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首页> 外文期刊>American Journal of Orthodontics and Dentofacial Orthopedics >Three-dimensional cephalometric analysis of the maxilla: Analysis of new landmarks
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Three-dimensional cephalometric analysis of the maxilla: Analysis of new landmarks

机译：颌骨三维头对象分析：新地标的分析

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Introduction: Clinical evaluation of the midface including the paranasal and upper lip regions is highly subjective and complex. Traditional and 3-dimensional cephalometrics were not developed with the clinical appearance of these midfacial areas in mind and are therefore inappropriate surrogates for the clinical appearance of the midface, making them unsuitable as aids in diagnosing dentofacial deformities. The aim of this study was to evaluate traditional as well as newly defined landmarks and measurements and their correlation with clinical appearance of the midface. Methods: Fifty-two subjects who underwent full-field cone-beam computed tomography were recruited for this study. A single examiner assessed each subject's midfacial region (paranasal and upper lip), and a second examiner obtained traditional and newly defined cephalometric measurements for each subject. Both examiners were blinded to each other's data throughout the study. Statistical analysis was performed to assess the correlations of the traditional and novel cephalometric measurements with clinical midfacial findings. The impact of the soft tissue thickness in the paranasal region was also analyzed. The performance of any classification derived from statistically significant variables was analyzed with the use of micro-F scores and area under the receiver operating characteristic curve (AUC). Results: Both traditional (SNA) and newly defined measurements (SNANS, SNPR, SNNP, SNh) had no statistically significant correlation with clinical paranasal diagnosis. However, in the absence of upper lip procumbency or protrusion, SNNP and SNh had statistically significant correlations with clinical paranasal diagnosis (P = 0.047 and P = 0.003, respectively). For upper lip analysis, both traditional (SNA) and newly defined measurements (SNCEJ) had strong correlations with clinical upper lip diagnosis (P = 0.972 and >= 0.968, respectively) except SNA, which had a low interobserver reliability (correlation coefficient 0.739). Fitted models for paranasal and upper lip analyses showed low micro-F scores, indicating low precision and recall. However, AUC values of 0.7019 and 0.6362 for the paranasal and upper lip analysis, respectively, suggest improved performance of the model when properly trained with a larger sample size. Newly defined measurements SNh and SNNP correlated with clinical paranasal diagnosis only in the absence of upper lip procumbency and protrusion. SNA and SNICEJ were strongly correlated with clinical upper lip diagnosis. However, fitted models based on this study sample yielded low micro-F scores, making the fitted models currently unsuitable for anything besides correlation with clinical findings. A larger sample size will be necessary to further clarify the potential roles of these measurements, especially given the reasonable AUC values. The findings of this study demonstrate the highly subjective and relative nature of midfacial diagnosis and the importance of clinical judgment despite the potential utility of some traditional and new measurements.
机译：介绍：包括普拉纳拉斯和上唇地区的中表面的临床评价是高度主观和复杂的。传统和三维头孢素测定学没有于这些中型地区的临床外观，因此不适合中型的临床外观，使其不适合诊断牙齿畸形。本研究的目的是评估传统的和新定义的地标和测量及其与临床外观的相关性。方法：为这项研究招募了52个接受全场锥形束计算机断层扫描的受试者。单一检查者评估了每个受试者的中型区域（Paranasal和上唇），第二次检查员为每个受试者获得传统和新定义的头部测量测量。两位审查员在整个研究中都蒙蔽了彼此的数据。进行统计分析以评估传统和新型头脑测量与临床中型发现的相关性。还分析了软组织厚度在矛醛地区的影响。利用接收器操作特性曲线（AUC）下的微F分和面积分析了衍生自统计学显着变量的任何分类的性能。结果：传统（SNA）和新定义的测量（SNANS，SNPR，SNNP，SNH）与临床促胰岛诊断无统计学相关。然而，在没有上唇下降或突出的情况下，SNNP和SNH与临床促异纳斯诊断具有统计学的相关性（P = 0.047和P = 0.003）。对于上唇分析，传统（SNA）和新定义的测量（SNCEJ）与临床上唇诊断（P = 0.972和> = 0.968）除SNA之外具有很强的interobserver可靠性（相关系数0.739） 。普通和上唇分析的适用模型显示出低的微型分数，表明低精度和召回。然而，分别为0.7019和0.6362的AUC值分别表明，在适当培训的样本大小的适当培训时提出了模型的性能。新定义的测量SNH和SNNP与临床促胰岛诊断相关，只有在没有上唇下垂和突起的情况下。 SNA和SNICEJ与临床上唇诊断强烈相关。然而，基于该研究样本的拟合模型产生了低的微型分数，使拟合模型目前不适合与临床发现相关的任何内容。需要更大的样本量以进一步阐明这些测量的潜在作用，特别是给出合理的AUC值。本研究的结果表明了中型诊断的高度主观和相关性，尽管有一些传统和新测量的潜在效用，但临床判决的重要性。

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