• The korean journal of orthodontics
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• v.28 no.1 s.66
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• pp.75-83
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• 1998

This study was done to recognize the importance of errors in measurements of cephalometric radiograph and to find the anatomical structures those need special care to select as a reference points through the detection of the systematic errors and estimation of random errors. For this purose, 100 cephalometric radiographs were prepared by usual manner and 61 reference points, and 130 measurement variables were established. Measurement errors were detected and estimated by the comparison of the 25 randomly-selected samples for repeated measurements with the main sample. The following results were obtained : 1. In comparison of the repeated measurements, there were statistical significant differences in 24 variables which were 18.4% of 130 total variables. 2. The frequency of the difference in identification of the reference points between the repeated measurements was very high in the root apex of upper incisor(as), the most posterior wall of maxilla(tu), soft tissue nasion(n'), soft tissue frontal eminence(ft), and ad3 in airway. 3. After correction of reference points marking until the level of below 5% significance, the range of random errors were from 0.67 to 1.71 degree or mm. 4. The variable shown the largest random error was the interincisal angle(ILs-ILi). 5. Measurement errors were mainly caused by the lack of precision in anatomic definitions and obscure radiographic image. From the above results, the author could find the high possibility of errors in cephalometric measurements and from this point, we should include error analysis in all the studies concerning measurments. In is essential to have a concept of error analysis not only for the investigator but also for a reader of other articles.

• Journal of Yeungnam Medical Science
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• v.18 no.1
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• pp.123-137
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• 2001

Background: The purpose of this study is to evaluate the accuracy of measurements obtained from 3-dimensional computerized tomography and 3-dimensional cephalogram constructed by using the frontal and lateral cephalogram of six human dry skulls. Materials and Methods: After CT scans and each cephalograms were taken, 3-dimensional coordinates (X, Y, Z) of landmarks were obtained using computer programs. In this study, the accuracy of both methods were determined by means of 14 linear measurements compare with caliper measurements. Results: The standard deviation of landmarks of 3-dimensional CT and 3-dimensional cephalogram were 0.23 mm, and 0.30 mm in X axis, 0.27 mm and 0.25 mm in Y axis, and 0.27 mm and 0.31 mm in Z axis. In both methods, the standard deviation were less than 0.5 mm in all landmarks, and the most of landmarks showed less than 1 mm in range. Concerning the accuracy, the mean difference between 3-dimensional CT and manual measurements was 0.33 mm, and 1.13 mm between 3-dimensional cephalogram and manual measurements. The distance between RGo and LGo showed the largest difference (2.03 mm). There were highly significant, and large correlation with manual measurements in both methods (p<0.01). Conclusion: It is concluded that closeness of repeated measures to each skulls reveal the precision of both methods. Computerized tomography and cephalogram for 3-dimensional measurement of maxillofacial structure are equivalent in quality to caliper measurements.

• The korean journal of orthodontics
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• v.41 no.2
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• pp.98-111
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• 2011

Objective: Superimposition of frontal cephalograms cannot be performed when the cephalograms are taken with different vertical head rotations. The purpose of the present study was to evaluate the validity of correcting the positional change of frontal cephalometric landmarks caused by vertical head rotation. Methods: In 30 adult individuals, frontal and lateral cephalograms were taken at a $90^{\circ}$ angle. Geometric principles of radiography were used to calculate the possible vertical and horizontal landmark changes if the head should be rotated down $5^{\circ}$ about an ear rod axis. The calculated changes were then compared with cephalometric changes measured on frontal cephalogram actually taken with the head rotated down $5^{\circ}$. Results: When the frontal cephalograms were taken with the head rotated down $5^{\circ}$ about an ear rod axis, significant changes in the vertical position of the landmarks occurred, particularly in the landmarks located farther anteriorly from the ear rod axis. The comparison of calculated changes and real cephalometric changes showed that the differences were less than 0.4 mm in the vertical direction and less than 0.2 mm in the horizontal direction. The differences between calculated and real changes were smaller in the landmarks less affected by vertical head rotation. Conclusions: Even when frontal cephalograms are taken at different vertical head rotations, the concomitant changes in the position of the landmarks can be corrected through calculation using the geometric principle of radiography as long as frontal and lateral cephalograms are taken perpendicular to each other.

• The korean journal of orthodontics
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• v.38 no.6
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• pp.427-436
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• 2008

Objective: The purpose of this study is to compare landmark position between cephalometric radiography and midsagittal plane projected images from 3 dimensional (3D) CT. Methods: Cephalometric radiographs and CT scans were taken from 20 patients for treatment of mandibular prognathism. After selection of land-marks, CT images were projected to the midsagittal plane and magnified to 110% according to the magnifying power of radiographs. These 2 images were superimposed with frontal and occipital bone. Common coordinate system was established on the base of FH plane. The coordinate value of each landmark was compared by paired t test and mean and standard deviation of difference was calculated. Results: The difference was from $-0.14{\pm}0.65$ to $-2.12{\pm}2.89\;mm$ in X axis, from $0.34{\pm}0.78$ to $-2.36{\pm}2.55\;mm$ ($6.79{\pm}3.04\;mm$) in Y axis. There was no significant difference only 9 in X axis, and 7 in Y axis out of 20 landmarks. This might be caused by error from the difference of head positioning, by masking the subtle end structures, identification error from the superimposition and error from the different definition.

• The korean journal of orthodontics
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• v.38 no.4
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• pp.240-251
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• 2008

Objective: The purpose of this study was to evaluate the effect of head position changes on the root parallelism between adjacent teeth on panoramic radiographs. Methods: A model with normal occlusion was constructed in the SolidWorks program, then RP (rapid protyping) model was fabricated. The model was repeatedly imaged and repositioned five times at each of the following nine positions: ideal head position, $5^{\circ}$ up, $10^{\circ}$ up, $5^{\circ}$ down, $10^{\circ}$ down, $5^{\circ}$, right, $10^{\circ}$, up, and $5^{\circ}$ right rotation, $10^{\circ}$ right rotation. Panoramic radiographs were taken by Planmeca ProMax and the angle between the long axes of adjacent teeth was directly measured in the monitor. Results: Axes of adjacent teeth tended to converge toward the occlusal plane when the head tilted up and converged in the opposite direction to the occlusal plane when the head tilted down. Anterior teeth showed the most notable differences. When one side of the head tilted up $5^{\circ}$ and $10^{\circ}$ along the anteroposterior axis (Y axis), tooth axes of the same side tended to converge toward the occlusal plane and tooth axes of the opposite side tended to converge in the opposite direction to the occlusal plane. When the head rotated to one side along the vertical axis (Z axis), the canine and lateral incisor of the same side converged in the opposite direction to the occlusal plane and the canine and lateral incisor of the other side converged toward the occlusal plane. Conclusions: When assessing the root parallelism on panoramic radiographs, the occlusal plane cant (anteroposterior or lateral) or asymmetry of the dental arch should be considered because these can cause distortion of tooth axes on panoramic radiographs.

• The korean journal of orthodontics
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• v.26 no.3
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• pp.255-265
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• 1996

The purpose of this study was to investigate if there were a significant difference between cephalometric measurements of mandibular position derived from a centric occlusion tracing compared to those of a converted centric relation tracing in the Class III malocclusion. The sample consisted of 25 Class III malocclusion and 25 normal occlusion persons who had no orthodontic treatment. The records included an lateral cephalometrics in centric occlusion, centric relation and centric occlusion bite registration and diagnostic casts mounted on the SAM II articulator in CR. The amount of CR-CO discrepancy of condyle was recorded using a MPI(Mandibular Position Indicator, MPI $200^{(R)}$, Great Lakes Orthodontics, USA). The conversion of the CO cephalogram to CR using the MPI readings was performed on the Conversion work sheet. Measures of mandibular position were chosen for the purpose of this study. The comparison of the difference between CO and CR cephalometric measurements in the normal occlusion and Class III malocclusion group were studied. The results were as follows: 1. In the features of CR-CO discrepancy of the condyle, the condyle was displaced posterior and inferior when the teeth were in centric occlusion. The horizontal component(${\Delta}X$) in Class HI malocclusion group was greater than the vertical component(${\Delta}Z$) and also greater than the horizontal component(${\Delta}X$) in normal occlusion group. There was no statistically significant correlation between MPI measurements and the groups of normal occlusion and Class III malocclusion group. 2. In the comparison of the cephalometric measurements in each group, Normal occlusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity and ODI. Class HI malocclusion group showed significant difference in measurements such as ANB, Facial angle, Facial convexity, ODI, SNB, APDI, L1-FP and it had more significance than the normal occlusion group. 3. The Value of cephalometric measurements was significantly different between CO and CR but there were no differences between the groups of normal occlusion and Class III malocclusion. The results of this study suggest that if the discrepancies are greater than the amount of normal displacement from clinically captured centric relation, centric relation should be considered as the starting point for proper diagnosis and treatment planning.

• The korean journal of orthodontics
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• v.28 no.2 s.67
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• pp.285-295
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• 1998

In clinical orthodontics, it is significant to understand the stage of growth in a growing patient. In order to assess the skeletal maturity of the patients, the hand-wrist radiograph and the cervical vertebrae (Cervical Vertebrae Maturation Indicators : CVMI) was evaluated from the lateral cephalograph and the skeletal maturity determined from the hand-wrist X-ray (Skeletal Maurity Indicators : SMI) taken on the same day in the same patients, and its interrelationship examined to come up with the following results: 1. The skeletal maturity evaluated from the hand-wrist radiograph and the maturation of the cervical vertebrae from the lateral cephalograph showed a significant interrelationship with each other. 2. In the evaluation of the skeletal maturity using the SMI and CVMI, the CVMI 1 showed a siginificant correlation with SMI 1, 2, the CVMI 2 with SMI 3, 4, CVMI 3 with SMI 6, 7, CVMI 4 with SMI 7, 8, CVMI 5 with 9, 10 and CVMI 6 with SMI 11. 3. When the morphological changes in the 2nd and 3rd cervical vertebrae were separately observed, it was seldom that the concavity appeared in the lower border of the 2nd cervical vertebra and at the same time not appear in the 3rd cervical vertebra (CVMI 2 : 10.38%, CVMI 3 : 6.56%) 4. In each of the skeletal maturation stage evaluated from the hand-wrist and the cervical vertebra, the average age and its standard deviation in male and female patients appeared to have large differences among individuals. Skeletal maturation seemed to appear earlier for the girls than for the boys, and its termination 24 months faster for girls.

• Journal of Korean Academy of Oral and Maxillofacial Radiology
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• v.24 no.2
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• pp.347-359
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• 1994

The reproducibility of cephalography in repeated exposures were studied by tracing and photographic subtraction. The materials consisted of 50 pairs of 'same day' radiograph taken under identical conditions. The evaluation included skull, cervical column, hyoid bone, pharynx, tongue, soft tissue profile resulting 43 items in tracing, and 19 items in photographic subtraction. The results obtained from the differences between each pair were as follows: 1. The means and standard deviations by tracing of skull, cervical column, hyoid bone, pharynx, tongue, soft tissue profile were 0.34±0.62㎜, 1.02±1.59㎜, 1.37±1.78㎜, 0.55±1.16㎜, 0.51±1.51㎜, 0.15±0.3㎜ each. 2. The means and standard deviations by photographic subtraction of skull, cervical column, hyoid bone, pharynx, tongue were 0.09±0.35㎜, 0.70±0.95㎜, 1.22±1.33㎜, 0.53±0.86㎜, 0.27±0.41㎜ each.

• Journal of Oral Medicine and Pain
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• v.38 no.2
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• pp.203-213
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• 2013

Objecives : The purpose of the study was to evaluate treatment outcome of mandibular advancement device(MAD) in obstructive sleep apnea (OSA) patients using full night polysomnography and cephalometry. Methods : Twenty-seven OSA patients were confirmed by full night, lab-attended polysomnography. Cephalometric examinations were conducted to obtain SNA, ANB, $AH{\bot}MP$, AH-C3, SPT, PNS-U, NAS, SOAS, MOAS, and HAS. Mandibular advancement devices (MADs) were fabricated and delivered for all subjects. After acclimation period of MAD, the second polysomnographic examinations were conducted in the same manner. Polysomnographic variables were compared between before and after MAD placement. Also, correlation coefficients were calculated between apnea-hypopnea index (AHI) and each item of cephalometric parameters. Results : There were significant improvements in total AHI, lowest $SpO_2$, and total arousal index after MAD therapy. Also, there were significant improvements in NREM $SpO_2$ and NREM AHI, but not in REM $SpO_2$ and REM AHI with MAD. Stratifying the sleep stage, there were significant decrease in stage I and significant increases in stage II and REM, but change in stage III was not significant. SNA and SOAS were significantly correlated with total AHI and NAS was significantly correlated with supine AHI. ANB was significantly associate with the effect of MAD. Conclusions : MAD is an effective treatment in OSA patients comparing polysomnographic variables before and after treatment. Cephalometric examination can be useful to evaluate OSA patients and predict treatment outcome of MAD.

• 대한치과교정학회:학술대회논문집
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• 2002.11a
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• pp.82.2-82.2
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• 2002