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VOLUME 22 , ISSUE 3 ( March, 2021 ) > List of Articles

ORIGINAL RESEARCH

Sella Turcica Area and Location of Point Sella in Cephalograms Acquired with Simulated Patient Head Movements

Olesya Svystun, Lars Schropp, Ann Wenzel, Rubens Spin-Neto

Keywords : Cephalogram, Digital image, Distortion, Sella turcica

Citation Information : Svystun O, Schropp L, Wenzel A, Spin-Neto R. Sella Turcica Area and Location of Point Sella in Cephalograms Acquired with Simulated Patient Head Movements. J Contemp Dent Pract 2021; 22 (3):207-214.

DOI: 10.5005/jp-journals-10024-3056

License: CC BY-NC 4.0

Published Online: 01-03-2021

Copyright Statement:  Copyright © 2021; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim and objective: This study assesses changes in the sella turcica area (STA) and location of the cephalometric point sella (S) on lateral cephalograms acquired by charge-coupled device (CCD)-based cephalostats with and without simulated patient head movements. Materials and methods: A real skull was placed on a robot, able to simulate four head movements (anteroposterior translation/lifting/nodding/lateral rotation) at three distances (0.75/1.5/3 mm) and two patterns (returning to 0.5 mm away from the start position/staying at maximum movement excursion). Two ProMax-2D cephalostats (Dimax-3, D-3 or Dimax-4, D-4), and an Orthophos-SL cephalostat (ORT) acquired cephalograms during the predetermined movements (“cases,” 48 images/unit) and without movement (“controls,” 24 images/unit). Three observers manually traced the contour of sella turcica and marked point sella using a computer mouse. STA was calculated in pixels2 by dedicated software based on the tracing. S was defined by its x and y coordinates recorded by the same software in pixels. Ten percent of the images were assessed twice. The difference between cases and controls (case minus control) for the STA and S (namely Diff-STA and Diff-S) was calculated and assessed through descriptive statistics. Results: Inter- and intraobserver agreement ranged from moderate to good for STA and S. Diff-STA ranged from −42.5 to 12.9% (D-3), −15.3 to 9.6% (D-4), and −25.3 to 39.9% (ORT). Diff-S was represented up to 50% (D-3), 134% (D-4), and 103% (ORT) of the mean sella turcica diameter in control images. Conclusion: Simulated head movements caused significant distortion in lateral cephalograms acquired by CCD-based cephalostats, as seen from STA and S alterations, depending on the cephalostat. Clinical significance: Patient-related errors, including patient motion artifacts, are influential factors for the reliability of cephalometric tracing.


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  1. Tekiner H, Acer N, Kelestimur F. Sella turcica: an anatomical, endocrinological, and historical perspective. Pituitary 2015;18(4):575–578. DOI: 10.1007/s11102-014-0609-2.
  2. Jones RM, Faqir A, Millett DT, et al. Bridging and dimensions of sella turcica in subjects treated by surgical-orthodontic means or orthodontics only. Angle Orthod 2005;75(5):714–718. DOI: 10.1043/0003-3219(2005)75.
  3. Muhammed FK, Abdullah AO, Liu Y. Morphology, incidence of bridging, dimensions of sella turcica, and cephalometric standards in three different racial groups. J Craniofac Surg 2019;30(7):2076–2081. DOI: 10.1097/SCS.0000000000005964.
  4. Axelsson S, Storhaug K, Kjaer I. Post-natal size and morphology of the sella turcica. Longitudinal cephalometric standards for Norwegians between 6 and 21 years of age. Eur J Orthod 2004;26(6):597–604. DOI: 10.1093/ejo/26.6.597.
  5. Zagga AD, Ahmed H. Plain radiographic cephalometry of the sella turcica: an overview. Niger J Med 2008;17(3):333–336.
  6. Bjork A, Solow B. Measurement on radiographs. J Dent Res 1962;41:672–683. DOI: 10.1177/00220345620410032101.
  7. Axelsson S, Kjaer I, Bjornland T, et al. Longitudinal cephalometric standards for the neurocranium in Norwegians from 6 to 21 years of age. Eur J Orthod 2003;25(2):185–198. DOI: 10.1093/ejo/25.2.185.
  8. Gandikota CS, Rayapudi N, Challa PL, et al. A comparative study of linear measurements on facial skeleton with frontal and lateral cephalogram. Contemp Clin Dent 2012;3(2):176–179. DOI: 10.4103/0976-237X.96823.
  9. Chadwick JW, Prentice RN, Major PW, et al. Image distortion and magnification of 3 digital CCD cephalometric systems. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2009;107(1):105–112. DOI: 10.1016/j.tripleo.2008.09.025.
  10. Svystun O, Schropp L, Wenzel A, et al. Prevalence and severity of image-stitching artifacts in charge-coupled device-based cephalograms of orthodontic patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2020;129(2):158–164. DOI: 10.1016/j.oooo.2019.07.004.
  11. Svystun O, Wenzel A, Schropp L, et al. Image-stitching artefacts and distortion in CCD-based cephalograms and their association with sensor type and head movement: ex vivo study. Dentomaxillofac Radiol 2020;49(3):20190315. DOI: 10.1259/dmfr.20190315.
  12. Spin-Neto R, Wenzel A. Patient movement and motion artefacts in cone beam computed tomography of the dentomaxillofacial region: a systematic literature review. Oral Surg Oral Med Oral Pathol Oral Radiol 2016;121(4):425–433. DOI: 10.1016/j.oooo.2015.11.019.
  13. Schropp L, Alyass NS, Wenzel A, et al. Validity of wax and acrylic as soft-tissue simulation materials used in in vitro radiographic studies. Dentomaxillofac Radiol 2012;41(8):686–690. DOI: 10.1259/dmfr/33467269.
  14. McIntyre GT, Mossey PA. Size and shape measurement in contemporary cephalometrics. Eur J Orthod 2003;25(3):231–242. DOI: 10.1093/ejo/25.3.231.
  15. Kunz F, Stellzig-Eisenhauer A, Zeman F, et al. Artificial intelligence in orthodontics: evaluation of a fully automated cephalometric analysis using a customized convolutional neural network. J Orofac Orthop 2020;81(1):52–68. DOI: 10.1007/s00056-019-00203-8.
  16. Chen Yj CS, Huang HW, Yao CC, et al. Reliability of landmark identificationin cephalometric radiography aquired by a storage phosphor imaging system. Dentomaxillofac Radiol 2004;33(5):1259. DOI: 10.1259/dmfr/85147715.
  17. Riedel RA. The relation of maxillary structures to cranium in malocclusion and in normal occlusion. Angle Orthodontist 1952;22(3):142–145.
  18. Devereux L, Moles D, Cunningham SJ, et al. How important are lateral cephalometric radiographs in orthodontic treatment planning? Am J Orthod Dentofacial Orthop 2011;139(2):e175–e181. DOI: 10.1016/j.ajodo.2010.09.021.
  19. Steiner CC. Cephalometrics for you and me. Am J Orthod Dentofac 1953;39(10):729–755. DOI: 10.1016/0002-9416(53)90082-7.
  20. Schulze R, Heil U, Gross D, et al. Artefacts in CBCT: a review. Dentomaxillofac Radiol 2011;40(5):265–273. DOI: 10.1259/dmfr/30642039.
  21. Durão AP, Morosolli A, Pittayapat P, et al. Cephalometric landmark variability among orthodontists and dentomaxillofacial radiologists: a comparative study. Imaging Sci Dent 2015;45(4):213–220. DOI: 10.5624/isd.2015.45.4.213.
  22. Oktay H. A comparison of ANB, WITS, AF-BF, and APDI measurements. Am J Orthod Dentofacial Orthop 1991;99(2):122–128. DOI: 10.1016/0889-5406(91)70114-C.
  23. Huh KH, Benavides E, Jo YT, et al. Quantitative evaluation of patient movement during simulated acquisition of cephalometric radiographs. J Digit Imaging 2011;24(3):552–559. DOI: 10.1007/s10278-010-9318-1.
  24. Spin-Neto R, Matzen LH, Hermann L, et al. Head motion and perception of discomfort by young children during simulated CBCT examinations. Dentomaxillofac Radiol 2020:20200445. DOI: 10.1259/dmfr.20200445.
  25. Hagg U, Cooke MS, Chan TC, et al. The reproducibility of cephalometric landmarks: an experimental study on skulls. Aust Orthod J 1998;15(3):177–185.
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