Fatima Fariha, Hallolli Chandrashekhar, Tubaki Roopa, Shah Ieeshan Farooq, Thekiya Altaf H, Tabassum Humera, Gupta Seema
Department of Orthodontics and Dentofacial Orthopedics, Amrith Educational & Cultural Society (AECS) Maaruti College of Dental Sciences and Research Centre, Bengaluru, IND.
Department of Conservative Dentistry and Endodontics, Kalka Dental College, Meerut, IND.
Cureus. 2025 Mar 30;17(3):e81445. doi: 10.7759/cureus.81445. eCollection 2025 Mar.
Facial analysis plays an important role in evaluating and planning treatments related to dental, surgical, and forensic applications. Traditionally, cephalometric radiography has been widely used to assess craniofacial structures, providing information on skeletal and dental relationships. Recently, photogrammetry has gained attention as a noninvasive method that utilizes standardized photographs to evaluate facial proportions and symmetry, eliminating radiation exposure. This study focuses on comparing photogrammetric measurements with radiographic and direct measurements to evaluate the accuracy and reliability of photogrammetry for facial analysis.
This prospective, observational, cross-sectional study was conducted in the Department of Orthodontics and Dentofacial Orthopedics, Amrith Educational & Cultural Society (AECS) Maaruti College of Dental Sciences & Research Centre, Bengaluru, over two years, from September 2020 to July 2022. Fifty participants (18-25 years old) with well-balanced facial profiles were included in this study. Standardized frontal and lateral photographs were obtained under controlled lighting conditions and subject positioning. Cephalometric radiographs were obtained using digital radiography units (DRUs). Direct anthropometric measurements were recorded using a digital Vernier caliper. Eighteen cephalometric landmarks were identified for comparison purposes. Image analysis was performed using image software. Statistical analysis was conducted using Kruskal-Wallis and post hoc Dunn tests to compare the methods. Intra- and inter-examiner reliability was assessed using the intraclass correlation coefficient (ICC).
The ICC values (0.85-0.91) indicated excellent measurement reliability. Photogrammetric measurements were generally higher in the horizontal frontal plane, whereas radiographic measurements yielded higher values in the vertical frontal plane. Lateral plane measurements showed greater agreement among the three methods, except for parameters such as tragon-to-subnasale distance (Trg-Sn) and alar-to-pronasale distance (Al-Prn), which differed significantly between groups.
Photogrammetry is a viable, noninvasive alternative to cephalometry, offering ease of use and radiation-free assessment. However, variations owing to head positioning, lack of depth perception, and minor magnification errors must be considered. Future studies should integrate three-dimensional imaging to enhance its accuracy and clinical applicability.
面部分析在评估和规划与牙科、外科及法医应用相关的治疗中起着重要作用。传统上，头影测量放射摄影已被广泛用于评估颅面结构，提供骨骼和牙齿关系的信息。最近，摄影测量法作为一种非侵入性方法受到关注，它利用标准化照片来评估面部比例和对称性，避免了辐射暴露。本研究重点比较摄影测量法与放射摄影测量法及直接测量法，以评估摄影测量法用于面部分析的准确性和可靠性。
本前瞻性、观察性横断面研究于2020年9月至2022年7月在班加罗尔阿姆里特教育与文化协会（AECS）马鲁蒂牙科学院及研究中心的正畸与牙颌面正畸科进行，为期两年。本研究纳入了50名面部轮廓匀称的参与者（年龄在18至25岁之间）。在可控照明条件和受试者体位下获取标准化的正面和侧面照片。使用数字放射摄影设备（DRU）获取头影测量放射照片。使用数字游标卡尺记录直接人体测量数据。为了进行比较，确定了18个头影测量标志点。使用图像软件进行图像分析。使用Kruskal-Wallis检验和事后Dunn检验进行统计分析以比较这些方法。使用组内相关系数（ICC）评估检查者内和检查者间的可靠性。
ICC值（0.85 - 0.91）表明测量可靠性极佳。在水平正面平面上，摄影测量法的测量值通常较高，而在垂直正面平面上，放射摄影测量法得出的值较高。除了诸如颧弓至鼻下点距离（Trg - Sn）和鼻翼至鼻前点距离（Al - Prn）等参数在各组之间存在显著差异外，侧面平面测量在三种方法之间显示出更高的一致性。
摄影测量法是一种可行的、非侵入性的头影测量替代方法，使用方便且无辐射评估。然而，必须考虑由于头部位置、缺乏深度感知和微小放大误差引起的变化。未来的研究应整合三维成像以提高其准确性和临床适用性。
