Li Chenshuang, Lin Leanne, Zheng Zhong, Chung Chun-Hsi
Department of Orthodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Division of Growth and Development, Section of Orthodontics, School of Dentistry, University of California, Los Angeles, CA 90095, USA.
J Clin Med. 2021 Jan 1;10(1):127. doi: 10.3390/jcm10010127.
Since cone-beam computed tomography (CBCT) technology has been widely adopted in orthodontics, multiple attempts have been made to devise techniques for mandibular segmentation and 3D superimposition. Unfortunately, as the software utilized in these methods are not specifically designed for orthodontics, complex procedures are often necessary to analyze each case. Thus, this study aimed to establish an orthodontist-friendly protocol for segmenting the mandible from CBCT images that maintains access to the internal anatomic structures.
The "sculpting tool" in the Dolphin 3D Imaging software was used for segmentation. The segmented mandible images were saved as STL files for volume matching in the 3D Slicer to validate the repeatability of the current protocol and were exported as DICOM files for internal structure analysis and voxel-based superimposition.
The mandibles of all tested CBCT datasets were successfully segmented. The volume matching analysis showed high consistency between two independent segmentations for each mandible. The intraclass correlation coefficient (ICC) analysis on 20 additional CBCT mandibular segmentations further demonstrated the high consistency of the current protocol. Moreover, all of the anatomical structures for superimposition identified by the American Board of Orthodontics were found in the voxel-based superimposition, demonstrating the ability to conduct precise internal structure analyses with the segmented images.
An efficient and precise protocol to segment the mandible while retaining access to the internal structures was developed on the basis of CBCT images.
自从锥形束计算机断层扫描（CBCT）技术在正畸学中被广泛应用以来，人们多次尝试设计下颌骨分割和三维叠加技术。遗憾的是，由于这些方法中使用的软件并非专门为正畸学设计，通常需要复杂的程序来分析每个病例。因此，本研究旨在建立一种对正畸医生友好的方案，用于从CBCT图像中分割下颌骨，同时保持对内部解剖结构的观察。
使用Dolphin 3D成像软件中的“雕刻工具”进行分割。分割后的下颌骨图像保存为STL文件，以便在3D Slicer中进行体积匹配，以验证当前方案的可重复性，并导出为DICOM文件用于内部结构分析和基于体素的叠加。
所有测试的CBCT数据集的下颌骨均成功分割。体积匹配分析显示每个下颌骨的两次独立分割之间具有高度一致性。对另外20个CBCT下颌骨分割进行的组内相关系数（ICC）分析进一步证明了当前方案的高度一致性。此外，在基于体素的叠加中发现了美国正畸委员会确定的所有用于叠加的解剖结构，证明了使用分割图像进行精确内部结构分析的能力。
基于CBCT图像开发了一种高效、精确的方案，用于分割下颌骨，同时保留对内部结构的观察。
