Comparison of Inter and Intra-Operator Differences for Cephalometric Landmark Identification on Three-Dimensional CBCT Images using Pro Plan CMF

Objective: To establish reliability of cephalometric landmark identification in threedimensions using ProPlan CMF software. Methods: Two orthodontist identified a series of 33 cephalometric landmarks on 20 CBCT scans of Class I, pre-orthodontic patients and repeated the landmark identification about two months later. Intraclass correlations (ICC) were calculated by landmark in the X, Y, and Z dimensions and F-test were used to assess difference in landmark location in the X, Y, and Z dimensions. Results: The majority of landmarks had good to excellent ICC for both inter- and intraobserver reliability. F-test also showed the majority of landmarks had no significant difference between the observers. Conclusion: Most landmarks showed good to very good reliability and reproducibility using ProPlan CMF, with some landmarks proving more reliable than others and further research is needed to establish the utility and practicality of three-dimensional cephalometrics as a common diagnostic tool in orthodontics