A method for measuring three-dimensional mandibular kinematics in vivo using single-plane fluoroscopy

Objectives: Accurate measurement of the three-dimensional (3D) motion of the mandible in vivo is essential for relevant Clinical applications. Existing techniques are either of limited accuracy or require the use of transoral devices that interfere with jaw movements. This study aimed to develop further an existing method for measuring 3D, in vivo mandibular kinematics using single-plane fluoroscopy; to determine the accuracy of the method; and to demonstrate its clinical applicability via measurements on a healthy subject during opening/closing and chewing movements. Methods: The proposed method was based on the registration of single-plane fluoroscopy images and 3D low-radiation cone beam CT data. It was validated using roentgen single-plane photogrammetric analysis at static positions and during opening/closing and chewing movements. Results: The method was found to have measurement errors of 0.1 +/- 0.9 mm for all translations and 0.2 degrees +/- 0.6 degrees for all rotations in static conditions, and of 1.0 +/- 1.4 mm for all translations and 0.2 degrees +/- 0.7 degrees for all rotations in dynamic conditions. Conclusions: The proposed method is considered an accurate method for quantifying the 3D mandibular motion in vivo. Without relying on transoral devices, the method has advantages over existing methods, especially in the assessment of patients with missing or unstable teeth, making it useful for the research and clinical assessment of the temporomandibular joint and chewing function. Dentomaxillofacial Radiology (2013) 42, 95958184. doi: 10.1259/dmfr/95958184