Objectives: The purpose of this study was to evaluate and reduce potential errors associated with superimposition of serial cone-beam computerized tomography (CBCT) images using planes based on cranial base landmarks.
Methods: CBCTs from 10 patients were analyzed. The potential impact of errors in cranial base landmark identification on assessment of the relative position of distant landmarks is mitigated by means of a mathematical algorithm that ensures that the distances and angles between landmark identification points are maintained for different images by readjusting the landmark coordinates.
Results: Significant improvement was observed after optimization. The errors found in a previous study were significantly reduced, some by more than 90%. Errors found in the standardization were viewed in both infraorbitals and mentons ranging from 1 to 3 mm.
Conclusions: The mathematical transformation to readjust the coordinates of ELSA, left and right auditory external meatus (AEM), and dorsum foramen magnum (DFM) points significantly improves their use for image superimposition.
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