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
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.
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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