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Accuracy of integration of dental cast and cephalograms compared with cone-beam computed tomography: a comparative study

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This study proposes a method that integrates maxillary dental cast and cephalograms and evaluates its accuracy compared with cone-beam computed tomography (CBCT) scans. The study sample comprised 20 adult patients with records of dental casts, cephalograms, and craniofacial CBCT scans. The maxillary dental cast was integrated with lateral and frontal cephalograms based on best-fit registration of palatal and dental outline curves from dental cast with cephalogram tracings. Linear measurement was conducted to assess the intra- and inter-examiner reproducibility of the proposed integration method using intraclass correlation coefficients; linear and angular measurements were conducted to assess its accuracy with CBCT scans as a standard reference. Paired t test, one sample t test, and mean ± standard deviation of the absolute value of difference were used to compare the integrated images and CBCT. The integration method showed good intra- and inter-examiner reproducibility (intraclass correlation coefficients > 0.98). The differences in linear and angular measurements between the integrated images and CBCT were not statistically significant but with a large deviation. When absolute value of difference was computed, the linear distance error was 0.51 ± 0.34 mm, the tooth point coordinate errors in X, Y and Z axes were 0.22 ± 0.22, 0.38 ± 0.32 and 0.21 ± 0.21 mm, respectively; the angular error in pitch, roll and yaw of the dental cast was 0.82 ± 0.51, 0.92 ± 0.59 and 0.80 ± 0.41 degree, respectively. The proposed method for integration of dental cast and cephalograms showed good reproducibility and acceptable accuracy compared with CBCT. It could be helpful for researchers to study three-dimensional tooth growth changes using the existing craniofacial growth data especially cephalograms.

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Availability of data and materials

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.



Cone-beam computed tomography


Three dimensional


Two dimensional




Anterior nasal spine


Posterior nasal spine


Mesiobuccal cusp of right second molar


Mesiobuccal cusp of left second molar


Midpoint of the incisal edge of the right central incisor


Intraclass correlation coefficients


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We thank M.C. Yu (Center of Information Science, School of Electronics Engineering and Computer Science, Peking University) for MATLAB programming.


This work was supported by the International Science & Technology Cooperation Program of China (grant No. 2014DFA31800), National Nature Science Foundation of China (grant No. 82071172, 51972005, 51672009), Beijing Natural Science Foundation (grant No. 7192227) and Beijing Municipal Science and Technology Commission (No. Z181100001718112) in the design of the study and collection, analysis, and interpretation of the data and in writing the manuscript.

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Authors and Affiliations



BH and TX designed the experiments. JJ, RJ and JL provided the sample. FD and TF executed the experiments. FD and WL analyzed the data and wrote the manuscript. SC and GC made critical revision. All the authors read and approved the final manuscript.

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Correspondence to Bing Han or Tianmin Xu.

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The authors declare that they have no competing interests.

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This study was approved by the Ethics Committee of the Peking University School and Hospital of Stomatology (PKUSSIRB-201626009).

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Written informed consent was obtained from all the patients involved in the study.

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Dai, F., Chen, S., Feng, T. et al. Accuracy of integration of dental cast and cephalograms compared with cone-beam computed tomography: a comparative study. Odontology 111, 238–247 (2023).

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