Abstract
BackgroundThe objective of this study is to analyze a set of previously developed and proposed image segmentation protocols for precision in both intra- and inter-rater reliability for in vivo tooth volume measurements using cone-beam computed tomography (CBCT) images.MethodsSix 3D volume segmentation procedures were proposed and tested for intra- and inter-rater reliability to quantify maxillary first molar volumes. Ten randomly selected maxillary first molars were measured in vivo in random order three times with 10 days separation between measurements. Intra- and inter-rater agreement for all segmentation procedures was attained using intra-class correlation coefficient (ICC).ResultsThe highest precision was for automated thresholding with manual refinements.ConclusionsA tooth volume measurement protocol for CBCT images employing automated segmentation with manual human refinement on a 2D slice-by-slice basis in all three planes of space possessed excellent intra- and inter-rater reliability. Three-dimensional volume measurements of the entire tooth structure are more precise than 3D volume measurements of only the dental roots apical to the cemento-enamel junction (CEJ).
Highlights
The objective of this study is to analyze a set of previously developed and proposed image segmentation protocols for precision in both intra- and inter-rater reliability for in vivo tooth volume measurements using cone-beam computed tomography (CBCT) images
Historically, the in vivo detection of changes to dental root morphology such as those associated with external root resorption (ERR) during the course of orthodontic treatment or related to trauma has been mainly through use of two-dimensional (2D) radiographs, most notably periapical radiographs [1,2,3]
2D periapical radiographs do not reveal external root resorption to an appreciable extent, except for frank apical root resorption, which appears to be in their realm of identification [7]
Summary
The objective of this study is to analyze a set of previously developed and proposed image segmentation protocols for precision in both intra- and inter-rater reliability for in vivo tooth volume measurements using cone-beam computed tomography (CBCT) images. The resulting use of 3D imaging has enabled the quantification and measurement of ERR to be completed with a high level of diagnostic accuracy and repeatability when compared to periapical radiographs [9,16,17,18]. The strength of cone-beam computed tomography (CBCT) for accurate dental volume measurements in vivo has been shown not to be statistically significantly different as in vitro measurements in one study [19] and even when comparing its accuracy to in vitro micro-CT imaging methods [20]; there may exist machine-specific variations. There exists a potential limiting factor inherent in the use of CBCT scans to measure accurate volumetric information as the time period required to capture the radiograph as patient movement during scans can reduce the accuracy of measurements [15,25]
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