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. 2022 Jan 1;51(1):20210233.
doi: 10.1259/dmfr.20210233. Epub 2021 Jul 8.

Ex-vivo imaging of buccal and oral periodontal bone with low-dose CBCT in porcine jaws

Maurice Ruetters  1 , Holger Gehrig  1 , Dorohtea Kronsteiner  2 , Vanessa Weyer  3   4 , Ti-Sun Kim  1 , Christopher J Lux  5 , Sinan Sen  5
Affiliations

Ex-vivo imaging of buccal and oral periodontal bone with low-dose CBCT in porcine jaws

Maurice Ruetters et al. Dentomaxillofac Radiol. .

Abstract

Objectives: New CBCT devices have been developed which can provide "low-dose CBCTs (LD-CBCT)". Aim of this study is to investigate the suitability of LD-CBCT for measurement of alveolar buccal/oral bone.

Methods and materials: Vestibular and oral bone loss of the teeth of seven porcine mandibles free of soft tissues were investigated by Micro-CT and three CBCT-modes: high-dose (HD), standard-dose (SD) and low-dose (LD). Radiographic measurements of bone loss (bl) and vestibular and oral bone thickness (bt) were made by two raters at 69 sites. Measurement means and differences, Intraclass correlation (ICC) and Bland-Altman plots were calculated.

Results: ICCs between raters(r) concerning bl were 0.954 for HD, 0.949 for SD and 0.945 for LD; concerning bt they were 0.872 for HD, 0.845 for SD and 0.783 for LD. Means of differences of bt measurements were -0.01 mm(r1)/0.00 mm(r2) for HD, 0.04 mm(r1)/0.02 mm(r2) for SD and 0.02 mm(r1)/0.04 mm(r2) for LD; for bl measurements they were 0.06 mm(r1)/0.05 mm(r2) for HD, -0.01 mm(r1)/0.13 mm(r2) for SD and 0.07 mm(r1)/0.16 mm(r2) for LD.Linear regression indicates no noticeable differences between methods and the raters with respect to bl and bt.

Conclusions: Relating to the CBCT-device used in this study, LD-CBCT is a promising method to detect and describe buccal and oral periodontal bl and bt. Further studies with human anatomic structures must confirm these results.

Keywords: Cone Beam Computed Tomography; Low-Dose Cone Beam Computed Tomography; computed radiography; orthodontics; periodontal bone defects; periodontitis.

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Figures

Figure 1.
Figure 1.
scheme of measurements. CEJ = Cemento-Enamel-Junction, LA = Limbus Alveolaris; bl = vertical bone loss, distance from CEJ to LA; o = orthogonal to bl and tangential to LA, bt = horizontal bone thickness, parallel too
Figure 2.
Figure 2.
Examples of device- and protocol-dependent images of the same tooth. (a) Micro-CT, (b) HD-CBCT, (c) SD-CBCT, (d) LD-CBCT. LD-CBCT, low-dose CBCT; HD-CBCT, high-dose CBCT; SD-CBCT, standard-dose CBCT.
Figure 3.
Figure 3.
Bland–Altman Plots of bl-measurements. Bland–Altman LD = LD CBCT vs MCT-measurements; Bland–Altman SD = SD CBCT vs MCT; Bland–Altman HD = HD CBCT vs MCT; upper and lower dashed lines: 95% of values are in between these two lines, middle dashed line: mean difference. The mean of differences of all bl-measurements (A + B) from LD-CBCT to Micro-CT were 0.07 mm ±1.96 SD:[−0.63; 0.78] (r1)/0.16 mm ±1.96 SD:[ −0.45; 0.77](r2), (C + D) from SD-CBCT to Micro-CT −0.01 mm ±1.96 SD:[ −0.68;0.64](r1)/ 0.13 ± 1.96SD:[−0.47; 0.75] and (E + F) from HD-CBCT to Micro-CT 0.06 mm ±1.96SD: [−0.50; 0.63](r1)/0.05 mm ±1.96 SD: [−0.51;0.62](r2). LD-CBCT, low-dose CBCT; HD-CBCT, high-dose CBCT; SD-CBCT, standard-dose CBCT.
Figure 4.
Figure 4.
Bland–Altman Plots of bt-measurements. LD = LD CBCT, MCT = micro CT, SD = SD CBCT, HD = HD CBCT; upper and lower dashed lines: 95% of values are in between these two lines, middle solid line: mean difference; The means of differences of all bt-measurements (A + B) from LD-CBCT to Micro-CT were 0.02 mm ±1.96 SD:[−0.39; 0.43] (r1)/0.03 mm ±1.96 SD:[−0.28; 0.35](r2), (C + D) from SD-CBCT to Micro-CT 0.04 mm ±1.96 SD:[−0.31; 0.40](r1)/ 0.02 ± 1.96SD:[−0.33; 0.37] and E + F) from HD-CBCT to Micro-CT −0.01 mm ±1.96SD: [−0.32; 0.30](r1)/0.00 mm ±1.96 SD: [−0.33; 0.34](r2). LD-CBCT, low-dose CBCT; HD-CBCT, high-dose CBCT; SD-CBCT, standard-dose CBCT.
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