{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,28]],"date-time":"2026-06-28T07:01:20Z","timestamp":1782630080818,"version":"3.54.5"},"reference-count":18,"publisher":"The Angle Orthodontist (EH Angle Education & Research Foundation)","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2009,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n        <jats:p>\n          <jats:bold>Objective:<\/jats:bold> To evaluate intra-examiner and inter-examiner reliability of 3D CBCT-generated landmarks previously used in traditional 2D cephalometry.<\/jats:p>\n        <jats:p>\n          <jats:bold>Materials and Methods:<\/jats:bold> Twenty-four CBCTs NewTom 3G (Aperio Services, Verona, Italy) were randomly selected from patients participating in a clinical trial involving maxillary expansion treatments. The principal investigator located the landmarks five times, and four other investigators located the same landmarks once. Intra-examiner and inter-examiner reliability values were determined using intraclass correlation coefficients (ICCs). To assist in interpretation of the clinical significance of landmark identification differences, average mean differences for x, y, and z landmark coordinates were determined from the repeated assessments. Landmarks then were separated into groups with respect to the region they represented and then were compared via repeated measures ANOVA and multiple comparisons via Bonferroni corrected \u03b1.<\/jats:p>\n        <jats:p>\n          <jats:bold>Results:<\/jats:bold> Intra-examiner and inter-examiner reliability for x, y, and z coordinates for all landmarks were acceptable, all being greater than 0.80. Most of the mean measurement differences obtained from trials within the principal investigator in all three axes were less than 1.5 mm. Inter-examiner mean measurement differences generally were larger than the intra-examiner differences.<\/jats:p>\n        <jats:p>\n          <jats:bold>Conclusions:<\/jats:bold> Based on this, the best landmarks for use in verifying expansion treatment results are Ekm, buccal surface, and apexes of upper molars, upper premolars and upper canines, and buccal surfaces of lower molars and lower canines. Foramen Spinosum, ELSA, Auditory External Meatus, and Dorsum Foramen Magnum demonstrated adequate reliability for determining a standardized reference system.<\/jats:p>","DOI":"10.2319\/010509-10r.1","type":"journal-article","created":{"date-parts":[[2009,5,29]],"date-time":"2009-05-29T18:16:08Z","timestamp":1243620968000},"page":"1047-1056","source":"Crossref","is-referenced-by-count":53,"title":["Reliability of Traditional Cephalometric Landmarks as Seen in Three-Dimensional Analysis in Maxillary Expansion Treatments"],"prefix":"10.2319","volume":"79","author":[{"given":"Manuel O.","family":"Lagrav\u00e8re","sequence":"first","affiliation":[{"name":"a\u2009Research Associate, Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta, Canada"},{"name":"Corresponding author: Dr Manuel O. Lagrav\u00e8re, Faculty of Medicine and Dentistry, Room 4048, Dentistry\/Pharmacy Centre, University of Alberta, Edmonton, Alberta T6G 2N8, Canada (manuel@ualberta.ca)"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian M.","family":"Gordon","sequence":"additional","affiliation":[{"name":"b\u2009MSc student, Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ines H.","family":"Guedes","sequence":"additional","affiliation":[{"name":"c\u2009MSc student, TMD\/Orofacial Pain Program, Faculty of Medicine and Dentistry, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos","family":"Flores-Mir","sequence":"additional","affiliation":[{"name":"d\u2009Associate Professor, Orthodontic Graduate Program, Department of Dentistry, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jason P.","family":"Carey","sequence":"additional","affiliation":[{"name":"e\u2009Associate Professor, Mechanical Engineering, Faculty of Engineering, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giseon","family":"Heo","sequence":"additional","affiliation":[{"name":"f\u2009Assistant Professor of Statistics, Orthodontic Graduate Program, Department of Dentistry, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul W.","family":"Major","sequence":"additional","affiliation":[{"name":"g\u2009Professor, Director of the Orthodontic Graduate Program, Faculty of Medicine and Dentistry, University of Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1164","reference":[{"key":"i0003-3219-079-06-1047-b1","series-title":"Angle Orthod","first-page":"1046","article-title":"Long-term skeletal changes with rapid maxillary expansion: a systematic review.","volume":"75","author":"Lagrav\u00e8re, M. O.","year":"2005","unstructured":"Lagrav\u00e8re, M. O., P. W.Major, and C.Flores-Mir. Long-term skeletal changes with rapid maxillary expansion: a systematic review.Angle Orthod2005. 75:1046\u20131052."},{"key":"i0003-3219-079-06-1047-b2","series-title":"Angle Orthod","first-page":"155","article-title":"Long-term dental arch changes after rapid maxillary expansion treatment: a systematic review.","volume":"75","author":"Lagrav\u00e8re, M. O.","year":"2005","unstructured":"Lagrav\u00e8re, M. O., P. W.Major, and C.Flores-Mir. Long-term dental arch changes after rapid maxillary expansion treatment: a systematic review.Angle Orthod2005. 75:155\u2013161."},{"key":"i0003-3219-079-06-1047-b3","series-title":"J Am Dent Assoc","first-page":"194","article-title":"Skeletal and dental changes with fixed slow maxillary expansion treatment: a systematic review.","volume":"136","author":"Lagrav\u00e8re, M. O.","year":"2005","unstructured":"Lagrav\u00e8re, M. O., P. W.Major, and C.Flores-Mir. Skeletal and dental changes with fixed slow maxillary expansion treatment: a systematic review.J Am Dent Assoc2005. 136:194\u2013199."},{"key":"i0003-3219-079-06-1047-b4","series-title":"Int J Oral Maxillofac Surg","first-page":"481","article-title":"Dental and skeletal changes following surgically assisted rapid maxillary expansion.","volume":"35","author":"Lagrav\u00e8re, M. O.","year":"2006","unstructured":"Lagrav\u00e8re, M. O., P. W.Major, and C.Flores-Mir. Dental and skeletal changes following surgically assisted rapid maxillary expansion.Int J Oral Maxillofac Surg2006. 35:481\u2013487."},{"key":"i0003-3219-079-06-1047-b5","series-title":"Angle Orthod","first-page":"447","article-title":"Landmark identification error in posterior anterior cephalometrics.","volume":"64","author":"Major, P. W.","year":"1994","unstructured":"Major, P. W., D. E.Johnson, K. L.Hesse, and K. E.Glover. 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C.","year":"2007","unstructured":"Goldenberg, D. C., N.Alonso, and F. C.Goldenberg. et al. Using computed tomography to evaluate maxillary changes after surgically assisted rapid palatal expansion.J Craniofac Surg2007. 18:302\u2013311."},{"key":"i0003-3219-079-06-1047-b9","series-title":"J Craniofac Surg","first-page":"433","article-title":"Transverse effects after surgically assisted rapid maxillary expansion in the midpalatal suture using computed tomography.","volume":"19","author":"Loddi, P. P.","year":"2008","unstructured":"Loddi, P. P., M. D.Pereira, A. B.Wolosker, C. T.Hino, T. M.Kreniski, and L. M.Ferreira. 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J.","year":"2008","unstructured":"Garrett, B. J., J. M.Caruso, K.Rungcharassaeng, J. R.Farrage, J. S.Kim, and G. D.Taylor. Skeletal effects to the maxilla after rapid maxillary expansion assessed with cone-beam computed tomography.Am J Orthod Dentofacial Orthop2008. 134:8\u20139."},{"key":"i0003-3219-079-06-1047-b12","series-title":"Angle Orthod","first-page":"548","article-title":"Rapid maxillary expansion\u2014tooth tissue-borne versus tooth-borne expanders: a computed tomography evaluation of dentoskeletal effects.","volume":"75","author":"Garib, D. G.","year":"2005","unstructured":"Garib, D. G., J. F.Henriques, G.Janson, M. R.Freitas, and R. A.Coelho. 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O.Lagrav\u00e8re, and W.Harzer. Three-dimensional evaluation of surgically assisted implant bone-borne rapid maxillary expansion: a pilot study.Am J Orthod Dentofacial Orthop2007. 131:S92\u2013S99."},{"key":"i0003-3219-079-06-1047-b15","series-title":"Angle Orthod","first-page":"51","article-title":"Effect of head orientation on posterior anterior cephalometric landmark identification.","volume":"66","author":"Major, P. W.","year":"1996","unstructured":"Major, P. W., D. E.Johnson, K. L.Hesse, and K. E.Glover. Effect of head orientation on posterior anterior cephalometric landmark identification.Angle Orthod1996. 66:51\u201360."},{"key":"i0003-3219-079-06-1047-b16","series-title":"Eur J Orthod","first-page":"569","article-title":"The clinical significance of error measurement in the interpretation of treatment results.","volume":"23","author":"Kamoen, A.","year":"2001","unstructured":"Kamoen, A., L.Dermaut, and R.Verbeeck. 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