Impact of CBCT image quality on the confidence of furcation measurements

Rinne, Carin A.; Dagassan-Berndt, Dorothea; Connert, Thomas; Müller‐Gerbl, Magdalena; Weiger, Roland; Walter, Clemens

doi:10.1111/jcpe.13298

Cited by 11 publications

(17 citation statements)

References 26 publications

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“…Compared with intrasurgical measurements of furcation defects, HD-CBCT and LD-CBCT showed moderate Cohen’s kappa values. This is in line with the findings of other studies testing different CBCT protocols for furcation diagnostics 13 . These moderate Cohen’s kappa values may be explained by limitations of the clinical probe used to measure the fine furcation defects.…”

Section: Discussionsupporting

confidence: 93%

Imaging furcation defects with low-dose cone beam computed tomography

Ruetters

Gehrig

Kim

et al. 2022

Sci Rep

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Different cone beam computed tomography (CBCT) protocols have shown promising results for imaging furcation defects. This study evaluates the suitability of low-dose (LD)-CBCT for this purpose. Fifty-nine furcation defects of nine upper and 16 lower molars in six human cadavers were measured by a high-dose (HD)-CBCT protocol, a LD-CBCT protocol, and a surgical protocol. HD-CBCT and LD-CBCT measurements were made twice by two investigators and were compared with the intrasurgical measurements, which served as the reference. Furcation defect volumes generated from HD-CBCT and LD-CBCT imaging were segmented by one rater. Cohen’s kappa and intraclass correlation coefficient (ICC) values were calculated to determine intra- and interrater reliability. The level of significance was set at α = 0.05. In total, 59 furcation defects of nine upper and 16 lower human molars were assessed. Comparing CBCT furcation defect measurements with surgical measurements revealed a Cohen’s kappa of 0.5975 (HD-and LD-CBCT), indicating moderate agreement. All furcation defects identified by HD-CBCT were also detected by LD-CBCT by both raters, resulting in a Cohen’s kappa of 1. For interrater agreement, linear furcation defect measurements showed an ICC of 0.992 for HD-CBCT and 0.987 for LD-CBCT. The intrarater agreement was 0.994(r1)/0.992(r2) for HD-CBCT and 0.987(r1)/0.991(r2) for LD-CBCT. The intermodality agreement was 0.988(r1)/0.991(r2). Paired t-test showed no significant differences between HD-CBCT and LD-CBCT measurements. LD-CBCT is a precise and reliable method for detecting and measuring furcation defects in mandibular and maxillary molars in this experimental setting. It has the potential to improve treatment planning and treatment monitoring with a far lower radiation dose than conventional HD-CBCT.

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Section: Discussionsupporting

confidence: 93%

Imaging furcation defects with low-dose cone beam computed tomography

Ruetters

Gehrig

Kim

et al. 2022

Sci Rep

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“…Another critical issue to be highlighted is that different CBCT settings and devices may influence image accuracy for FI detection 21,31,32 , and a small field of view should be preferred 28 . In summary, clinical, CBCT and intra-surgical measurements showed similar results in assessing maxillary molar furcation involvement.…”

Section: Discussionmentioning

confidence: 99%

Comparison of cone-beam computed tomography, clinical and surgical analysis for detection of maxillary molar furcation

Oliveira¹,

Sousa²,

Valladares‐Neto³

et al. 2021

Acta Odontol Latinoam

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The aim of this study was to compare the performance of conebeam computed tomography (CBCT), clinical and surgical probing in assessing maxillary molar furcation involvement (FI). Furcation defects (n= 120) were assessed through CBCT, clinical and intra-surgical evaluation (ISE). Furcation Involvement, vertical and horizontal bone loss were assessed through clinical probing, CBCT and probing during ISE. Three trained radiologists evaluated CBCT images and intra- and interobserver agreement were calculated by Kappa test and Intraclass Correlation Coefficient (ICC). McNemar and Wilcoxon tests were used to compare clinical probing, ISE and CBCT. Accuracy, sensitivity, specificity, positive and negative predictive values were calculated to detect FI. Clinical findings showed 28 sites with Degree I, 25 sites with Degree II, and 8 sites with Degree III. Good intra- (k=1.00) and interobserver agreement (k=0.773) were observed. Intraobserver and interobserver agreement for horizontal bone loss were moderate, k=0.485 and k=0.549, respectively. Intra-surgical findings showed Degree I at 21 sites, and Degree II and Degree III FI at fifteen sites each. Clinical evaluation showed 75% agreement with ISE and 78% with CBCT. Accuracy for clinical detection of FI was 75%, while for CBCT evaluation ranged from 72.5% to 77.5%, considering the 3 observers. Significant differences were found at distal sites using CBCT (p<0.05). Clinical evaluation and CBCT showed similar results for the presence or absence of FI. Concerning horizontal and vertical bone loss, CBCT was not considered a precise examination method for incipient bone defects.

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“…However, it was concluded previously that in some cases, direct clinical measurements and IRs do not provide sufficient information on the morphology of intrabony periodontal defects, therefore surgical planning cannot be carried out properly [10,11]. Application of CBCT scans has proven to be beneficial in the diagnostics of periodontal defects [15][16][17][18][19][20][21][22]; however, it should be used in cases where conventional methods are unable to provide an exact diagnosis [26]. In the present study, in five out of six cases conventional diagnostic methods did not provide sufficient information on defect characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…The application of cone-beam computed tomography (CBCT) in periodontal diagnostics has been proposed by many authors [12][13][14]. A series of in vitro and in vivo studies have demonstrated that CBCT is superior to IRs in the detection of certain periodontal defects (i.e., furcation defects, three wall intrabony defects, midbuccal intrabony defects, or dehiscence-type defects) [15][16][17][18][19][20][21][22]; however, it is difficult to justify the cost-benefit ratio of the higher irradiation dose [23][24][25]. Therefore, CBCT should only be used for periodontal diagnosis if conventional radiographic methods do not provide a sufficient amount of information [26].…”

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confidence: 99%

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Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning

et al. 2020

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Background In the regenerative treatment of intrabony periodontal defects, surgical strategies are primarily determined by defect morphologies. In certain cases, however, direct clinical measurements and intraoral radiographs do not provide sufficient information on defect morphologies. Therefore, the application of cone-beam computed tomography (CBCT) has been proposed in specific cases. 3D virtual models reconstructed with automatic thresholding algorithms have already been used for diagnostic purposes. The aim of this study was to utilize 3D virtual models, generated with a semi-automatic segmentation method, for the treatment planning of minimally invasive periodontal surgeries and to evaluate the accuracy of the virtual models, by comparing digital measurements to direct intrasurgical measurements. Methods Four patients with a total of six intrabony periodontal defects were enrolled in the present study. Two months following initial periodontal treatment, a CBCT scan was taken. The novel semi-automatic segmentation method was performed in an open-source medical image processing software (3D Slicer) to acquire virtual 3D models of alveolar and dental structures. Intrasurgical and digital measurements were taken, and results were compared to validate the accuracy of the digital models. Defect characteristics were determined prior to surgery with conventional diagnostic methods and 3D virtual models. Diagnostic assessments were compared to the actual defect morphology during surgery. Results Differences between intrasurgical and digital measurements in depth and width of intrabony components of periodontal defects averaged 0.31 ± 0.21 mm and 0.41 ± 0.44 mm, respectively. In five out of six cases, defect characteristics could not be assessed precisely with direct clinical measurements and intraoral radiographs. 3D models generated with the presented semi-automatic segmentation method depicted the defect characteristics correctly in all six cases. Conclusion It can be concluded that 3D virtual models acquired with the described semi-automatic segmentation method provide accurate information on intrabony periodontal defect morphologies, thus influencing the treatment strategy. Within the limitations of this study, models were found to be accurate; however, further investigation with a standardized validation process on a large number of participants has to be conducted.

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Impact of CBCT image quality on the confidence of furcation measurements

Cited by 11 publications

References 26 publications

Imaging furcation defects with low-dose cone beam computed tomography

Imaging furcation defects with low-dose cone beam computed tomography

Comparison of cone-beam computed tomography, clinical and surgical analysis for detection of maxillary molar furcation

Digital three-dimensional visualization of intrabony periodontal defects for regenerative surgical treatment planning

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