Imaging Sci Dent.  2016 Jun;46(2):93-101. 10.5624/isd.2016.46.2.93.

The accuracy of linear measurements of maxillary and mandibular edentulous sites in conebeam computed tomography images with different fields of view and voxel sizes under simulated clinical conditions

• Ganguly R
• Ramesh A
• Pagni S

• KMID: 2308872
• DOI: http://doi.org/10.5624/isd.2016.46.2.93

Abstract

PURPOSE
The objective of this study was to investigate the effect of varying resolutions of cone-beam computed tomography images on the accuracy of linear measurements of edentulous areas in human cadaver heads. Intact cadaver heads were used to simulate a clinical situation.
MATERIALS AND METHODS
Fiduciary markers were placed in the edentulous areas of 4 intact embalmed cadaver heads. The heads were scanned with two different CBCT units using a large field of view (13 cm×16 cm) and small field of view (5 cm×8 cm) at varying voxel sizes (0.3 mm, 0.2 mm, and 0.16 mm). The ground truth was established with digital caliper measurements. The imaging measurements were then compared with caliper measurements to determine accuracy.
RESULTS
The Wilcoxon signed rank test revealed no statistically significant difference between the medians of the physical measurements obtained with calipers and the medians of the CBCT measurements. A comparison of accuracy among the different imaging protocols revealed no significant differences as determined by the Friedman test. The intraclass correlation coefficient was 0.961, indicating excellent reproducibility. Inter-observer variability was determined graphically with a Bland-Altman plot and by calculating the intraclass correlation coefficient. The Bland-Altman plot indicated very good reproducibility for smaller measurements but larger discrepancies with larger measurements.
CONCLUSION
The CBCT-based linear measurements in the edentulous sites using different voxel sizes and FOVs are accurate compared with the direct caliper measurements of these sites. Higher resolution CBCT images with smaller voxel size did not result in greater accuracy of the linear measurements.

Keyword

Cone-Beam Computed Tomography; Dental Implants; Cadaver; Imaging, Diagnostic

MeSH Terms

Cadaver
Cone-Beam Computed Tomography
Dental Implants
Diagnostic Imaging
Head
Humans
Observer Variation
Dental Implants

Figure

• 

  Fig. 1 Maxillary and mandibular measurement sites on the cone-beam computed tomography images. A. Max R1 is the height of the bone from the floor of the right maxillary sinus to the alveolar crest and Max R2 is the width of the bone at the alveolar crest at the right maxillary molar site. B. Man R1 is the height of the bone from the inferior alveolar nerve (IAN) canal to the alveolar crest in the molar area of the right mandible. Man R2 is the buccolingual width of bone at the alveolar crest in the molar area of the right mandible. Man R3 is the buccolingual width of the bone midway between the alveolar crest and superior cortex of the IAN in the molar area of the right mandible. Man R4 is the width of bone buccal to the IAN in the right mandibular molar area. Man R5 is the width of bone lingual to the IAN in the right mandibular molar area. C. The measurements are made at the right maxillary molar site. D. The measurements are made at the right mandibular molar site. E. reconstructed panoramic image of the cadaver head with the reference lines shows the site of the right mandibular molar measurements.

• 

  Fig. 2 Bland-Altman plot comparing measurement variability between both observers.

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