Integration accuracy of craniofacial cone-beam computed tomography images with three-dimensional facial scans according to different registration areas

Objectives: To evaluate the integration accuracy of cone-beam computed tomography (CBCT) images with three-dimensional (3D) facial scans according to different registration areas.Materials and Methods: Twenty-five patients (14 males and 11 females), with a mean age of 19.0 6 11.3 years, were included in this study. Each patient underwent CBCT and facial scans on the same day in an upright position. The facial scans were integrated with the corresponding soft-tissue images of CBCT scans. Three methods were used to integrate the two imaging modalities based on the facial regions scanned: R1, only the forehead and nasal bridge area were included; R2, the right and left malar area were included; and R3, the forehead, nasal bridge, and malar areas were included. The integration accuracy between the facial scans and CBCT images was evaluated by color-mapping methods and average surface distances, calculated by measuring the 3D distances between the surface points on the two superimposed images.Results: The average surface differences between facial scans and CBCT images were less than 1.0 mm in all three methods. The R3 method showed fewer differences between the facial scans and CBCT images than the other methods did.Conclusions: Facial scans obtained using a low-cost facial scanner showed clinically acceptable performance. The integration accuracy of facial and CBCT scans can be increased by including the forehead, nasal bridge, and malar areas as registration areas. (Angle Orthod. 2022;93:66-70.)