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[Serial determinations of serum oxytocinase and ultrasonic biparietal cephalometry in normal and high-risk pregnancies].

The value of sonor biparietal cephalometry and serum oxytocinase that we have obtained with weekly simultaneous determinations in 14 females with normal pregnancy and in 5 with pathological pregnancy, from 24th to 39th week, show a statical positive relation. Serum oxitocinase determination against hormonal tests of the phetoplancental function (urinary oestriol, pregnandiol, serum HCS, ecc.) give advantages: it is the easyer, faster and less espandove determination. Therefore we think that it is helpful to determin togheter serial values of sonar biparietal cephalometry and serum oxytocinase to anticipate the endouterine fetal growth retardation.

Aminopeptidases↗
PubMed1995

Facial anthropometrics versus cephalometry as predictors for surgical treatment in patients with Class III dentofacial deformities.

The purpose of this study was to determine statistically the relative importance of facial anthropometrics and cephalometry in diagnosing the specific jaw deformity in patients with Class III relationships, ie, the contribution that maxillary deficiency and/or mandibular prognathism made to the Class III deformity. Frontal and right profile photographic views and pretreatment lateral cephalometric radiographs of 20 randomly selected Class III patients were analyzed. Correlation and multiple-regression analyses were utilized to determine the relative importance of clinical diagnosis and cephalometric diagnosis in determining the actual surgery performed. In addition, these analyses determined the relative importance of the various facial anthropometrics and cephalometric parameters critical to making the specific diagnosis of maxillary deficiency and/ or mandibular prognathism. It was concluded that a jaw-specific diagnosis of the Class III population studied was best made with facial anthropometrics rather than cephalometry, and the most important predictive facial features on which to based this diagnosis were paranasal configuration and chin projection. Although the overall cephalometric diagnosis had no statistically significant correlation to the actual surgery preformed, two individual cephalometric parameters, maxillary first molar to pterygoid vertical and mandibular plane angle, were found to statistically correlate to the actual surgery performed. These cephalometric parameters should be scrutinized along with the facial anthropometric data when the jaw-specific surgery is selected.

Anthropometry↗
PubMed2004

Image processing for craniofacial landmark identification and measurement: a review of photogrammetry and cephalometry.

Facial surface anthropometry and cephalometry have been used for many years for the diagnosis of malformations, surgical planning and evaluation, and growth studies. These disciplines rely on the identification of craniofacial landmarks. Methods for 3D reconstruction of landmarks have been introduced, as have image processing algorithms for the automation of landmark extraction. This paper reviews facial surface anthropometry and cephalometry with reference to the image processing algorithms that have been applied and their effectiveness.

Algorithms↗
PubMed2001

Three-dimensional cephalometry using individual skeletal laser technology models.

When planning operations on the facial skull, transversal asymmetries of the maxillo-mandibular complex cannot be adequately assessed using conventional two-dimensional (2D) x-ray cephalometry. On eight patients who presented with facial skull asymmetries, a three-dimensional (3D) laser technology model (LTM) using CT data was fabricated. Five sagittal plane points and six symmetry points were marked on the LTM, measured with the FlashPoint 3-D Digitizer and then geometrically converted, such that using the sagittal plane points, sella, basion, and nasion, a method could be developed that allowed the localization of each spatial point in the three symmetry planes. Thus one could quantitatively record a patient's specific facial skull asymmetry in all three planes and a 3D measurement became feasible. Based on the measurements, the asymmetry could be assessed with respect to the sagittal, vertical, and horizontal planes. With the 3-D LTM Digitizer measuring system, the surgeon now had precise numerical information regarding the symmetry ratios of the skull at his disposal, information that would have been difficult to evaluate solely using a model analysis. The results from this study show that our measuring system is applicable and useful for complex maxillofacial asymmetries. The planning of surgical interventions was optimized because precise numerical values regarding the degree of the asymmetry were available. With the 3-D LTM Digitizer measuring system, cephalometric analysis of complex asymmetries in the three spatial planes can be pragmatically supported.

Cephalometry↗
PubMed2005

Classification of anterior open bite using individualized cephalometry.

OBJECTIVE: The objective of this study was to describe the cephalometric characteristics of the open bite, and to classify the open bite according to individualized norms. MATERIAL AND METHOD: The lateral cephalograms of 134 patients with an anterior open bite (min -0.5 mm) were analyzed. Patients were classified according to the inclination of the jaws, applying the principles of individualized cephalometry. The harmony box described by Hasund was used to define individualized norms for the inclination of the upper and lower jaws in each patient. The open bite was classified into four sub-types: (1) dental, (2) skeletal with enlarged ML-NSL angle, (3) skeletal with reduced ML-NSL angle, and (4) skeletal with deviations in upper and lower jaws. A skeletal open bite was found in 89 patients (66.4%). A dental open bite was found in 45 patients (33.6%). RESULTS: A number of significant differences were found between these four groups using single-factor variance analysis and the Bonferroni a posteriori test, (p < or = 0.05, p < or = 0.01, p < or = 0.001). The most prominent variables were index value of anterior facial hight, total facial height ratio, gonial angle, and Y-axis. No significant differences were found for overbite, however. CONCLUSION: It was possible to use individualized norms to classify the open bite into four sub-types. The demarcation between the four groups was supported statistically. The extent of the anterior open bite does not allow any conclusions as to the craniofacial pattern.

Adolescent↗
PubMed1979

Amniotic fluid phosphatidylglycerol and real-time ultrasonic cephalometry.

The fetal biparietal diameter (BPD) was measured at the time of real-time ultrasound-directed amniocentesis in 159 cases and a phospholipid profile was obtained from the amniotic fluid. BPD measurements of 9.0, 8.7, and 9.2 cm were then compared with a lecithin/sphingomyelin (L/S) ratio greater than or equal to 2.0 for the ability to predict the presence of phosphatidylglycerol (PG) in the profile. The data from the diabetic and nondiabetic patients were analyzed separately. The results demonstrated that in the presence of a L/S ratio greater than or equal to 2.0 the BPD does not aid in the identification of amniotic fluid samples which contain PG in either the diabetic or nondiabetic groups. The data also confirmed previous findings that the BPD is not a reliable predictor of the L/S ratio. It is concluded that for the detection of PG in amniotic fluid, the use of real-time ultrasonic cephalometry cannot substitute for the performance of the phospholipid profile.

Amniotic Fluid↗
PubMed1980

Sonar cephalometry in twin pregnancy: discordancy of the biparietal diameter after 28 weeks' gestation.

Sonar measured biparietal diameter (BPD) differences of twin paires were examined in 123 twin pregnancies at or beyond 28 weeks' gestation. Among 117 liveborn sets, the risk of a twin infant being small for gestational age was threefold greater when paired BPD differences were 5 mm or more compared to 4 mm or less. The incidence of fetal death increased from 2.7% for twin pairs with 0 to 6 mm BPD differences to 20% when the difference was 7 mm or more. Sonar cephalometry may be helpful in the antepartum evaluation of twin pregnancies, although detection of BPD discordancy does not preclude normal twin outcome.

Adult↗
PubMed2004

Comparison between traditional 2-dimensional cephalometry and a 3-dimensional approach on human dry skulls.

The cephalogram is the standard used by orthodontists to assess skeletal, dental, and soft tissue relationships. This approach, however, is based on 2-dimensional (2D) views used to analyze 3-dimensional (3D) objects. The purpose of this project was to evaluate and compare a 3D imaging system and traditional 2D cephalometry for accuracy in recording the anatomical truth as defined by physical measurements with a calibrated caliper. Thirteen skeletal landmarks were located by both radiographic methods on 9 dry human skulls. Intraclass correlation (0.995), variance (0.054 mm(2)), and standard deviation (SD) (0.237 mm) were averaged over 76 measurements and derived from precision calipers to establish these physical measurements as a reliable gold standard to make comparisons of the 2D and 3D radiographic methods. The results showed great variability of the 2D from the gold standard, with the range varying from -17.68 mm (underestimation of Gn-Zyg R) to +15.52 mm (overestimation of Zyg L-Zyg R). In contrast, the 3D method (Sculptor, Glendora, Calif) indicated a range of the SD from -3.99 (underestimation) mm to +2.96 mm (overestimation). The 3D evaluation was much more precise, within approximately 1 mm of the gold standard. These results indicate that, when the actual distance is measured on a human skull in its true dimensions of 3D space, the Sculptor program, by using a 3D method, is more precise and 4 to 5 times more accurate than the 2D approach. Evaluating distances in 3D space with a 2D image grossly exaggerates the true measure and offers a distorted view of craniofacial growth. There is an inherent problem of representing a linear measure occupying a 3D space with a 2D image.

Analysis of Variance↗
PubMed2005

Three-dimensional fetal cephalometry: an evaluation of the reliability of cephalometric measurements based on three-dimensional CT reconstructions and on dry skulls of sheep fetuses.

AIM: To develop a 3D CT cephalometric analysis for maxillary growth evaluation of sheep fetuses operated in utero, and to evaluate the reliability of this analysis by comparing it with a direct cephalometric analysis on dry skulls. MATERIAL AND METHODS: Five skulls of operated sheep fetuses were used, which after preparation were CT scanned and a 3D reconstruction was performed. A cephalometric analysis was performed directly on the dry skulls as well as on the reconstructed 3D CT images. In total, 56 linear distances were measured. In order to access the error of the method, the procedure was repeated after a 2 week interval. RESULTS: The comparison between the direct cephalometric and the 3D CT analysis revealed that only 5 variables were significantly different. The evaluation of the error of method revealed that 7 variables of the direct cephalometric analysis and none of the 3D CT analysis differed significantly. CONCLUSIONS: According to the results of this study, it can be concluded that a cephalometric analysis on 3D CT reconstructed images of the skulls includes fewer identification errors and seems to be an accurate and reliable method that could be regarded at least as equivalent to conventional cephalometry.

Animals↗
PubMed1994

An evaluation of growth changes and treatment effects in Class II, Division 1 malocclusion with conventional roentgenographic cephalometry and finite element method analysis.

Conventional methods of roentgenographic cephalometry will yield differences in interpretation of growth or treatment changes depending on which methods of superimposition are used. The finite element method of analysis has been reported to have significant advantages since it does not require a reference frame to describe the changes that have taken place. This article describes the growth of a patient with a Class II, Division 1 malocclusion during approximately 2 years of orthodontic treatment with the use of conventional cephalometric growth and static analyses, as well as the finite element method. Thirty cephalometric points were digitized on the pretreatment and the posttreatment lateral cephalograms of a patient undergoing orthodontic treatment between the ages of 10 and 12 years. The finite element method provided a reference frame invariant description of the size, shape, change, and rotation of each of the 12 finite elements representing different anatomic structures.

Cephalometry↗
PubMed2000

Comparison of landmark identification in traditional versus computer-aided digital cephalometry.

The aim of this study was to assess landmark identification on digital images in comparison with those obtained from original radiographs. Ten cephalometric radiographs were selected randomly. Seven orthodontic residents identified 19 cephalometric landmarks on both the original radiographs and the digital images. To assess the concordance between landmarks identified on the original radiographs and on their digital counterparts, the x, y coordinates for each landmark in the 2 modalities were transformed with the identical references. The placement differences for 19 landmarks between 2 methods were calculated and their components in horizontal and vertical directions were analyzed respectively. Multivariate analysis of variance showed that the "cephalometric radiograph" and "landmark" variation had greater influence than that from "method" (landmark identification on digital / original radiograph). It was also noted that the differences of landmark identification between original radiographs and their digital counterparts were statistically significant. The landmarks with significant differences of horizontal component on the x-axis were Me, Gn, ANS, PNS, LIA. The differences were generally under 1 mm with the exception of Or, Me, PNS, LIA. The landmarks with significant differences of vertical component on the y-axis were Po, Or, Gn. The inter-observer error for each landmark in digital images was generally larger than that in the original radiographs. However, statistically significant differences of inter-observer errors between 2 modalities were only found for 4 of the 19 landmarks. These 4 landmarks, Po, Ar, ANS, and UM, should be scrutinized more carefully during potential applications of digital cephalometry.

Analysis of Variance↗
PubMed2002

Three-dimensional cephalometry using helical computer tomography: measurement error caused by head inclination.

We performed a study of three-dimensional (3-D) linear measurements in the maxillofacial region using helical computer tomography (CT). The high accuracy of the linear measurements showed errors of less than 5% from the actual measures. But, it is possible that the accuracy was influenced by inaccurate head positions. In this study, we evaluated the errors when the head positions were tilted using the 3-D measurement system. Helical CT was used to scan a dry skull, and the data were reconstructed into a 3-D image. A total of 18 points were plotted on the 3-D images, and the distance between two points was calculated when the points were expressed as coordinates. A dry skull was tilted by 10 degrees from the reference position in the horizontal, sagittal, and frontal planes and was then tilted in a combination of directions. Scanning was performed with slice thicknesses of 1 mm, 3 mm, 5 mm, and 7 mm. The length between two points measured by 3-D cephalometry was compared with the actual length determined using an antenna meter and a caliper and expressed as percentage errors of the actual length. In all head positions, errors in all linear measurements on the images and the actual length measured on the skull were less than 5% when a slice thickness of 1 mm or 3 mm was used. But, on using a slice thickness of 5 mm or 7 mm, some linear measurements showed larger measurement errors. Therefore, a thickness of less than 3 mm was thought to be clinically appropriate because the accuracy of the measurements was not influenced by head rotation.

Cephalometry↗
PubMed2004

The effects of differences in landmark identification on the cephalometric measurements in traditional versus digitized cephalometry.

The aim of this study was to explore the effects of differences in landmark identification on the values of cephalometric measurements on digitized cephalograms in comparison with those obtained from original radiographs. Ten cephalometric radiographs were randomly selected from orthodontic patients' records. Seven orthodontic residents identified 19 cephalometric landmarks on the original radiographs and digitized images. Twenty-seven cephalometric measurements were computed with a customized computer-aided program. To assess the concordance between cephalometric measurements derived from landmarks identified on the original radiographs and those from digitized counterparts, the values of 27 cephalometric measurements were compared to quantify the absolute value of measurement difference and the interobserver errors between these two methods. We found that the differences of all cephalometric measurements between original radiographs and their digitized counterparts were statistically significant. The differences in 21 of the 27 cephalometric items were less than two units of measurement (mm or degree), which is generally within one standard deviation of norm values in conventional cephalometric analysis. Moreover, statistically significant differences of interobserver errors between the two methods were noted only for seven of the 27 cephalometric items. In conclusion, the measurement differences between the original cephalograms and the digitized images are statistically significant but clinically acceptable. The interobserver errors for cephalometric measurements on our digitized cephalometric images are generally comparable with those on the original radiographs. The results of our study substantiated the benefits of digital cephalometry in terms of the reliability of cephalometric analysis.

Cephalometry↗
PubMed2001

Effect of Sandostatin LAR on sleep apnoea in acromegaly: correlation with computerized tomographic cephalometry and hormonal activity.

OBJECTIVES: Sleep apnoea has been reported to occur in subjects with acromegaly. This study evaluates the relationship among biochemical activity, sleep apnoeic activity and upper airway anatomic profile in acromegaly, and the effect of Sandostatin LAR, a long-acting somatostatin analogue, on these parameters. PATIENTS: Fourteen subjects with acromegaly were recruited. MEASUREMENTS: Subjects were assessed at baseline and those with apnoea-hypopnoea index (AHI) > or = 5 were reassessed after 6 months of treatment with Sandostatin LAR 20-30 mg IMI 4-weekly. Biochemical activity was assessed with levels of GH and IGF-1. Sleep disordered breathing was assessed with overnight polysomnography. Upper airway anatomic profile was defined with computerized tomographic cephalometry. RESULTS: Of 14 subjects (age 42.0 +/- 8.1 years, mean +/- SD; 11 men) at baseline, there was a positive correlation between GH and tongue length (VT; P = 0.004), and between AHI and cephalometric indices: length of soft palate (PMU; P = 0.002); mandibular plane-hyoid bone distance (MPH; P = 0.017), maximum thickness of soft palate (Max-SP; P = 0.018) and VT (P = 0.027). Eight patients had sleep disordered breathing (AHI > or = 5) which was predominantly obstructive in nature (AHI = 29.4 +/- 22.6). After treatment, there were significant improvements in hormonal profile: GH, mU/l (before, 51.5 +/- 27.8; after, 8.0 +/- 7.4; P = 0.017) and IGF-1, nmol/l (before, 95.5 +/- 23.4; after, 35.0 +/- 12.4; P = 0.012); sleep-disordered breathing: AHI (before, 29.4 +/- 22.6; after, 13.4 +/- 11.12; P = 0.025), snoring episodes (before, 486 +/- 240; after, 165 +/- 170; P = 0.05); cephalometric indices, mm: MPH (before, 18.8 +/- 12.1; after, 14.8 +/- 8.4; P = 0.018), VT (before, 72.3 +/- 4.4; after, 69.7 +/- 4.3; P = 0.05). There was a positive correlation between the reduction in GH and AHI (r = 0.738, P = 0.037). CONCLUSIONS: The findings demonstrated that there was correlation between sleep apnoea severity and soft tissue overgrowth at the upper airway region in acromegaly. They also suggest that Sandostatin LAR improved obstructive sleep apnoea in acromegaly, and the effect might be partly mediated via a reduction in upper airway soft tissue, in particular that of the tongue, concomitant with a reduction in GH levels.

Acromegaly↗
PubMed1997

Uvulopalatopharyngoplasty for the obstructive sleep apnoea syndrome: value of polysomnography, Mueller manoeuvre and cephalometry in predicting surgical outcome.

Sixty consecutive patients with the obstructive sleep apnoea syndrome (53 men and seven women) were analysed by questionnaire, polysomnography, röntgenographic cephalometry and the Mueller manoeuvre before and 6 months after uvulopalatopharyngoplasty (UPPP), to assess the surgical outcome and the prognostic value of preoperative evaluation. Seventy-three per cent of patients reported improvement of snoring and 55% reported improvement of excessive daytime sleepiness. Thirty-five per cent showed a decrease of at least 50% in the desaturation index, and 13% had a postoperative desaturation index below 5. Although the improvement of desaturation parameters was marked in some patients, the overall change was not significant. Neither the Body Mass Index (BMI), nor any of the cephalometric variables were significantly correlated to surgical outcome. Increased difference in collapsibility between the soft palate and the base of the tongue showed a close to significant relation with the improvement of desaturation index. High desaturation index, low mean saturation and deep lowest saturation were found to be slightly predictive of improvement in nocturnal desaturation. In a multivariate analysis however no significant predictors could be identified. It is concluded that UPPP is effective in reducing snoring and daytime sleepiness over a 6-month follow-up period, but that the overall improvement in nocturnal desaturation is limited and difficult to predict. Further research is needed to evaluate the long-term efficacy of UPPP.

Body Mass Index↗
PubMed1976

Fetal cephalometry. An improved method and an evaluation.

A method of fetal cephalometry is described which is an advance on the combined A and B scan technique previously used. A flow chart has been prepared which clearly specifies the procedure to be followed. The criteria used when making an estimation are reported. The method is applicable to various types of machine and it can be taught to a good degree of accuracy in a short time to people with limited obstetric knowledge. There may be a significant difference between operators but this difference is roughly the same from patient to patient and decreases with training. It is considered that the chief source of variation is the failure to measure the same diameter on each occasion.

Analysis of Variance↗
PubMed1978

A comparison of biparietal diameter measurements using a real-time scanner and a conventional scanner equipped with a coded cephalometry system.

In 131 patients a comparison was made between measurements obtained using a real-time scanner and those obtained using a conventional "B" scanner with an attached "coded cephalometry system": 69 per cent of the readings agreed within +/- 2 mm and, when the "B" scan reading was considered "good", 90 percent fell within this range. Between 14 and 28 weeks, gestational age diagnoses using the two methods were within one week of each other in 88 of 89 patients.

Cephalometry↗
PubMed1979

Dynamic fetal cephalometry.

An iterative method of fetal cephalometry for use with real time scanners is described using a flow chart. The method is shown to be capable of yielding measurements having a standard deivation of less than 1 mm and we have found it to be superior to the combined A and B scan technique from which it is derived.

Cephalometry↗