Standardization of Cephalograms Obtained From Various Imaging Systems

Objective To propose and validate a method for standardizing and printing cephalograms acquired from different imaging systems. Methods Validation of the proposed method was done using digital cephalograms, cone beam computed tomography (CBCT)-derived cephalograms, and direct measurements obtained from 3 dry human skulls. Each cephalogram was analyzed as-received and after standardization, using both manual and digital methods. 3-dimensional (3D) measurements were also computed from the CBCT images. After adequate blinding, 2 observers independently carried out all these measurements at 2 different times. Finally, the different cephalometric measurements of each skull were compared with the corresponding direct measurements (gold standard). Results The as-received digital cephalogram showed an inherent magnification of 33%, as determined from the calibration ruler. Compared to direct skull measurements, the as-received conventional and CBCT-derived cephalograms printed without standardization showed a reduction in measures of around 14% and 28%, respectively, whereas measurements obtained from cephalograms, which were standardized and printed by the proposed method, were comparable to direct measurements. Conclusions The findings of the validation study demonstrate the robustness of the proposed method in standardizing different cephalograms before printing.