Low-dose CBCT imaging of alveolar buccal bone adjacent to mandibular anterior teeth— a pilot study

Abstract

Objectives Accurate description of buccal bone adjacent to mandibular anterior teeth is helpful for planning and monitoring periodontal and orthodontic treatment. Low-dose cone beam computed tomography (LD-CBCT) imaging has shown promising results for very small dental structures in animals. This study asserts that LD-CBCT is sufficiently accurate to measure buccal alveolar bone adjacent to human mandibular anterior teeth. Materials and methods Buccal bone level adjacent to 16 mandibular anterior teeth from four human cadavers was measured radiographically using one high-dose (HD) CBCT protocol and two LD-CBCT protocols. The resulting radiographic measurements of buccal bone height (bl) and thickness (bt) were compared with reference probe and reflected-light microscopy measurements. Measurement medians and Bland–Altman plots were calculated, and a linear mixed model was used to compare raters and imaging modalities. Results All regression coefficients were approximately 0, indicating high interrater, intrarater, and intermodality agreement. No significant differences were found between reference measurements and CBCT protocols. The mean differences for bl measurements were 0.07 mm (rater 1 [r1]) and 0.12 mm (rater 2 [r2]) for HD-CBCT; 0.07 mm (r1) and 0.13 mm (r2) for LD-CBCT-1; and 0.02 mm (r1) and 0.01 mm (r2) for LD-CBCT-2. For bt measurements, mean differences were 0.02 mm (r1) and 0.02 mm (r2) for HD-CBCT; 0.01 mm (r1) and 0.01 mm (r2) for LD-CBCT-1; and 0.00 mm (r1) and 0.01 mm (r2) for LD-CBCT-2. Conclusions Within the limitations of the present study, LD-CBCT seems to be a precise method for describing buccal bone and its thickness adjacent to mandibular anterior teeth in this experimental setting. Clinical relevance For the first time, this study showed LD-CBCT produces excellent results and is a reliable modality for imaging buccal bone in vitro. If clinical studies confirm these results, LD-CBCT could enable better treatment planning and monitoring at a radiation dose that is far lower than that of conventional HD-CBCT but similar to that of panoramic views.

Accuracy of Intra-Oral Radiography and Cone Beam Computed Tomography in the Diagnosis of Buccal Bone Loss

“…Furthermore, creating extensive bone defects and taking multiple intra-oral radiographs and CBCT scans in a patient would be ethically unacceptable. For this reason, the methodology used is justified and in line with other studies [13,14,33].…”

“…In other words, it is far more likely to underestimate a buccal bone defect using IOR compared to CBCT. One of the only articles that is similar to our research is the paper by Ruetters et al [33]. In this pilot study, a low-dose CBCT was used to evaluate the buccal bone adjacent to the mandibular anterior teeth.…”

Performance of the Malmgren Index for Assessing Root Resorption on 2D vs. 3D Radiographs: A Pilot Study

“…Ruetters et al showed that low-dose CBCT is a precise and reliable method for detecting and measuring furcation defects in mandibular and maxillary molars in an experimental setting. They reported that low-dose CBCT has the potential to improve treatment planning and treatment monitoring, involving a far lower radiation dose than conventional high-dose-CBCT [ 28 ]. Oenning et al (DIMITRA research) demonstrated that it is possible to achieve a good balance between dose and image quality using a small FOV, and even small details can be assessed in likely optimized protocols (e.g., evaluation of lamina dura and periodontal ligament space).…”

The “Dedicated” C.B.C.T. in Dentistry

“…protocol and the Low Dose C.B.C.T. protocol used, ejected a dose (dap 69 and 87 mGycm2) which is lower than that of panoramic views (Dap 88 mGycm2) [10].…”

“…systems with low-dose protocols and ultra-low-dose C.B.C.T. are able to determine, with an appropriate diagnostic quality, both the vertical component and the horizontal component of bone, providing and representing an important accurate and reliable method for assessing the bone structure of the anterior area [10].…”