Diagnostic Value of Panoramic Radiography, Cone Beam Computed Tomography (CBCT) and Clinical Measurement in Determining Bone Dimensions

Abstract

Introduction: Calculation of the bone dimensions is of great importance for implant treatment. Several radiographic modalities have been used for this purpose. This study compared the accuracy of mesiodistal measurements of bone using panoramic radiography, cone beam computed tomography (CBCT), and the clinical methods. Methods: In this descriptive cross-sectional study, panoramic and CBCT images were obtained from 100 implant patients. Mesiodistal bone dimensions (distance between tooth CEJ in the mesial of edentulous region and CEJ of the tooth in distal of edentulous region) were calculated using a scaled ruler on the orthopantomograms and the system software in the CBCT images. During the implant insertions, a mucoperiosteal flap was raised and clinical dimensions of the bone were measured by a periodontal probe and bone gauge. The differences of bone height and thickness measurements between gold standard and CBCT or panoramic modalities were analyzed using Student’s t- test. Results: The mean bone height was 10.64±1.55, 11.44±1.51, and 10.68±1.6 mm in the clinical, panoramic and CBCT modalities, respectively. Statistically significant difference was noted between the clinical and panoramic techniques ( P 0.05). During the bone height calculations, 79%, 62% and 78% of the images were ranked in the normal range using CBCT, panoramic and gold standard measurements, respectively. The mean areas under the ROC curve were 0.92 and 0.83 in CBCT and panoramic techniques, respectively. Conclusion: Accuracy of the CBCT images was higher than panoramic technique in measuring the bone dimensions and this technique can be confidently used to calculate the bone dimensions for the implant surgeries. Keywords: Partially edentulous jaw; panoramic radiography; cone-beam computed tomography; bone dimensions