Assessment of the Accuracy of Panoramic Radiography (PR), Cone Beam Computed Tomography (CBCT) and Clinical Methods in Measuring Alveolar Bone Dimension: A Comparative Study

Abstract

Objective: To assess and compare the accuracy of panoramic radiography, cone beam computed tomography (CBCT) and clinical methods in measuring dimensions of alveolar bone.

Methods: One hundred and four panoramic radiographs (PR) and CBCT images were obtained from patients attending for implant therapy. Alveolar bone dimensions were determined using a accompanying system software on the PRs and the CBCT images. Mucoperiosteal flap was raised and clinical dimensions of the bone were measured by a periodontal probe and bone gauge while placing the implants. The differences of bone height and thickness measurements between clinical measurements and CBCT or PR were calculated using Student’s t- test.

Results: The mean bone height was 11.98±1.23 mm clinically, 11.04±1.42 and 11.01±1.47 mm when measured on PR and CBCT respectively.  A significant difference was observed between the clinical and PR(P<0.0001) but clinical and CBCT measurements revealed no significant difference (P>0.05). When the bone height was calculated, 61.5%, 53.8% and 59.61% of the images were in the normal range using CBCT, PR and clinical measurements, respectively. The mean areas under the ROC curve were 0.89 in CBCT and 0.84. The mean bone thickness was 7.09±0.54 mm when measured clinically and was 6.86±0.16 mm in CBCT (P=0.346, Student’s t-test).

Conclusion: Precision of the images by CBCT was higher than PR in analyzing the bone measurements and this system can be unquestionably used to compute the bone measurements during implant therapy.