3D stereophotogrammetric image superimposition onto 3D CT scan images: the future of orthognathic surgery. A pilot study.

The aim of this study was to register and assess the accuracy of the superimposition method of a 3-dimensional (3D) soft tissue stereophotogrammetric image (C3D image) and a 3D image of the underlying skeletal tissue acquired by 3D spiral computerized tomography (CT). The study was conducted on a model head, in which an intact human skull was embedded with an overlying latex mask that reproduced anatomic features of a human face. Ten artificial radiopaque landmarks were secured to the surface of the latex mask. A stereophotogrammetric image of the mask and a 3D spiral CT image of the model head were captured. The C3D image and the CT images were registered for superimposition by 3 different methods: Procrustes superimposition using artificial landmarks, Procrustes analysis using anatomic landmarks, and partial Procrustes analysis using anatomic landmarks and then registration completion by HICP (a modified Iterative Closest Point algorithm) using a specified region of both images. The results showed that Procrustes superimposition using the artificial landmarks produced an error of superimposition on the order of 10 mm. Procrustes analysis using anatomic landmarks produced an error in the order of 2 mm. Partial Procrustes analysis using anatomic landmarks followed by HICP produced a superimposition accuracy of between 1.25 and 1.5 mm. It was concluded that a stereophotogrammetric and a 3D spiral CT scan image can be superimposed with an accuracy of between 1.25 and 1.5 mm using partial Procrustes analysis based on anatomic landmarks and then registration completion by HICP.