Objectives

To compare the intra- and inter-examiner reliability of multidetector computed tomography (MDCT) and cone-beam computed tomography (CBCT) using Amira and Dolphin software analyses for craniofacial/airway measurements by six examiners.

Materials and Methods

Five adults and one dry skull with CBCT and MDCT scan files were duplicated and randomly numbered. Six orthodontic residents imported these files into two software programs, oriented the images, set thresholds, and performed 26 measurements. Intra- and inter-examiner reliabilities were determined by using intraclass correlation coefficient (ICC) and presented with scatterplots.

Results

Variables including anterior nasal width, posterior nasal width, frontomaxillary suture right-to-left, inner nasal contour point right-to-left, and minimum cross-sectional area in the oropharynx showed “moderate” to “substantial” intra- or inter-examiner agreement. Amira provided relatively reliable airway assessment, while Dolphin showed standard deviations 10 to 30 times larger for volumetric airway measurements. MDCT scans significantly reduced airway volume/area measurements compared to CBCT, except for intraoral airway volume.

Conclusions

Unreliable skeletal measurements and low reliability of Dolphin for airway analysis discourage using CT to quantitatively correlate changes in craniofacial structures with airway dimensions.

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Author notes

a

Visiting Staff, Department of Orthopedic Surgery, En Chu Kong Hospital, New Taipei City; and Professor, Department of Orthopedic Surgery, College of Medicine, National Taiwan University, Taipei, Taiwan.

b

Visiting Staff, Department of Dentistry, National Taiwan University Hospital, Taipei, Taiwan.

c

Postgraduate Student, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.

d

Visiting Staff, Department of Dentistry, MacKay Memorial Hospital, Taipei, Taiwan.

e

Visiting Staff, Department of Orthopedic Surgery, En Chu Kong Hospital, New Taipei City, Taiwan.

f

Visiting Staff, Department of Dentistry, National Taiwan University Hospital, Taipei; and Associate Professor, School of Dentistry, College of Medicine, National Taiwan University, Taipei, Taiwan.

The first two authors contributed equally to this work.