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Comparative Study
. 2014 Dec 23;15(1):69.
doi: 10.1186/s40510-014-0069-2.

Comparison of in vivo 3D cone-beam computed tomography tooth volume measurement protocols

Darren Forst, Simrit Nijjar, Carlos Flores-Mir, Jason Carey, Marc Secanell, Manuel Lagravere  1
Affiliations
Comparative Study

Comparison of in vivo 3D cone-beam computed tomography tooth volume measurement protocols

Darren Forst et al. Prog Orthod. .

Abstract

Background: 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.

Methods: Six 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).

Results: The highest precision was for automated thresholding with manual refinements.

Conclusions: A 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).

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Figures

Figure 1
Figure 1
YZ (sagittal) plane.
Figure 2
Figure 2
XY (axial) plane.
Figure 3
Figure 3
XZ (coronal) plane.
Figure 4
Figure 4
3D sample view of maxillary first molar volume without smoothing.
Figure 5
Figure 5
Three-dimensional tooth volume. (A) Three-dimensional complete tooth volume. (B) Three-dimensional tooth volume apical to the cemento-enamel junction.
Figure 6
Figure 6
Three-dimensional visualization of inter-observer volume differences for the whole tooth measurement. (A) Entire tooth volume. (B) Entire tooth volume with maximum inter-observer variability removed from palatal root. (C) Entire tooth volume with maximum inter-observer variability removed from apical portion of all three roots. (D) Entire tooth volume with maximum inter-observer variability removed from buccal surfaces of the mesiobuccal and distobuccal roots.
Figure 7
Figure 7
Three-dimensional visualization of the intra-observer volume difference for the maxillary right first molar mesio-buccal cusp tip.
Figure 8
Figure 8
Cusp tip attrition. This would have to be present to represent the maximum difference in additional variability between roots only and whole tooth in the repeated measures. (A) Normal 3D volume. (B) 3D volume representing maximum difference in additional variability of the roots versus the whole tooth (64.79 mm3 − 30.39 mm3 = 34.40 mm3) in the repeated measures removed from cusp tips.
Figure 9
Figure 9
Axial slice area at the cement-enamel junction (CEJ) versus cusp tip. (A) Axial slice area at the molar CEJ. (B) Axial slice area at the molar cusp tips.
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