REPRODUCIBILITY OF LINEAR ALVEOLAR RIDGE MEASUREMENTS IN 2 DICOM CBCT VIEWING SOFTWARE PROGRAMS: A PILOT STUDY

Abstract

Objectives The aim of the study was to determine if the same critical measurement of vertical alveolar ridge height at a dentoalveolar implant recipient site can be measured to the same degree of accuracy from cone beam computed tomography (CBCT) volumetric data with 2 very popular but different commercially available DICOM (Digital Imaging and Communications in Medicine) imaging software: InVivoDental (Anatomage, San Jose, CA, USA) and CareStream 3D (CareStream Dental, Rochester, NY, USA). To determine the degree of precision of alveolar ridge height measurements, we used 2 different DICOM imaging software: InVivoDental (Anatomage, San Jose, CA, USA) and CareStream 3D (CareStream Dental, Rochester, NY, USA). Methods Fifteen maxillary and 15 mandibular posterior implant sites were selected from CBCT patient records (institutional review board # 5160188) at the Loma Linda University School of Dentistry (Loma Linda, CA). The sites also had radiographic stents with directional guide holes for the proposed implant. Two observers, one for each software, used the measurement tools to record the measurements. The measurement line was along the guide hole path from the peripheral crestal cortex to the peripheral cortex of the sinus floor (maxilla) and to the superior mandibular canal border (mandible). The examiners were calibrated on identifying the inferior maxillary sinus border, superior mandibular canal border, and the radiographic stent guide holes. The 2 examiners then independently performed measurements in the paracoronal and parasagittal planes. The means of the 4 independent linear measurements at each of the implant locations in each software were tested with the GraphPad QuickCalcs t test calculator for paired samples at the 5% level of significance. Results There was no difference (P > .05) between linear measurement distances made in 2 different DICOM compliant 3D viewer software when comparing only sagittal, only coronal, or combined sagittal and coronal implant recipient site measurements in the posterior maxilla or mandible. Discussion No difference can be expected when making measurements from a CBCT scan when data are converted to the DICOM file format and measured with the 2 programs used in this study. However, to obtain agreement, the measurement process is very rigorous. Any variation in the technique could cause variation and clinical inaccuracy. Future studies are suggested to determine if proprietary volumetric data set file formats or other DICOM third-party software would also demonstrate the same degree of measurement comparability. In support of such research, the data from this study suggest that if clinicians make measurements relative to predefined reference points, then a similar degree of accuracy in the measurements can be expected. Conclusions There is no difference in vertical linear measurements of implant sites in the posterior maxilla or the posterior mandible when measuring DICOM-compatible volumetric data sets with either InVivoDental or CareStream viewer software.