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Journal of Peking University(Health Sciences) ›› 2019, Vol. 51 ›› Issue (5): 937-943. doi: 10.19723/j.issn.1671-167X.2019.05.024

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Using three-dimensional craniofacial images to construct horizontal reference plane

Min-jung KIM,Yi LIU()   

  1. Department of Orthodontics, Peking University School and Hospital of Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Laboratory for Digital and Material Technology of Stomatology & Beijing Key Laboratory of Digital Stomatology, Beijing 100081, China
  • Received:2017-09-07 Online:2019-10-18 Published:2019-10-23
  • Contact: Yi LIU E-mail:lyortho@163.com

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Abstract:

Objective: To compare four different three-dimensional horizontal planes and detect anatomical landmarks so as to provide theoretical reference for horizontal reference plane constructed by three-dimensional cephalometry. Methods: The subjects of this study were 32 facial symmetry patients (menton from mid-sagittal plane ≤2 mm). Cone-bead computed tomography (CBCT) was obtained before orthodontic treatment, and the data were imported into Dolphin imaging soft in DICOM format. The sagittal plane was passing through the Nasion, Sella and Dent. Four horizontal reference planes were constructed by three points of bilateral porion and bilateral orbitale. Plane 1: horizontal reference plane constructed by right porion and bilateral orbitale. Plane 2: horizontal reference plane constructed by left porion and bilateral orbitale. Plane 3: horizontal reference plane constructed by bilateral porion and right orbitale. Plane 4: horizontal reference plane constructed by bilateral porion and left orbitale. Pitch, yaw, roll for four planes were measured three dimensionally. All the samples were measured two times by one judge at an interval of two weeks. The two times measuring results were evaluated with Intraclass correlation coefficient (ICC) for verifying reliability. The multiple sets of repeated measurement analysis were used to compare the four different planes. Based on ages, the samples were divided into two groups (group 1: ages 13 to 17, group 2: over 18 years), the mean and standard deviation of landmark coordinates measured with Dent as the origin point, the circumference formula was applied to calculate the change of landmark position generated by head rotation. Results: No significant differences of pitch, yaw and roll among the four planes (P=0.196, 0.314, and 0.341). One degree of pitch rotation made changes of porion and orbitale approximate 0.5 mm, and 1.6 mm, respectively. One degree of yaw rotation made changes of porion and orbitale approximate 1.1 mm, and 1.5 mm, respectively. One degree of roll rotation made changes of porion and orbitale approximate 1.2 mm, and 0.7 mm, respectively. Conclusion: There was no significant difference among the four horizontal planes constructed by any three points of bilateral orbitales and bilateral porions. It has the highest concordance using bilateral orbitales and one porion to construct horizontal plane in this study, probably the best option in clinical practice. Different head rotation generated different distance changes of anatomical landmarks.

Key words: Head position, Frankfort plane, Cone beam computed tomography, Three-dimensional cephalometry

CLC Number: 

  • R783.5

Table 1

Define of hard and soft tissue landmarks for head orientation"

Landmark Definition
Menton The lowest point on the symphyseal shadow of the mandible
Sella The geometric center of the pituitary fossa
Dentes epistrophei The most posterior point of dentes epistrophei
Nasion The most anterior point on frontonasal suture in the midsagittal plane
Orbitale The lowest point on the inferior rim of the orbit
Porion The most superiorly positioned point of the external auditory meatus

Table 2

Define of plus and minus to confirmed direction of 3D rotation"

Items + -
Pitch Downward Upward
Yaw Right posterior Left after
Roll Lower right Left lower

Table 3

Define of 3D rotation degrees"

Rotarion Definition
Pitch Rotates around the X-axis, intersection between horizontal reference plane and rotated horizontal plane projected to MSP
Yaw Rotates around the Y-axis, intersection between MSP reference plane and rotated MSP projected to horizontal reference plane
Roll Rotates around the Z-axis, intersection between horizontal reference plane and rotated horizontal plane projected to coronal plane

Table 4

Rotation degree differences between three planes with Rp plane respectively/(°)"

Items Rp-Lp Rp-Ro Rp-Lo
Pitch -0.078±0.892 0.023±0.505 -0.121±0.850
Yaw 0.032±0.177 -0.002±0.010 0.002±0.008
Roll -0.013±0.091 -0.048±0.753 0.117±0.636

Figure 1

Tracing the bilateral orbitale and bilateral porion"

Figure 2

Define of horizontal planes:Rp plane constructed by bilateral orbitale and right porion; Lp plane constructed by bilateral orbitale and left porion; Ro plane constructed by bilateral porion and right orbitale; Lo plane constructed by bilateral porion and left orbitale"

Figure 3

Define of 3-dimensional rotation degree"

Table 5

Landmark coordinates in different age groups/mm"

Age groups Coordinate Right orbitale Left orbitale Right porion Left porion
X 31.017±2.651 31.067±2.180 59.344±3.323 61.578±5.017
13-17 years old Y 26.967±3.998 26.800±3.944 26.700±3.803 26.739±3.826
Z 80.622±3.944 80.467±4.149 4.811±3.790 4.033±3.524
X 32.364±2.623 32.507±3.546 59.064±6.088 60.964±4.532
≥18 years old Y 28.393±4.482 28.193±4.452 28.179±4.519 27.943±4.715
Z 83.300±2.986 83.179±3.417 6.207±2.806 7.421±2.252

Table 6

Based on different ages apply the circumference formula calculated change of bilateral porion and orbitale position generated by head rotation in different directions/mm"

Age groups Rotation Right orbitale Left orbitale Right porion Left porion
Pitch 1.484 1.480 0.474 0.472
13-17 years old Yaw 1.508 1.505 1.039 1.077
Roll 0.717 0.716 1.135 1.172
Pitch 1.536 1.533 0.504 0.505
≥18 years old Yaw 1.560 1.559 1.037 1.072
Roll 0.751 0.751 1.142 1.170
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