BACKGROUND Reproducible and descriptive Three-dimensional treatment evaluation can enhance future treatment based on realistic results. So, the purpose of this study was to describe a new method for three-dimensional treatment evaluation showing how to use fully-automated craniofacial superimposition of CBCT records combined with reference system to obtain descriptive and comparable results. This new method was named United Reference Method (URM). METHODS URM is a combination of automated 3D superimposition on anterior cranial base surface anatomy and measurements based on reference system. It was developed to show how to use fully-automated superimposition to obtain descriptive numerical comparable values. The method is based on: one main reference system for both superimposed CBCT records, semi-automation to increase accuracy, all measurements are projections and auxiliary references to aid in landmarks identification and measurements. The method steps can be described following a four-step approach: (1) Superimposition performed through a fully automated, voxel-wise, rigid registration considering only cranial base as a stable structure; (2) Identification of reference landmarks once on the superimposed records for corrected Frankfort Horizontal plane (C-FH) construction and a new semi-automated constructed Sella point to correct Orbital asymmetry; (3) Head orientation of superimposed CBCT images based on the C-FH; (4) Identification of landmarks affected by treatment with the aid of auxiliary reference planes. Evaluation of linear or angular changes derived by projection of same pre- and post-treatment landmarks on the C-FH. Pre- and post-expansion CBCT scans of 20 unilateral cleft lip and palate patients were used to calculate intra and inter-rater reliability. (X, Y and Z) coordinates, mean, standard deviation (SD) and Intra-class Correlation Coefficient (ICC) were calculated. RESULTS The proposed coordinates for C-FH construction showed ICC ≥ 0.998 and SD ranging from 0.064 to 0.242 mm. On the other hand, excluded coordinates due to expected natural craniofacial asymmetry had the lowest reliability ICC ≥0.742 and SD dramatically increased up to 1.112 mm. CONCLUSION URM showed adequate reliability so it can be used to produce three-dimensional descriptive data of craniofacial structural changes.

中文翻译：

---

联合参考方法用于三维治疗评估。

背景技术可再现和描述性的三维治疗评估可以根据实际结果增强将来的治疗效果。因此，本研究的目的是描述一种用于三维治疗评估的新方法，该方法显示了如何使用全自动颅面面部CBCT记录与参考系统相结合来获得描述性和可比较的结果。此新方法称为联合参考方法（URM）。方法URM是在前颅底表面解剖结构上进行自动3D叠加和基于参考系统进行测量的结合。它被开发来显示如何使用全自动叠加来获得描述性的数值可比较值。该方法基于：两个叠加CBCT记录的主要参考系统，半自动化以提高准确性，所有测量都是投影和辅助参考，以帮助标识和测量地标。方法步骤可通过四个步骤来描述：（1）通过仅考虑颅底作为稳定结构的全自动，体素方向的刚性配准进行叠加；（2）一次在叠加记录上识别参考地标，以纠正法兰克福水平面（C-FH）的构造，并使用新的半自动构造的Sella点来纠正轨道不对称性；（3）基于C-FH的叠加CBCT图像的头部方向；（4）借助辅助参考平面识别受处理影响的地标。通过在C-FH上投影相同的前后标志物得出的线性或角度变化的评估。扩展前和扩展后的20例单侧唇left裂患者的CBCT扫描用于计算评估者内部和评估者之间的可靠性。（X，Y和Z）坐标，均值，标准差（SD）和类内相关系数（ICC）被计算。结果建议的C-FH构造坐标显示ICC≥0.998，SD范围为0.064至0.242 mm。另一方面，由于预期的自然颅面不对称性导致的排除坐标具有最低的可靠性，ICC≥0.742，SD显着增加至1.112 mm。结论URM具有足够的可靠性，因此可用于生成颅面结构变化的三维描述性数据。计算标准差（SD）和类内相关系数（ICC）。结果建议的C-FH构造坐标显示ICC≥0.998，SD范围为0.064至0.242 mm。另一方面，由于预期的自然颅面不对称性导致的排除坐标具有最低的可靠性，ICC≥0.742，SD显着增加至1.112 mm。结论URM具有足够的可靠性，因此可用于生成颅面结构变化的三维描述性数据。计算标准差（SD）和类内相关系数（ICC）。结果建议的C-FH构造坐标显示ICC≥0.998，SD范围为0.064至0.242 mm。另一方面，由于预期的自然颅面不对称性导致的排除坐标具有最低的可靠性，ICC≥0.742，SD显着增加至1.112 mm。结论URM具有足够的可靠性，因此可用于生成颅面结构变化的三维描述性数据。