Introduction: Recently, there are many investigations in a trail to shift from
the direct three- dimensional image to CBCT derived cephalometric image takes
place. It is important to investigate whether it is possible to use a CBCT derived
cephalometric image to direct three-dimensional image, by comparing the angle and
linear measurements of soft tissue structures assessed from a midsagittal projection
using 3D cone-beam computed tomography (CBCT) compared with those evaluated
through derived lateral cephalometric imaging. Aim: to evaluate the dependability
and reliability of soft tissue orthodontic measurements acquired from derived cone
beam computed tomography (CBCT). Materials and Methods: Forty CBCT scans;
from the archive of Oral Radiology department Suez Canal University, Ismailia,
Egypt, were used. Landmark identification carried out using OnDemand3DApp < br />program (cybermed Inc., Seoul, Korea) imaging software. Ten linear ratios and five
angles were measured three times. Independent T-test used in this study to analyze the
distinctions between two imaging modalities (direct CBCT and derived images at a
significant level of probability (P£0.05). Results: There were no statistically significant
differences were found between the direct CBCT and the derived imaging types in all
measurements assessed, with the exception of the upper lip in reference to the E-line,
which demonstrated a highly significant result. Conclusion: The derived CBCT can be
considered a reliable approach for creating a database of facial soft tissue and can be
utilized as a substitute for traditional lateral cephalograms when the patient's CBCT is
already available, thereby minimizing the patient's exposure to radiation.