Accuracy Of CBCT Research Articles

Evaluation of the Information Content of Cone Beam Computed Tomography and Sectioning of the Skeletonized Skull in the Study of Parameters of the Maxillary Sinus: A Retrospective Study

Annotation. The aim of the study is to compare the data obtained from the cutting of the jawbone in the maxillary sinus and the measurements obtained during the study of CBCT data. CBCT has been found to be sufficiently accurate to assess the anatomical topographic features of the maxillary sinus structure, with high research reliability. The accuracy of CBCT is comparable to that of the skeletal skull, making CBCT a reliable tool for studying maxillary sinus anatomy. Materials and methods. 48 certified skulls were studied. According to CBCT data, a three-dimensional model was constructed for each maxillary sinus by direct and indirect methods. To measure the parameters on the skull, a barbell rod was used with a follow-up check. Results. The corresponding metric characteristics are obtained: the volume of the sinus varies from 8.30 ± 1.48 cm3 to 41.92 ± 0.94 cm3, the tip of the anterior root of 1.7 teeth was from the bottom of the sinus, on average, by 4.86 ± 0.18 mm, 2.6 teeth – 4.04 ± 0.72 mm; which must be taken into account when performing interventions. Conclusions. The combination of CBCT and direct analysis provides the most complete understanding of the structure and variations of the structure of the sinus structure.

Influence of CBCT filters and contrast adjustments on peri-implant buccal bone thickness measurement and blooming expression.

To assess whether filter and contrast adjustments can improve the accuracy of CBCT in measuring the buccal bone thickness (BBT) adjacent to dental implants by reducing blooming artifacts. Homogeneous bone blocks with peri-implant BBT of 0.3mm, 0.5mm, and 1mm were scanned using the Orthophos SL system. Three dentists measured the BBT in 234 CBCT scans under different settings of contrast adjustments and 'Sharpen' filter activation. Additionally, implant diameter measurements were taken to assess blooming artifact expression. The differences between tomographic and actual measurements of BBT and implant diameter [(CBCT - actual) * 100 / actual] were subjected to Mixed ANOVA (α = 0.05). The group with the thinnest BBT (0.3mm) had the greatest difference between tomographic and actual measurements (79.9% ± 29.0%). Conversely, the 0.5mm (36.1% ± 38.4%) and 1mm (29.4% ± 12.3%) groups exhibited lower differences (p < 0.05). 'Sharpen' filter activation reduced blooming expression since it resulted in a lower difference for implant diameter (p < 0.05), but it did not influence BBT measurements (p = 0.673). Contrast settings had no impact on BBT (p = 0.054) or implant diameter measurements (p = 0.079). Although filter activation reduced blooming artifacts, neither filter nor contrast adjustments improved the accuracy of CBCT in measuring peri-implant BBT; actual BBT influenced this task. When assessing the peri-implant buccal bone plate in the CBCT system studied, dental surgeons may find it beneficial to adjust contrast and apply filters according to their preferences, since such adjustments were found to have no adverse effects on the diagnostic accuracy of this task. The use of the 'Sharpen' filter may lead to improved representation of implant dimensions.

The role of implants and implant prostheses on the accuracy and artifacts of cone-beam computed tomography: an in-vitro study

To assess the accuracy of CBCT in implant-supported prostheses and to evaluate metal artifacts with and without implants or implant prostheses. Accuracy and artifacts were assessed in the dried mandible at three points on the buccal and lingual cortical plates on the mandible's body near the crest and the base. On the buccal cortical plate, these points were labelled as A, B and C near the crest and D, E and F near the base of the body of the mandible. Similarly, points a to f were marked on the lingual cortical plate corresponding to points A to F. The study had two control groups, C0 for physical linear measurement (PLM) and C1 for radiographic linear measurement (RLM) and artifact assessment. There were seven test groups, TG 1 to 7, progressing from a single implant to implant full-arch prosthesis. For accuracy assessment, PLM was compared to RLM. CBCT artifacts were investigated in images integrated at 0.25 mm, 10 mm, and 20 mm at regions of interest on concentric circles at different intersecting angles by comparing grayscale values at C1 and TG1 to 7. The data were collected and statistically analyzed. A significant difference was observed between C0 and C1, and RLM in test groups at the superior axial plane. Similarly, PLM and test RLM in the sagittal plane at A-B, B-C, and D-E were statistically significant. A significant difference between PLM and RLM was also observed in the vertical plane at A-D, B-E, and C-F. Quantification of CBCT artifacts in the presence of implants or prostheses revealed that full-arch prostheses had the highest mean grayscale value, whereas single implants with a prosthesis had the lowest. The mean grayscale change was greatest around the implant and implant prosthesis. The mean grayscale value was maximum at 20 mm voxel integration scales (VIS) and lowest at 0.25 mm. CBCT is a clinically reliable device. Metal in implants or implant-supported prostheses prevents true assessment of the peri-implant area; therefore, lower VIS is suggested in the presence of implants or implant prostheses.

A 1 year follow-up of a molar root canal treatment using periapical radiographs and CBCT

CBCT offers many significant advantages in dentistry, while the periapical radiographs provide a cheaper technique and a lower radiation compared to CT scan. The aim of this clinical case was to compare the outcome 1 year after root canal treatment, using digital periapical radiographs versus CBCT. Tooth 46 with necrotic pulp and periapical periodontitis was rotary prepared and filled using continuous wave condensation and AH Plus. X-rays and CBCT scans were made both before and after the treatment, at 1 year recall. On x-ray the lesion appeared to be healed, while on CBCT one can still see a smaller lesion, so the tooth is healing. The increased accuracy of CBCT offers the most relevant information for the outcome of endodontic treatment.

MARGINAL BONE LEVEL CHANGES AROUND DENTAL IMPLANT BASED ON CONE BEAM COMPUTED TOMOGRAPHY AND RADIOVISIOGRAPHY - AN IN VIVO STUDY

Purpose:The aim of the present study was to evaluate and compare the marginal bone level changes around dental implants based on radiological examination by Radiovisiography and Cone beam computed tomography Materials and Method: For this in-vivo study, total of 14 implants were replaced in the edentulous area within the mouth randomly categorized under two groups which differ in evaluation method based on RVG and CBCT ..Group 1(n=7) Patients in which marginal bone loss was evaluated using RVG at baseline 3, 6 months interval . Group 2 (n=7) Patients in which marginal bone loss was evaluated using CBCT at baseline 3, 6 months interval Result: At the 3 months time interval the mean bone loss in the RVG was 0.155 and 0.672 in the CBCT on the mesial side The intergroup comparison of bone loss between RVG and CBCT was statistically significant when analyzed using Independent t test (p=0.001).At the 6 months time interval the mean bone loss in the RVG was 0.304 and 1.396 in the CBCT on the mesial side The intergroup comparison of bone loss between RVG and CBCT was statistically significant when analyzed using Independent t test (p=0.001) Conclusion: To conclude, though CBCT and RVG both are reliable tool for evaluation of marginal bone loss ,the intergroup comparison showed in the result states the accuracy of CBCT as compared to RVG during the follow up time of the present study.

Evaluation of Cone-beam Computed Tomography to differentiate Odontogenic Periapical Cysts and Granulomas

Background: Cone-beam Computed Tomography is a useful diagnostic tools for the detection of odontogenic peripheral cysts and granulomas.&#x0D; Objective: The purpose of the present study was to assess the accuracy of CBCT for diagnosing periapical cyst and granuloma.&#x0D; Methodology: This cross-sectional study was conducted from February 2017 to November 2017. Following inclusion and exclusion criteria consecutive patients who were consult in the department of oral and maxillofacial surgery of Dhaka Dental College Hospital and Bangabandhu Seikh Mujib Medical University for periapical infection was selected. Only those patients showing a periapical lesion of minimum 5 mm size was included in the study subject. Intra-oral periapical radiograph showing criteria was presence of apical radiolucency of 5 mm, corticated borders and displacements of roots. The CBCT images were done for those patients. The following features were documented on CBCT like location at the apex of involved tooth, well defined corticated border, shape is curved or circular, internal structure of lesion is radiolucent, displacement and resorption of the roots of adjacent teeth with a curved outline and perforation of cortical plate. Histopathological specimens were obtained for microscopic examination. The findings of histopathological examinations were correlated with the findings of CBCT.&#x0D; Results: Out of 50 subjects, 41(82.0%) subjects were diagnosed as cyst and 9(18.0%) subjects were as granuloma. Postoperative histopathology revealed 37 out of 41 were cysts and 4 were granulomas. Out of 9 granulomas 3 were cysts and 6 were granulomas. In this study we found the PPV 90.2439 and NPV 66.66. Diagnostic Accuracy was measured by calculating TP, TN and total population. The accuracy was 86%.&#x0D; Conclusion: In conclusion Cone-beam Computed Tomography has high accuracy of CBCT for diagnosing periapical cyst and granuloma.&#x0D; Journal of National Institute of Neurosciences Bangladesh, July 2022;8(2):171-174

Diagnostic Accuracy of CBCT for the Detection of Accessory Mental Foramina Using Different Devices and Imaging Modalities

This study investigated the diagnostic accuracy of CBCT for detection of accessory mental foramina (AMFs) in dry mandibles using two different devices and three different CBCT imaging modalities. A total of 40 dry mandibles (20 per group) were selected to generate corresponding CBCT images, each with three different CBCT imaging modalities (high, standard, and low doses), using ProMax 3D Mid (Planmeca) and Veraview X800 (J. Morita). The presence, count (n), location, and diameter of the AMFs were measured on both dry mandibles and CBCT scans. The Veraview X800 with different imaging modalities showed the highest accuracy (97.5%), while the ProMax 3D Mid in low-dose imaging modality exhibited the lowest accuracy (93.8%). The most common AMF sites on dry mandibles were anterior-cranial and posterior-cranial, while anterior-cranial was the most frequent on CBCT scans. As for AMF diameter, the mean mesiodistal and vertical diameters on dry mandibles were 1.89 mm and 1.47 mm, respectively, which were greater or equal to the values obtained from CBCT scans. The overall diagnostic accuracy for assessing AMFs exhibited good results, but some caution is warranted when using a low-dose imaging modality with a large voxel size (400 μm).

Accuracy of CBCT in the Identification of Mental, Lingual, and Retromolar Foramina: A Comparison with Visual Inspection of Human Dry Mandibles

The present dry-mandible study evaluated the presence of the mental (MF), lingual (LF), and retromolar (RMF) foramina to assess the accuracy of CBCT in detecting these anatomical structures. In total, 38 human dry mandibles were analyzed (30 men, 8 women; mean age: 61.9 ± 13.7 years). CBCT scans were taken using low-dose parameters, and LF, MF, and RMF were assessed visually and radiographically. Both the presence (yes/no) and the count (n) of each foramen were compared between CBCTs and visual assessment. For the presence assessment, only RMF exhibited a significant difference between CBCT and visual inspection (P = .035). For count, the RMF (P = .049) and paramedian LF (P = .003) exhibited differences between the two methods. The agreement between CBCT and visual inspection was excellent for the MF, moderate-excellent for the LF, and low-moderate for the RMF. Intra- and interassessor agreement varied from excellent (MF), to moderate-excellent (LF), and low-moderate (RMF). The LF and RMF represent challenging structures to identify on CBCT images due to their limited dimension. False negative findings in CBCTs in the assessment of foramina, especially LF, might lead to surgical complications during implant surgery.

Diagnostic Accuracy of Cone Beam Computed Tomography in Identifying Peri-implantitis-Like Bone Defects Ex Vivo.

This pilot study aimed to assess the diagnostic accuracy of CBCT in identifying peri-implantitis-like bone defects in cadavers. Three cadaver dental arches treated with the Thiel embalming method were used. Three different types of peri-implant bone defects (buccal dehiscence, two- to three-wall defects, and circumferential defects) were prepared on 15 implants. Defect depths and lengths were identified clinically using a periodontal probe, radiologically by means of CBCT images, and histologically with a micrometer using an optic microscope. Peri-implant bone defect morphology evaluated using CBCT images matched the clinical defect configuration (100% accuracy). CBCT assessment demonstrated lower values in defect depth and defect length when compared with the clinical evaluation. A statistically significant difference in defect depth (0.35 ± 0.45 mm; P = .037) was recorded between the clinical and CBCT data. Regarding defect length, a statistically significant mean difference of 0.81 ± 0.83 mm (P = .003) was noted between the clinical and CBCT data. Similarly, a mean difference of 1.09 ± 1.52 mm was recorded between the defect length assessed histologically and the CBCT data (P = .031). No statistically significant differences were observed between the other evaluated variables. CBCT is a reliable tool for peri-implantitis diagnosis and treatment planning, though the underestimation of defect severity may affect the prognosis and clinical decision-making. Clinicians need to be flexible in establishing prognoses and treatment based on CBCT assessment.

Diagnostic Accuracy of CBCT for Detection of Second Canal of Permanent Teeth: A Systematic Review and Meta-Analysis.

Introduction Missed canal is one of the common reasons for nonsurgical endodontic retreatments. The missed canals were frequently associated with periapical pathology. The aim of this systematic review was to find the diagnostic accuracy of CBCT for detection of the second canal of the root canal system of permanent teeth. Materials and Methods The articles were selected from seven electronic databases according to selection criteria. All eligible studies were judged by the reviewers. The selected studies were checked with the QUADAS-2 tool for risk of bias and applicability concerns. Finally, 12 studies were selected for qualitative and quantitative analyses. The summary estimates of sensitivities and specificities and SROC curves were calculated and drawn by RevMan 5.3 and MetaDTA software. Results Summary estimates of CBCT for detection of second canal anatomy in permanent teeth were 94% sensitivity and 93.1% specificity. 96.6% sensitivity of MB2 was followed by 88.8% sensitivity of maxillary and mandibular premolars and 81% that of mandibular molars. The specificity of 97.6% for premolars was trialed by 85% specificity of mandibular molars and MB2. For permanent mandibular canines, 67% sensitivity and 100% specificity were estimated. CBCT showed more agreement with detecting the second canal with micro-CT, estimating 100% sensitivity and 95.6% specificity. The highest prevalence of the second canal comprised the highest sensitivity of 99.1% and lowest specificity of 77.5%. After the exclusion of case-control studies, a 3% drop of sensitivity from the summary estimate was observed. Multiple spectrum of the second canal had 8.6% higher sensitivity and 4.4% lower specificity than single spectrum. Conclusion CBCT is informative for detecting the second canal. Clinicians should keep in mind that the accuracy can vary in different types of teeth, with the prevalence of second canal across different populations, and with the spectrum of second canal anatomy in spite of the reviewers having postulated overestimation of the findings.

Diagnostic accuracy of CBCT versus intraoral imaging for assessment of peri\u2010implant bone defects

BackgroundEarly detection of marginal bone loss is vital for treatment planning and prognosis of teeth and implant. This study was conducted to assess diagnostic accuracy of CBCT compared to intra-oral (IO) radiography for detection, classification, and measurement of peri-implant bone defects in an animal model.MethodsFifty-four mandible blocks with implants were harvested from nine male health adult beagle dogs with acquisition of IO, CBCT and micro-CT images from all samples. Peri-implant bone defects from 16 samples were diagnosed using micro-CT and classified into 3 defect categories: dehiscence (n = 5), infrabony defect (n = 3) and crater-like defect (n = 8). Following training and calibration of the observers, they asked to detect location (mesial, distal, buccal, lingual) and shape of the defect (dehiscence, horizontal defect, vertical defect, carter-like defect) utilizing both IO and CBCT images. Both observers assessed defect depth and width on IO, CBCT and micro-CT images at each side of peri-implant bone defect via CT-analyzer software. Data were analyzed using SPSS software and a p value of < 0.05 was considered as statistically significant.ResultsOverall, there was a high diagnostic accuracy for detection of bone defects with CBCT images (sensitivity: 100%/100%), while IO images showed a reduction in accuracy (sensitivity: 69%/63%). Similarly, diagnostic accuracy for defect classification was significantly higher for CBCT, whereas IO images were unable to correctly identify vestibular dehiscence, with incorrect assessment of half of the infrabony defects. For accuracy of measuring defect depth and width, a higher correlation was observed between CBCT and gold standard micro-CT (r = 0.91, 95% CI 0.86–0.94), whereas a lower correlation was seen for IO images (r = 0.82, 95% CI 0.67–0.91).ConclusionsThe diagnostic accuracy and reliability of CBCT was found to be superior to IO imaging for the detection, classification, and measurement of peri-implant bone defects. The application of CBCT adds substantial information related to the peri-implant bone defect diagnosis and decision-making which cannot be achieved with conventional IO imaging.

The Accuracy of CBCT in the Detection of Dens Invaginatus in a Tunisian Population.

Objective To assess the prevalence and characteristics and to classify the type of dens invaginatus (DI), in anterior teeth, basing on 200 Tunisian patients' cone-beam computed tomography. Material and Methods. A retrospective study was performed using CBCT images of 200 Tunisian patients. Maxillary and mandibular anterior teeth were evaluated for the presence and characteristics of dens invaginatus. Results were reported as frequencies, means ± SD. Statistical evaluation of the presence of DI related to gender was performed by the Pearson chi-square test. Results Dens invaginatus was observed in 42 out of 4945 examined teeth, with a prevalence of 0.85%.The anomaly affected especially maxillary lateral incisors (p ≤ 0.001). DI location was unilateral in 36% and bilateral in 64%. Type II DI was the most commonly observed (47.61%), followed by type I (30.95%) and type III (21.42%). Apical periodontitis (AP) was mostly seen in type III DI, with a periapical index (PAI) varying from 3″ to 5 E″.The maxillary lateral incisors seem to be the most affected anterior teeth. The symmetric occurrence of DI was observed with a statistically significant difference (p ≤ 0.001). Conclusion Within the limits related to the present study, DI detected by CBCT is a rare anomaly that could be associated with AP. Maxillary anterior teeth should be bilaterally examined for DI in the absence of clinical symptoms.

High-Resolution Cone-Beam Computed Tomography is a Fast and Promising Technique to Quantify Bone Microstructure and Mechanics of the Distal Radius.

Obtaining high-resolution scans of bones and joints for clinical applications is challenging. HR-pQCT is considered the best technology to acquire high-resolution images of the peripheral skeleton in vivo, but a breakthrough for widespread clinical applications is still lacking. Recently, we showed on trapezia that CBCT is a promising alternative providing a larger FOV at a shorter scanning time. The goals of this study were to evaluate the accuracy of CBCT in quantifying trabecular bone microstructural and predicted mechanical parameters of the distal radius, the most often investigated skeletal site with HR-pQCT, and to compare it with HR-pQCT. Nineteen radii were scanned with four scanners: (1) HR-pQCT (XtremeCT, Scanco Medical AG, @ (voxel size) 82μm), (2) HR-pQCT (XtremeCT-II, Scanco, @60.7μm), (3) CBCT (NewTom 5G, Cefla, @75μm) reconstructed and segmented using in-house developed software and (4) microCT (VivaCT40, Scanco, @19μm-gold standard). The following parameters were evaluated: predicted stiffness, strength, bone volume fraction (BV/TV) and trabecular thickness (Tb.Th), separation (Tb.Sp) and number (Tb.N). The overall accuracy of CBCT with in-house optimized algorithms in quantifying bone microstructural parameters was comparable (R2 = 0.79) to XtremeCT (R2 = 0.76) and slightly worse than XtremeCT-II (R2 = 0.86) which were both processed with the standard manufacturer's technique. CBCT had higher accuracy for BV/TV and Tb.Th but lower for Tb.Sp and Tb.N compared to XtremeCT. Regarding the mechanical parameters, all scanners had high accuracy (R2 [Formula: see text] 0.96). While HR-pQCT is optimized for research, the fast scanning time and good accuracy renders CBCT a promising technique for high-resolution clinical scanning.

The Characteristics of Adjacent Anatomy of Mandibular Third Molar Germs: A CBCT Pilot Study in Patients with Osteogenesis Imperfecta.

(1) Objectives: The aim of our study was to investigate the anatomical features of lower third molar and its adjacent anatomical connections in type I Osteogenesis Imperfecta (OI) patients through cone beam computed tomography (cbct). (2) Methods: The study was conducted among 25 patients, 13 patients with type I OI and 12 control patients (individuals with no disorders and no treatment); average age was 15.44 ± 2.06, 23 third molar germs for each group. The germs have been compared to the parameters using the Mann-Whitney test. A chi-square test was also used to investigate the correlation between the status case/control and tooth development stage. (3) Results: Mann-Whitney test showed significant differences between cases and controls: diameter of the tooth germ in toto (U = 93.5; p < 0.001), tooth development stage, (U = 145; p < 0.01), roots length (U = 44.5; p < 0.01), cementoenamel junction diameter (U = 157.5; p < 0.05), size of the pulp chamber (U = 95.5; p < 0.05). Type I OI is not associated with the relationship between the germ of mandibular third molar and alveolar canal on axial plane (χ2 = 4.095; p = 0.129), and parasagittal (χ2 = 4.800; p = 0.091). The association between type I OI and relationship with the germ of mandibular third molar and alveolar canal on the coronal plane has been significant (χ2 = 9.778; p < 0.05) as the perforation of the lingual cortical bone in the region of mandibular third molar tooth germ (χ2 = 11.189; p < 0.01). (4) Conclusions: The results confirm the cbct accuracy in the evaluation of bone density in type I OI patients giving also the opportunity to study the tridimensional anatomy of germs and the adjacent anatomical structures in order to avoid any perioperative complications.

Accuracy of CBCT based computer assisted surgical guide for implant placement with tilted position in posterior atrophied mandible

Purpose: Investigate the accuracy of CBCT based computer aided surgical guide CASG for implant placement in posterioratrophied mandible with tilted position (buccal or lingual) to inferior alveolar nerve IAN avoiding its injury.Materials and Methods: 15 partially edentulous patients with atrophied mandible were included based on certain eligibilitycriteria, the work flow in this study run as following, CBCT imaging, virtual implant planning and CASG designing, 3Dstereolithographic printing of surgical guide, surgical procedures of implant placement using the CASG, post-operative CBCTimaging, registration of pre- and post-operative CBCT images, assessment of angular deviation between actual and plannedimplants and linear deviation between them cervically and apically, comparison between virtual and actual implants distanceto IAN.Results: Wilcoxon signed-rank test Comparing between virtual and actual implants’ distance to IAN showed a statisticallysignificant difference with a mean distance of 0.72 ± 0.25 mm for actual implants and 1.7 ± 0.56 mm for virtualimplants. (4.13 ± 1.86°) was the mean angular deviation, while 1.15 ± 0.49 mm and 1.32 ± 0.63 were the mean cervical andapical linear deviation respectively.Conclusion: although a significant difference was found between virtual and actual implants distance to IAN, the valuesof linear and angular deviation between them were well accepted and within the range reported by most of similar clinicalstudies with less crucial situations, which enhance using fully guided stereolithographic CASG for implant placement withtilted position in posterior atrophied mandible but with considering at least 2 mm distance between virtual implant and IAN inplanning procedures.

The accuracy of CBCT for the detection and diagnosis of vertical root fractures invivo.

To compare the invivo accuracy of CBCT for the detection of fracture lines versus the diagnosis of vertical root fractures (VRFs) according to characteristic patterns of associated bone resorption. Eighty-eight patients with symptoms typical of VRFs in root filled teeth, who underwent a CBCT examination and later had the teeth extracted, were divided into two groups: the fracture group (n=65) and the control group (n=23). Five blinded observers assessed the CBCT images in two sessions. During the first session, they were asked to state the diagnosis according to the CBCT and clinical data. During the second session after 2weeks, they assessed only axial slices and were asked to detect a fracture line. The mean CBCT specificity, sensitivity, accuracy values and area under the receiver operating characteristic (AUROC) curve were calculated and compared using the Wilcoxon signed-rank test. The average sensitivity of CBCT for the diagnosis of VRFs was 0.84±0.2. The accuracy and AUC values were 0.81±0.08 and 0.84±0.17, respectively. The sensitivity, accuracy and AUC values for the detection of VRFs were significantly lower: 0.17±0.24 (P=0.042), 0.54±0.07 (P=0.043), and 0.52±0.09 (P=0.043), respectively. The specificity of CBCT for the detection and diagnosis of VRFs did not differ significantly (P=0.50). Cone-beam computed tomography was helpful in VRF diagnosis even when it was not possible to visualize the fracture line.

Accuracy of cone beam computed tomography in predicting the linear dimensions of impacted maxillary canines- A clinical study

Background and Objectives: This study was conducted to investigate the accuracy of CBCT by comparing the linear measurements of impacted maxillary canines measured by CBCT scans with physical measurements from digital calipers. Method: 18 patients in the age group of 13 years and above having impacted maxillary canine/s classified as sector III or IVwith complete root formation and willing for surgical extractionwere included. CBCT scan was taken of the quadrant of interest using KODAK 9000 3D Extraoral Imaging System. All linear measurements (mesiodistal width, labiolingual width and total length of tooth) were carried out. After the atraumatic surgical removal of impacted canines, the teeth were collected and the same measurements were made by digital calipers, using the same points as those used for the CBCT scans. The data obtained were subjected to statistical analysis. Results: Intra and inter observer reliability was excellent as coefficient of correlation was above 0.92 for all digital caliper and CBCT measurements. Comparison of intra-examiner CBCT and Digital Caliper methods in measurements of labiolingual width, mesiodistal width and total tooth length by Paired-t test showed no statistically significant difference for labiolingual width and mesiodistal. Conclusion: The labiolingual and mesiodistal tooth width measurements from CBCT scans were accurate and the differences between the digital caliper and CBCT measurements were not statistically significant. Total tooth length measurements derived from the CBCT images were less accurate compared with the actual measurements.

Cone-Beam Computed Tomography to Assess Mandibular Invasion in Oral Squamous Cell Carcinoma

Background: Oral squamous cell carcinoma which occurs closely to the mandible has a tendency to invade mandible. An accurate preoperative evaluation of mandibular invasion is important for optimum treatment planning. Aim of this study is to determine the accuracy of CBCT in detection of mandibular invasion in oral squamous cell carcinoma.&#x0D; Study design: In this prospective observational study 35 patients of histologically proven squamous cell carcinoma which was close proximity to the mandible were selected. The results of preoperative CBCT scan of mandible were compared with that of post operative histopathology of bone and thus sensitivity, specificity, negative predictive value, positive predictive value were calculated.&#x0D; Results: Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy of CBCT were 96%, 90.90%, 96%, 90.90%, 97.14% respectively (Chi squared with Yates correction equals 21.844 with 1 degrees of freedom, p value &lt; o.oooo1).&#x0D; Conclusion: Cone beam computed tomography is a sensitive test and has an acceptable range of specificity.&#x0D; Update Dent. Coll. j: 2018; 8 (2): 18-22

Cone-beam computed tomography or conventional radiography for localising of maxillary impacted canines?

Data sourcesPubMed, Web of Science, CINHAL and the Cochrane Library were searched until May 2016. Unpublished data were searched in Pro-Quest Dissertation, Abstracts and Thesis and Google Scholar, supplemented with manual search of the included studies references. No language restriction was used.Study selectionAll types of study designs were included, except case reports, comparing CBCT data with conventional radiographs. The primary outcome was: diagnostic accuracy between modalities, agreement in position, treatment planning and outcome efficacy. The secondary outcome was intermodality agreement in lateral root resorption detection and intra and inter-observer agreement values.Data extraction and synthesisTwo reviewers independently selected the studies for inclusion, performed data extraction and evaluated risk of bias. Discrepancies were resolved by discussions and reaching consensus. The Newcastle-Ottawa Scale was used to assess the risk of bias for case-controlled and cohort studies and a modified version for cross-sectional studies. The Quality Assessment of Diagnostic Accuracy (QUADAS-2) tool was used to rate diagnostic accuracy studies.ResultsEight studies met the inclusion criteria, two on diagnostic accuracy. The remaining six included 292 impacted canines in 224 patients. Outcomes were presented as calculated level of agreement and statistical significance for each primary outcome reported. Based on the diagnostic accuracy of two in vitro studies, the CBCT accuracy ranged from 50% to 95% while for conventional radiographs it ranged from 39% to 85%.The other six studies reported inter-modalities agreement in localisation (six studies) and treatment planning agreement (three studies). The inter-modalities agreement varied from 0.20 to 0.82, with observed agreement of 64% to 84% in localisation of canine. The treatment planning agreement varied from 0.36 to 0.72.ConclusionsThe authors concluded that CBCT is more accurate than conventional radiographs in localising maxillary impacted canines and there is a broad range of inter-observer and modalities agreement for location and treatment planning. There is no robust evidence to support using CBCT as first line imaging method.

4:12 PM Abstract No. 189 Is dual-phase C-arm CBCT accurate enough for the detection of colorectal cancer liver metastasis during liver intraarterial treatment? Results of a prospective study

This study aimed at calculated the Dual-Phase CBCT accuracy in the detection of colorectal cancer liver metastases (CRCLM) compared to multi detector computed tomography (MDCT). Between March 2012 and December 2015 49 consecutive patients referred to intraarterial treatment for CRCLM were enrolled in a single-center prospective observational study approved by our institutional review board. All were examined with triphasique MDCT protocol and Dual-Phase CBCT before intraarterial treatment. Two blinded observers independently reviewed all examination. Dual-Phase CBCT diagnostic Sensibility (Se.) and Specificity (Sp.) were calculated using a 6-cell matrix method and using a “worse case scenario” defining a “real life” situation. Se. and Sp. of both phases were compared using McNemar’s test. The Dual-Phase CBCT early Arterial Phase (eAP) yielded a Se. of 93% and a Sp. of 85% and the late Arterial Phase (lAP) yielded a Se. of 99% of Sp. of 88% with the 6-cell matrix method. The probability to correctly diagnose a CRCLM at the eAP and the lAP was 60% and 90% respectively. The worse case scenario yielded a Se. and a Sp. of 58% and 51% at eAP respectively (p<0.0001), and 84% and 70% at the lAP respectively and (p = 0.02) The eAP had limited accuracy in the intra procedural detection of CRCLM. Only the lAP appears relevant and can be proposed to operators within the goal to correctly place the microcatheter allowing a correct intraarterial hepatic treatment.