Accuracy of Cephalometric Analyses and Tooth Movements of Conventional vs CBCT-Generated Cephalograms

Purpose: The aim of this study was to compare Ricketts and American Board of Orthodontics (ABO) cephalometric measurements and tooth movements from tracings between conventional lateral cephalograms (Sirona Orthophos XG Plus, Charlotte, NC) and CBCT-generated cephalograms (NewTom 5G; QR srl, Verona, Italy). Materials and Methods: Patients who had bilateral Angle’s class II molar were evaluated. Pre-treatment (T1) and post-treatment (T2) conventional lateral cephalograms (CLCs) and CBCT-generated lateral cephalograms (CBLCs) were traced in Quick Ceph Studio using Ricketts and ABO cephalometric analyses. Linear and angular cephalometric measurements from tracings were compared between the two radiographic modalities using one-sample Wilcoxon signed rank test (=0.05) and intraclass correlation coefficient. Ricketts superimpositions between CLCs T1 and CLCs T2, CBLCs T1 and CBLCs T2, and CBLCs T1 and CLCs T2 were also measured to assess molar and incisor movements for the maxillary and mandibular arch. Comparison between the three groups was completed using Friedman’s two-way analysis of variance of ranks and pairwise comparison, adjusted by the Bonferroni correction (=0.05). Results: Records of thirty-eight patients were used in this study. Ricketts and ABO cephalometric measurements between CLCs and CBLCs were statistically significant for 8 out of 26 landmarks. Ricketts superimposition showed that directional tooth movements (DTMs) between the two radiographic modalities were not statistically significant. Total tooth movements (TTMs) showed statistical significance at maxillary molar furcation and maxillary molar root. All statistical significance found in this study did not seem to reach clinical significance. Conclusions: Statistical significance for cephalometric measurements with landmark identification at porion, orbitale, gonion, gnathion, nasion, and pterygomaxillary point was found. DTMs of CLCs and CBLCs were comparable to one another. TTMs did however show statistical significance, which was potentially due to the superimposition of radiopaque structures and the greater density in the region of the maxillary first molar