Comparison of the accuracy of 2D and 3D cephalometry: a systematic review and meta-analysis

Objectives To compare the measurement of cephalometric parameters using 3D images obtained from CBCT to 2D images obtained from a conventional cephalogram. Methods An electronic literature search was conducted using PubMed, Embase, Web of Science, CNKI, CENTRAL, and the grey literature database of SIGLE (up to May 2021). The selection of the eligible studies, data extraction, and an evaluation for possible risk of bias (Quality Assessment of Measurement Accuracy Studies tool) were performed independently by two authors. Inconsistencies were judged by a third author. Statistical pooling, subgroup analysis, a sensitivity analysis and an evaluation of publication bias were performed using Comprehensive Meta-Analysis (version 2.2.064, Biostat, Englewood, NJ). Results A total of eight articles were eligible for final meta-analysis. The differences in two of the skeletal measurement parameters [Ar(Co)-Gn, Me-Go] and one of the dental measurement parameters (U1-L1) were found to be statistically significant when using CBCT and conventional cephalograms (P = 0.000, P = 0.004, P = 0.000, respectively). Conclusions CBCT can be used as a supplementary option to support conventional cephalometric measurements. In clinical situations in which three-dimensional information is required, patients can benefit from CBCT analysis to improve diagnosis and treatment planning.