Reliability and Reproducibility of Landmark Identification in Unilateral Cleft Lip and Palate Patients: Digital Lateral Vis-A-Vis CBCT-Derived 3D Cephalograms

Background: The aim of the retrospective observational study was to compare the precision of landmark identification and its reproducibility using cone beam computed tomography-derived 3D cephalograms and digital lateral cephalograms in unilateral cleft lip and palate patients.

Methods: Cephalograms of thirty-one (31) North Indian children (18 boys and 13 girls) with a unilateral cleft lip and palate, who were recommended for orthodontic treatment, were selected. After a thorough analysis of peer-reviewed articles, 20 difficult-to-trace landmarks were selected, and their reliability and reproducibility were studied. These were subjected to landmark identification to evaluate interobserver variability; the coordinates for each point were traced separately by three different orthodontists (OB, OB, OB). Statistical analysis was performed using descriptive and inferential statistics with paired -tests to compare the differences measured by the two methods. Real-scale data are presented in mean ± SD. A -value less than 0.05 was considered as significant at a 95% confidence level.

Results: When comparing, the plotting of points posterior nasal spine (PNS) ( < 0.05), anterior nasal spine (ANS) ( < 0.01), upper 1 root tip ( < 0.05), lower 1 root tip ( < 0.05), malare ( < 0.05), pyriforme ( < 0.05), porion ( < 0.01), and basion ( < 0.05) was statistically significant.

Conclusion: In patients with a cleft lip and palate, the interobserver identification of cephalometric landmarks was significantly more precise and reproducible with cone beam computed tomography -derived cephalograms vis-a-vis digital lateral cephalograms.