Melsen B. The cranial base. Acta Odontol Scand.- 1974.- 32(suppl 62).- P. 9-111.
