Importance of head positioning in cephalometric analysis of 3 D-CT stereotaxic images

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Positioning of the head during cephalometric radiography significantly influences evaluation of symmetry in frontal images and is also important in evaluating lateral images. In the past, however, the head has been positioned simply by placing ear rods in the right and left external auditory foramens. We examined the effects on morphological evaluation and diagnosis with positioning of the head based on criteria other than the external auditory foramens. Based on computed tomographic data collected from patients with jaw deformities, we positioned the head image using the right and left external auditory foramens and other reference points with a three-dimensional stereotaxic imaging system. We found that even in the same subject, the horizontal and vertical relationship of structures can vary depending on the reference planes used to determine orientation of the frontal and transverse planes, thus affecting morphological evaluation and diagnosis markedly. These results indicate that morphological evaluation of the craniofacial bone structure and diagnosis of orthodontic patients should be made in a range of anatomical directions, instead of relying on a single positioning criterion. (J Osaka Dent Univ 2005 ; 39 : 47-55.)
大阪歯科学会の論文