Assessing the Correlation between Skeletal and Corresponding Soft-Tissue Equivalents to Determine the Relationship between CBCT Skeletal/Dental Dimensions and 3D Radiographic Soft-Tissue Equivalents

OBJECTIVE: Compare measurements of skeletal and dental areas on the CBCT to the corresponding soft-tissue measures taken from a 3D Facial Scanner. METHODS: 30 patients with CBCT and 3D Facial scanner photos were selected from the orthodontic program database. 30 different distance measurements were obtained from CBCT and facial scan. OrthoInsight software was used to obtain the measurements from the facial scan images, and AVIZO software was used for corresponding CBCT landmarks. The Euclidean distance formula was used to determine the distances for the corresponding x, y, and z coordinates of the CBCT. Reliability for CBCT and Facial Scanner was completed by calculating 30 distances for 10 patients, 3 times. Once reliability was determined, all 30 distances were calculated once for CBCT and facial scanner on each patient and descriptive statistics and paired t-test were applied. RESULTS: All distances measured presented excellent reliability, the lowest one being the left eye width for the facial scanner (ICC 0.847). The landmark with the highest mean error on the CBCT was 2.0 ± 1.6 mm on the z-axis for the spinal level landmark. The Facial Scanner's largest mean measurement error was 1.5 ± 0.9 mm for the distance of the left corner of the mouth to gonion. All data except width between outer eye corners were statistically significant (p < 0.05). The average differences between facial scan and CBCT measurements ranged between 0.77 mm (left canine to cheekbone) to 26.94 mm (left subnasale to gonion) and are thus comparable. All measurements show a reasonable standard deviation between 2.57 mm (left eye width) to 9.91 mm (left gnathion to EAM). CONCLUSION: Distances obtained from CBCT and facial scan present mild differences giving the perspective of a relationship between them. Understanding this difference and relationship can make it plausible to expect certain underlying skeletal distances under soft-tissue structures.