A 3D cephalometric protocol for the accurate quantification of the craniofacial symmetry and facial growth

Manuel Pinheiro (Lead / Corresponding author), Xinhui Ma, Michael J. Fagan, Grant T. McIntyre, Ping Lin, Gautham Sivamurthy, Peter A. Mossey

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Abstract

Background: Cephalometric analysis is used to evaluate facial growth, to study the anatomical relationships within the face. Cephalometric assessment is based on 2D radiographic images, either the sagittal or coronal planes and is an inherently inaccurate methodology. The wide availability of 3D imaging techniques, such as computed tomography and magnetic resonance imaging make routine 3D analysis of facial morphology feasible. 3D cephalometry may not only provide a more accurate quantification of the craniofacial morphology and longitudinal growth, but also the differentiation of subtle changes in occlusion. However, a reliable protocol for the computation of craniofacial symmetry and quantification of craniofacial morphology is still a topic of extensive research. Here, a protocol for 3D cephalometric analysis for both the identification of the natural head position (NHP) and the accurate quantification of facial growth and facial asymmetry is proposed and evaluated. A phantom study was conducted to assess the performance of the protocol and to quantify the ability to repeatedly and reliably align skulls with the NHP and quantify the degree of accuracy with which facial growth and facial asymmetry can be measured.

Results: The results obtained show that the protocol allows consistent alignment with the NHP, with an overall average error (and standard deviation) of just 0.17 (9.10e-6) mm, with variations of 0.21 (2.77e-17) mm in the frontonasal suture and 0.30 (5.55e-17) mm in the most prominent point in the chin. The average errors associated with simulated facial growth ranged from 1.83 to 3.75% for 2 years' growth and from - 9.57 to 14.69% for 4 years, while the error in the quantification of facial asymmetry ranged from - 11.38 to 9.31%.

Conclusions: The protocol for 3D skull alignment produces accurate and landmark free estimation of the true symmetry of the head. It allows a reliable alignment of the skull in the NHP independently of user-defined landmarks, as well as an accurate quantification of facial growth and asymmetry.

Original languageEnglish
Article number42
Pages (from-to)1-11
Number of pages11
JournalJournal of Biological Engineering
Volume13
DOIs
Publication statusPublished - 17 May 2019

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Cephalometry
Facial Asymmetry
Head
Growth
Skull
Imaging techniques
Chin
Magnetic resonance
Sutures
Tomography
Magnetic Resonance Imaging
Availability

Keywords

  • Cephalometry
  • Craniofacial morphology
  • Facial growth
  • Facial symmetry
  • Phantom study

Cite this

@article{2b47599cacaa4dbaab7edab520da7993,
title = "A 3D cephalometric protocol for the accurate quantification of the craniofacial symmetry and facial growth",
abstract = "Background: Cephalometric analysis is used to evaluate facial growth, to study the anatomical relationships within the face. Cephalometric assessment is based on 2D radiographic images, either the sagittal or coronal planes and is an inherently inaccurate methodology. The wide availability of 3D imaging techniques, such as computed tomography and magnetic resonance imaging make routine 3D analysis of facial morphology feasible. 3D cephalometry may not only provide a more accurate quantification of the craniofacial morphology and longitudinal growth, but also the differentiation of subtle changes in occlusion. However, a reliable protocol for the computation of craniofacial symmetry and quantification of craniofacial morphology is still a topic of extensive research. Here, a protocol for 3D cephalometric analysis for both the identification of the natural head position (NHP) and the accurate quantification of facial growth and facial asymmetry is proposed and evaluated. A phantom study was conducted to assess the performance of the protocol and to quantify the ability to repeatedly and reliably align skulls with the NHP and quantify the degree of accuracy with which facial growth and facial asymmetry can be measured.Results: The results obtained show that the protocol allows consistent alignment with the NHP, with an overall average error (and standard deviation) of just 0.17 (9.10e-6) mm, with variations of 0.21 (2.77e-17) mm in the frontonasal suture and 0.30 (5.55e-17) mm in the most prominent point in the chin. The average errors associated with simulated facial growth ranged from 1.83 to 3.75{\%} for 2 years' growth and from - 9.57 to 14.69{\%} for 4 years, while the error in the quantification of facial asymmetry ranged from - 11.38 to 9.31{\%}.Conclusions: The protocol for 3D skull alignment produces accurate and landmark free estimation of the true symmetry of the head. It allows a reliable alignment of the skull in the NHP independently of user-defined landmarks, as well as an accurate quantification of facial growth and asymmetry.",
keywords = "Cephalometry, Craniofacial morphology, Facial growth, Facial symmetry, Phantom study",
author = "Manuel Pinheiro and Xinhui Ma and Fagan, {Michael J.} and McIntyre, {Grant T.} and Ping Lin and Gautham Sivamurthy and Mossey, {Peter A.}",
note = "This research was supported by a Wellcome Trust Seed Award in Science to Xinhui Ma for the project Three Dimensional Analysis of Maxillofacial Growth in Patients with Cleft Lip and Palate (grant 205923/Z/17/Z).",
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A 3D cephalometric protocol for the accurate quantification of the craniofacial symmetry and facial growth. / Pinheiro, Manuel (Lead / Corresponding author); Ma, Xinhui; Fagan, Michael J.; McIntyre, Grant T.; Lin, Ping; Sivamurthy, Gautham; Mossey, Peter A.

In: Journal of Biological Engineering, Vol. 13, 42, 17.05.2019, p. 1-11.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A 3D cephalometric protocol for the accurate quantification of the craniofacial symmetry and facial growth

AU - Pinheiro, Manuel

AU - Ma, Xinhui

AU - Fagan, Michael J.

AU - McIntyre, Grant T.

AU - Lin, Ping

AU - Sivamurthy, Gautham

AU - Mossey, Peter A.

N1 - This research was supported by a Wellcome Trust Seed Award in Science to Xinhui Ma for the project Three Dimensional Analysis of Maxillofacial Growth in Patients with Cleft Lip and Palate (grant 205923/Z/17/Z).

PY - 2019/5/17

Y1 - 2019/5/17

N2 - Background: Cephalometric analysis is used to evaluate facial growth, to study the anatomical relationships within the face. Cephalometric assessment is based on 2D radiographic images, either the sagittal or coronal planes and is an inherently inaccurate methodology. The wide availability of 3D imaging techniques, such as computed tomography and magnetic resonance imaging make routine 3D analysis of facial morphology feasible. 3D cephalometry may not only provide a more accurate quantification of the craniofacial morphology and longitudinal growth, but also the differentiation of subtle changes in occlusion. However, a reliable protocol for the computation of craniofacial symmetry and quantification of craniofacial morphology is still a topic of extensive research. Here, a protocol for 3D cephalometric analysis for both the identification of the natural head position (NHP) and the accurate quantification of facial growth and facial asymmetry is proposed and evaluated. A phantom study was conducted to assess the performance of the protocol and to quantify the ability to repeatedly and reliably align skulls with the NHP and quantify the degree of accuracy with which facial growth and facial asymmetry can be measured.Results: The results obtained show that the protocol allows consistent alignment with the NHP, with an overall average error (and standard deviation) of just 0.17 (9.10e-6) mm, with variations of 0.21 (2.77e-17) mm in the frontonasal suture and 0.30 (5.55e-17) mm in the most prominent point in the chin. The average errors associated with simulated facial growth ranged from 1.83 to 3.75% for 2 years' growth and from - 9.57 to 14.69% for 4 years, while the error in the quantification of facial asymmetry ranged from - 11.38 to 9.31%.Conclusions: The protocol for 3D skull alignment produces accurate and landmark free estimation of the true symmetry of the head. It allows a reliable alignment of the skull in the NHP independently of user-defined landmarks, as well as an accurate quantification of facial growth and asymmetry.

AB - Background: Cephalometric analysis is used to evaluate facial growth, to study the anatomical relationships within the face. Cephalometric assessment is based on 2D radiographic images, either the sagittal or coronal planes and is an inherently inaccurate methodology. The wide availability of 3D imaging techniques, such as computed tomography and magnetic resonance imaging make routine 3D analysis of facial morphology feasible. 3D cephalometry may not only provide a more accurate quantification of the craniofacial morphology and longitudinal growth, but also the differentiation of subtle changes in occlusion. However, a reliable protocol for the computation of craniofacial symmetry and quantification of craniofacial morphology is still a topic of extensive research. Here, a protocol for 3D cephalometric analysis for both the identification of the natural head position (NHP) and the accurate quantification of facial growth and facial asymmetry is proposed and evaluated. A phantom study was conducted to assess the performance of the protocol and to quantify the ability to repeatedly and reliably align skulls with the NHP and quantify the degree of accuracy with which facial growth and facial asymmetry can be measured.Results: The results obtained show that the protocol allows consistent alignment with the NHP, with an overall average error (and standard deviation) of just 0.17 (9.10e-6) mm, with variations of 0.21 (2.77e-17) mm in the frontonasal suture and 0.30 (5.55e-17) mm in the most prominent point in the chin. The average errors associated with simulated facial growth ranged from 1.83 to 3.75% for 2 years' growth and from - 9.57 to 14.69% for 4 years, while the error in the quantification of facial asymmetry ranged from - 11.38 to 9.31%.Conclusions: The protocol for 3D skull alignment produces accurate and landmark free estimation of the true symmetry of the head. It allows a reliable alignment of the skull in the NHP independently of user-defined landmarks, as well as an accurate quantification of facial growth and asymmetry.

KW - Cephalometry

KW - Craniofacial morphology

KW - Facial growth

KW - Facial symmetry

KW - Phantom study

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U2 - 10.1186/s13036-019-0171-6

DO - 10.1186/s13036-019-0171-6

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VL - 13

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JO - Journal of Biological Engineering

JF - Journal of Biological Engineering

SN - 1754-1611

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