Imaging Sci Dent.  2019 Mar;49(1):9-17. 10.5624/isd.2019.49.1.9.

Reproducibility of cone-beam computed tomographic measurements of bone plates and the interdental septum in the anterior mandible

• Valerio CS
• e Alves CA
• Manzi FR

• KMID: 2442104
• DOI: http://doi.org/10.5624/isd.2019.49.1.9

Abstract

PURPOSE
This study aimed to introduce a novel method to evaluate the alveolar bone and interdental septum in the anterior mandible using cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
Fifty-six CBCT scans from adult patients were selected. The CBCT scans were obtained before and after orthodontic treatment. The following measurements were taken: width of the alveolar bone and the interdental septum, height of the interdental septum, height of the bone plates, distance between the cementoenamel junction and marginal bone crests, and vertical positioning of the mandibular incisor, using the lingual plane as a reference. To test the reproducibility and the stability of the lingual plane, a triangle was traced in the anterior mandible. The intra-class correlation coefficient (ICC) was used to determine intra- and inter-examiner agreement. The paired Student t-test was used to evaluate the area of the triangle and the reproducibility of all measurements.
RESULTS
The ICC was excellent for the alveolar bone and dental measurements (0.9989 and 0.9977, respectively), as well as for the interdental septum (0.9987 and 0.9961, respectively). The area of the triangles showed stability in the lingual plane (P>0.05). For the alveolar bone, mandibular incisor, and interdental septum measurements, no statistically significant differences were found between the 2 examiners (P>0.05), confirming the technical reliability of the measurements.
CONCLUSION
The method used in this study provides a valid and reproducible assessment of alveolar bone dimensions in the anterior mandible measured on CBCT images.

Keyword

Alveolar Process; Alveolar Bone Loss; Cone-Beam Computed Tomography; Mandible

MeSH Terms

Adult
Alveolar Bone Loss
Alveolar Process
Bone Plates*
Cone-Beam Computed Tomography
Humans
Incisor
Mandible*
Methods
Tooth Cervix

Figure

• 

  Fig. 1 On the axial slice of the mandible, the localization of the parasagittal slices was determined for the measurements of the alveolar bone (continuous AB lines) and the measurements of the interdental septum (interrupted CD lines).

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  Fig. 2 Parasagittal slice. A. Localization of the lingual foramen and the mandibular lingual canal. B. Tracing of the mandibular lingual canal (LC). C. Extension of the lingual canal line to obtain the lingual plane (LP).

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  Fig. 3 Parasagittal slice. Tracing of the compensatory lingual plane (LP′), with 20° of compensation. LP: lingual plane.

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  Fig. 4 Parasagittal slice. Tracing of the triangle. First, line 1 was traced over the lingual plane, respecting the limits of the symphysis (L1). The second side was traced with an internal angle of 20°, beginning from the facial limit of L1 (L2). The third side joined the lingual extremities of sides L1 and L2, forming L3. Height of the triangle (h).

• 

  Fig. 5 Parasagittal slice. A. Measurement of the height of the facial bone plate (FH-MBC-LP) and the lingual bone plate (LH-MBC-LP). B. Measurement of the distance between the CEJ and the marginal bone crest on the facial side (F-CEJ-MBC) and on the lingual side (L-CEJ-MBC). MBC: marginal bone crest; LP: lingual plane.

• 

  Fig. 6 Parasagittal slice. A. Measurement of the vertical positioning of the mandibular incisor (MI line). B and C. Measurement of the thickness of the alveolar bone. Initially, a line was traced along the incisor's long axis (MI line) and the joining line between the facial and lingual CEJs (CEJ-CEJ line). Next, the thicknesses of the alveolar process were measured using the A1, A2, A3, and A4 lines, traced 3 mm, 6 mm, 9 mm, and 12 mm below the CEJ-CEJ line, respectively.

• 

  Fig. 7 Parasagittal slice. A. Measurement of the height of the interdental septum through the SH line, traced perpendicular to the lingual plane (LP). B. Measurement of the thickness of the interdental septum at points located 3 mm (S1), 6 mm (S2), 9 mm (S3), and 12 mm (S4) below the bone crest. LP: lingual plane, SH: bone crest height.

• 

  Fig. 8 Triangle areas obtained at time 1 (T1) and time 2 (T2) (NS: P>0.05).

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