CBCT-based bone quality assessment: are Hounsfield units applicable?

Pauwels, Ruben; Jacobs, Reinhilde; Singer, Shepherd Roee; Mupparapu, Mel

doi:10.1259/dmfr.20140238

Cited by 320 publications

(279 citation statements)

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“…4 In addition, the evaluation of bone quality has evolved from a density-based approach to a structural approach. 6 Hence, the potential application of bone structure parameters has gained attention.…”

Section: Discussionmentioning

confidence: 99%

“…1 Currently, bone evaluation is mainly limited to dimensional measurements 2 and a visual analysis of bone quality. 3 Owing to various issues related to the use of grey values in CBCT for absolute or relative density estimations, 4 alternative methods for quantitative bone analysis have been explored. 5 Recently, the application of bone structure (or microarchitecture) analysis, 6 which has been used ex vivo on bone samples visualized in two dimension (histomorphometry) or three dimension (micro-CT), 7,8 has been considered for CBCT.…”

Section: Introductionmentioning

confidence: 99%

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Effect of exposure parameters and voxel size on bone structure analysis in CBCT

Pauwels¹,

Faruangsaeng²,

Charoenkarn³

et al. 2015

Dentomaxillofacial Radiology

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Objective: To evaluate the effect of exposure parameters and voxel size on bone structure analysis in dental CBCT. Methods: 20 cylindrical bone samples underwent CBCT scanning (3D Accuitomo 170; J. Morita, Kyoto, Japan) using three combinations of tube voltage (kV) and tube currentexposure time product (mAs), corresponding with a CT dose index of 3.4 mGy: 90 kV and 62 mAs, 73 kV and 108.5 mAs, and 64 kV and 155 mAs. Images were reconstructed with a voxel size of 0.080 mm. In addition, the 90 kV scan was reconstructed at voxel sizes of 0.125, 0.160, 0.200, 0.250 and 0.300 mm. The following parameters were measured: bone surface (BS) and bone volume (BV) per total volume (TV), fractal dimension, connectivity density, anisotropy, trabecular thickness (Tb. Th.) and trabecular spacing (Tb. Sp.), structure model index (SMI), plateness, branches, junctions, branch length and triple points. Results: For most parameters, there was no significant effect of the kV value. For BV/TV, "90 kV" differed significantly from the other kV settings; for SMI, "64 vs 73 kV" was significant. For BS/TV, fractal dimension, connectivity density, branches, junctions and triple points values incrementally decreased at larger voxel sizes, whereas an increase was seen for Tb. Th., Tb. Sp., SMI and branch length. For anisotropy and plateness, no (or little) effect of voxel size was seen; for BV/TV, the effect was inconsistent. Conclusions: Most bone structure parameters are not affected by the kV if the radiation dose is constant. Parameters dealing with the trabecular structure are heavily affected by the voxel size. Dentomaxillofacial Radiology (2015Radiology ( ) 44, 20150078. doi: 10.1259 Cite this article as: Pauwels R, Faruangsaeng T, Charoenkarn T, Ngonphloy N, Panmekiate S. Effect of exposure parameters and voxel size on bone structure analysis in CBCT. Dentomaxillofac Radiol 2015; 44: 20150078.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effect of exposure parameters and voxel size on bone structure analysis in CBCT

Pauwels¹,

Faruangsaeng²,

Charoenkarn³

et al. 2015

Dentomaxillofacial Radiology

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“…This type of measurement again requires taking a radiograph immediately after tooth extraction and one at the time of implant placement. However, CT scans must be made to determine the bone density, as reduced radiation CBCT can provide only limited density information [27]. Virtual overlays of CBCT images have been described as an alternative way of obtaining data from evaluations and measurements of three-dimensional radiographs [28].…”

Section: Exclusion Criteriamentioning

confidence: 99%

Alveolar Ridge Preservation as a Way to Reduce the Need for Bone Augmentation: Implementation of a New, Non-invasive Method of Measuring Bone Preservation: Study Protocol of a Randomized Controlled Clinical Trial and Feasibility Testing Results

Schnutenhaus¹,

Dreyhaupt²,

Doering³

et al. 2017

Int J Clin Res Trials

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Introduction: The efficacy of alveolar ridge preservation (ARP) in preserving the bone after tooth extractions and before rehabilitation with an implant-supported restoration is examined. A new, non-invasive measurement method to determine the extent of bone preservation is presented. This measurement method is based on a 3D comparison of the condition immediately after extraction with the data of a cone-beam computed tomography (CBCT) eight weeks after extraction. Method:The study is a single-center, randomized, controlled parallel-group clinical investigation. 88 patients who required extraction of a maxillary tooth participated in the study. In 44 patients (intervention group), the socket is filled with a combination of a collagen plug and a collagen membrane introduced in the empty socket immediately after tooth removal (ARP). The 44 patients (control group) experience unassisted socket healing the hyporeflective space. Primary endpoints are (1) bone loss after tooth extraction; (2) the preservation of the alveolar ridge (soft tissue and bone); (3) the need for augmentation during the subsequent implant treatment; and (4) the question whether ARP is more costeffective than the therapy with unassisted socket healing. Patients will be followed for 5 years. Discussion:The extent of bone resorption after tooth extraction significantly influences the subsequent implant placement. Preserving the bone as well as possible is of great importance for the stability, prosthetically correct position and long-term functional success of the implantological treatment. A new, non-invasive method, without additional, study-related X-ray exposure, presented here for the first time, the change in volume of the bone bed can be analyzed. The preliminary results of this feasibility test report a median value of buccal and palatal bone loss of 6.2 mm (control)/4.4 mm (test) and 2.5 mm (control)/2.8 mm (test), respectively. These values are comparable to studies that also determined bone resorption by CBCT.

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“…developers to fully achieve this potential as concluded in Paper 4 [53]. This paper was recently cited in the literature [90].…”

Section: Thesis Pointsmentioning

confidence: 99%

“…À1000.00 0.00* À1000.00 0.00* À1000.00 0.00* À1000.00 0.00* LDPE, low-density polyethylene. Phantoms are positioned in 4 different concentric rotational positions (90 ) in the analysis of the iCAT Classic cone beam computed tomography imaging system (RD600 02). The rotation of the phantom does not cause significant changes in AD fidelity.…”

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confidence: 99%

Examination of Grey Value Accuracy and Improvement of Image Quality in Cone Beam Computed Tomography (CBCT)

Plachtovics

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The WARM operation mode represents that the CBCT machine was switched on for at least two hours before the scan but no detector calibration was performed. WARM+C WARM+C scan protocol is consistent with the cone beam computed tomography scan with the complete calibration sequence after the warming-up period. The two-hour warming-up period preceded the calibration process. WUP warming-up period 2D 2 dimensional 3D 3 dimensional iv Galen's principal interest was in human anatomy but, from about 150 BC [2], Roman law had prohibited the dissection of human cadavers. Because of this restriction, Galen performed anatomical dissections on living (vivisection) and dead animals, mostly focusing on pigs and primates [3]. This work was useful because the anatomical structures of these animals usually closely mirror those of humans. Galen clarified the anatomy of the trachea, and was the first to demonstrate that the larynx generates the voice [4,5]. In one experiment, Galen used bellows to inflate the lungs of a dead animal. In his work De motu musculorum, Galen explained the difference between motor and sensory nerves, discussed the concept of muscle tone, and explained the difference between agonists and antagonists [5,6].Andreas Vesalius ( This environment, which lasted from the second century (Galenius) to the sixteenth century (Vesalius), developed a strong desire to have the ability to see inside the human body [7]. Development of medical imagingDuring many centuries the only way to visualize the inside of the human body was through dissection. With technical development, scientists had started to investigate the inside of the human body without its opening. In 1881, Alexander Graham Bell attempted to use magnets and sound waves to discover the location of the bullet that eventually killed U.S.President James A. Garfield [8].After a lengthy period, during scientific experiments with various types of vacuum tube equipment, the discovery of X-rays in 1895, by the Bavarian physicist Conrad Röntgen, represented a major breakthrough (Figure 3 A). When X-rays were finally discovered, they found their way to medical applications within months [9]. B C A 3The original discovery by Röntgen, at the Physical Institute, Julius-Maximilian University, Würzburg, Germany, is recorded to be on 8 November 1895 [9][10][11][12][13][14][15][16][17]. During the discovery, he speculated that a new kind of ray might be responsible for the observation.Since 8 th November was a Friday, instead of relaxing over the weekend, Röntgen took advantage of the time to repeat his experiments. In the following weeks he investigated many properties of the new rays he had temporarily termed 'X-ray'. In fact, he virtually lived in his laboratory during that time. The new X-ray is called the 'Röntgen ray' in many languages [18]. Nearly two weeks after his discovery, he took the very first picture using X-rays of his wife Anna Bertha's hand. When she saw her skeleton she exclaimed 'I have seen my death!' (Figure 3 B and C) [10,18]. Röntgen receive the fir...

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CBCT-based bone quality assessment: are Hounsfield units applicable?

Cited by 320 publications

References 85 publications

Effect of exposure parameters and voxel size on bone structure analysis in CBCT

Effect of exposure parameters and voxel size on bone structure analysis in CBCT

Alveolar Ridge Preservation as a Way to Reduce the Need for Bone Augmentation: Implementation of a New, Non-invasive Method of Measuring Bone Preservation: Study Protocol of a Randomized Controlled Clinical Trial and Feasibility Testing Results

Examination of Grey Value Accuracy and Improvement of Image Quality in Cone Beam Computed Tomography (CBCT)

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