Effect of Experience in Landmark Identification on 2D Lateral Cephalograms on Performance of Dental Students Concerning Landmark Identification on 3D Cone Beam Computed Tomography Scans

Golshah, Amin; Khavid, Atefeh; Nikkerdar, Nafiseh; Godiny, Mostafa; Imani, Mohammad Moslem; Mozafari, Neda

doi:10.1590/pboci.2020.104

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ORIGINAL ARTICLE • Pesqui. Bras. Odontopediatria Clín. Integr. 20 • 2020 • https://doi.org/10.1590/pboci.2020.104 copy

Effect of Experience in Landmark Identification on 2D Lateral Cephalograms on Performance of Dental Students Concerning Landmark Identification on 3D Cone Beam Computed Tomography Scans

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

To assess the effect of experience in landmark identification on two-dimensional (2D) lateral cephalograms on performance of dental students concerning landmark identification on three-dimensional (3D) cone-beam computed tomography (CBCT) scans.

Material and Methods:

This quasi-experimental study evaluated 40 dental students in two groups (n=20). Group 1 included senior dental students who had experience in landmark identification on 2D lateral cephalograms and Group 2 included third-year dental students with no such experience. Both groups received instructions on identification of eight landmarks on 3D CBCT scans. The coordinates of the landmarks were determined in x, y and z axes. One orthodontist determined the mean coordinates of each landmark as a reference by twice measurements with a one-week interval. The mean distance from the identified points to the reference points was reported as the mean consistency (MC), and the standard deviation of the mean was considered as precision of landmark identification. Data were analyzed using independent samples t-test.

Results:

The mean distances from the points identified as nasion, point B, orbitale, anterior nasal spine (ANS), menton, coronoid process and pogonion in x, y and z axes and point A in x and z axes (p<0.001) to the reference points in Group 1 were greater than those in Group 2 with no such experience.

Conclusion:

Previous experience in landmark identification on 2D cephalograms does not help in landmark identification on 3D CBCT scans and may even adversely affect the results.

Keywords:
Cephalometry; Cone-Beam Computed Tomography; Anatomic Landmarks; Education

Landmarks	X	Y	Z
Nasion	0.979	0.981	0.973
Point A	0.920	0.810	0.891
Point B	0.951	0.879	0.841
Orbitale	0.950	0.935	0.971
Anterior Nasal Spine	0.983	0.980	0.981
Menton	0.800	0.812	0.801
Coronoid Process	0.870	0.898	0.900
Pogonion	0.840	0.835	0.870

Landmarks	Group	X		Y		Z
	Group	Mean	SD	Mean	SD	Mean	SD
Nasion	Senior	1.28	0.41	0.79	0.25	0.96	0.27
	Third-Year	0.19	0.16	0.08	0.08	0.08	0.08
	p-value	<0.001		<0.001		<0.001
Point A	Senior	1.19	0.41	1.21	1.10	1.48	0.53
	Third-Year	0.06	0.07	0.52	1.50	0.12	0.10
	p-value	<0.001		0.109		<0.001
Point B	Senior	1.00	0.31	1.04	0.49	0.93	0.56
	Third-Year	0.06	0.06	0.14	0.18	0.20	0.18
	p-value	<0.001		<0.001		<0.001
Orbitale	Senior	0.98	0.44	1.19	0.38	1.12	0.51
	Third-Year	0.28	0.23	0.20	0.16	0.42	0.32
	p-value	<0.001		<0.001		<0.001
Anterior Nasal Spine	Senior	0.94	0.22	1.02	0.35	0.88	0.23
	Third-Year	0.09	0.06	0.26	0.25	0.11	0.08
	p-value	<0.001		<0.001		<0.001
Menton	Senior	1.09	0.35	1.43	0.62	1.16	0.39
	Third-Year	0.20	0.30	0.16	0.12	0.17	0.19
	p-value	<0.001		<0.001		<0.001
Coronoid Process	Senior	0.88	0.35	0.80	0.21	0.97	0.25
	Third-Year	0.13	0.15	0.18	0.15	0.20	0.17
	p-value	<0.001		<0.001		<0.001
Pogonion	Senior	1.24	0.88	1.39	0.32	1.67	1.19
	Third-Year	0.16	0.13	0.17	0.13	0.14	0.11
	p-value	<0.001		<0.001		<0.001

	Senior Students		Third-Year Students
Landmarks	Mean	SD	Mean	SD	p-value
Nasion	1.84	0.34	0.25	0.16	<0.001
A	2.43	0.89	0.61	1.48	<0.001
B	1.83	0.49	0.30	0.21	<0.001
Orbitale	2.00	0.49	0.63	0.27	<0.001
ANS	1.68	0.28	0.32	0.23	<0.001
Menton	2.23	0.48	0.38	0.29	<0.001
Coronoid Process	1.57	0.30	0.36	0.17	<0.001
Pogonion	2.73	1.01	0.32	0.11	<0.001

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[1] Author to whom correspondence should be addressed: Atefeh Khavid, Department of Oral and Maxillofacial Radiology, School of Dentistry, Kermanshah University of Medical Sciences, Kermanshah, Iran. Phone: +98 9188362065. E-mail: atefehkhavid@gmail.com.