Comparative Analysis of Cephalometric Measurements Based on 2d and 3d Imaging Methods

Digital planning of orthodontic treatment has numerous advantages, such as reduced radiation doses, simplified image acquisition, data archiving and sharing as well as easy treatment planning design. Two-dimensional (2D) cephalometric analysis of lateral skull radiographs obtained using a standardized cephalostat is used to determine the features of skeletal structure and assess the complexity of orthodontic treatment. Measurements of various anatomical structures are conducted using angular and linear measurements. However, this measurement method has certain limitations and potential sources of error. With advances in medical imaging technology and computer software, three-dimensional (3D) analysis based on cone-beam computed tomography (CBCT) has become feasible for maxillofacial cephalometry. This approach enables faster processing of radiographic data through overlay techniques, allowing multiple analyses to be performed simultaneously. The purpose of our study is to compare linear and angular meas-urements obtained using three different methods: traditional lateral cephalometric radiography (teleradiogra-phy), 3D reconstruction from CBCT and direct measurement on CBCT images. Materials and methods. The study included 24 people (5 men and 19 women. the average age was 22 years old), who applied for orthodontic help at the Department of Postgraduate Education of Orthodontists of the Poltava State Medical University in the period from January 2023 to January 2024. Our study consisted of several stages: at the first stage, a classic lateral TRG was performed on the «MORITA X800» device; at the second stage, for more in-depth orthodontic diagnostics, computer tomography of the facial skeleton was performed on the «VATECH PAX-ZENITH 3D» device. The following 10 angular and 10 linear cephalometric parameters were taken for comparison. The results. Among the indicators, such as SNB, Wits, GoGn, SGo, U1 to NA, II, Lower lip E-p, Nasolab angle no statistical significance was found in any of the three diagnostic methods. For indicators of SNA, NS-Pog, L1 to NB, L1 to NB, the statistical significance of measurements on LC and 3D СВСТ was established. The discussion of this topic showed that 3D cephalometric analysis can be a fairly reliable method as well as cephalometric analysis, but the informativeness of 3D cephalometric analysis is much higher. The СВСТ study is more suitable for the diagnosis of complex orthodontic anomalies, for ex-ample, in cases involving retained or ectopic teeth, congenital skeletal and craniofacial anomalies (SCA), syndromic conditions, or during orthodontic treatment prior to dental implantation. Conclusions. For the indicators SNA, NS-Pog, L1 to NB, L1 to NB, the statistical significance of the measurements on LC and 3D CBCT has been established. The p-values for the parameters (SNB, Wits, GoGn, SGo, Overjet, II, Upper lip E-p, Lower lip E-p and Nasolab angle) were greater than 0.05, indicating no statistically significant differences between the groups for these parameters, which may suggest a lack of significant changes in the position of the mandible and molars.