ArticleImaging science in dentistry2026
Reliability of dental-dedicated magnetic resonance imaging for 2-dimensional orthodontic diagnosis: A pilot study of landmark identification.
Article in Imaging science in dentistry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Lateral cephalograms are conventionally used for landmark identification and cephalometric analysis, but expose patients to ionizing radiation. Magnetic resonance imaging (MRI) is increasingly employed to evaluate various tissue types, with dental-dedicated MRI (ddMRI) emerging as a promising modality in clinical dentistry. High-quality MRI could offer a radiation-free alternative for orthodontic diagnosis and treatment planning. This pilot study aimed to evaluate the reliability of ddMRI for 2-dimensional (2D) orthodontic cephalometric landmark identification and annotation. Materials and Methods: Thirteen volunteers (7 men, 6 women; mean age 33±5.2 years) underwent ddMRI. Three independent raters identified 2D cephalometric landmarks and annotated their positions on the same ddMRI datasets twice. The 3D Slicer application was used to identify key orthodontic cephalometric landmarks on multiplanar reconstruction images in the sagittal plane. Intra-rater and inter-rater reproducibility were assessed using intraclass correlation coefficients (ICCs), and reliability was evaluated by nominal differences in linear distance (mm) between annotated points. Results: Intra-rater ICCs ranged from 0.909 to 0.999, and inter-rater ICCs ranged from 0.988 to 0.999, indicating excellent intra- and inter-rater reliability. Bland-Altman plots were used to display mean differences (mm) and limits of agreement (±1.96 standard deviations) between annotations to assess potential biases. Conclusion: ddMRI is a feasible imaging modality for 2D orthodontic landmark identification. Based on intra- and inter-rater reproducibility values, ddMRI demonstrates high reliability in identifying key orthodontic cephalometric landmarks, providing a radiation-free alternative for orthodontic diagnosis and treatment planning.
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