Editorial Type:
Article Category: Research Article
 | 
Online Publication Date: 14 Sept 2023

Comparative Evaluation of a Lower-Dose CBCT Acquisition Protocol for Preoperative Implant Site Assessment in Dry Human Skulls: A Proof-of-Concept Study

DDS, MDS,
DDS, MSD,
DDS, MDS, and
MDS, PhD
Page Range: 408 – 413
DOI: 10.1563/aaid-joi-D-22-00099R2
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Restoration of edentulous sites with dental implants is increasingly becoming a popular choice. Cross-sectional 3-dimensional imaging using cone-beam computed tomography (CBCT) provides a better depiction of the implant site to help the clinician plan the procedure better. In spite of the advantages, radiation dose will always remain a concern. The evolution of lower-dose protocols is ongoing, but whether those acquisition protocols yield comparable diagnostic information is still not well established. The objective of this study was to evaluate the diagnostic efficacy of a low-dose, 180° rotational CBCT acquisition protocol for evaluating a potential implant site in comparison with a conventional 360° rotational acquisition. Ten dentate and partially edentulous dry human skulls providing 82 randomized implant sites—40 in the maxilla and 42 in the mandible—were chosen for this study. Each skull was imaged using a 360° and a 180° rotational acquisition on a J. Morita Accuitomo CBCT scanner. Evaluation of cortical and trabecular bone, height, width, and proximity to critical structures, such as the inferior alveolar nerve canal and the maxillary sinus, were measured. An oral surgeon and an oral radiologist rated the diagnostic efficacy of the scans by evaluating the above characteristics. Statistical evaluation of the data with linear regression showed significant agreement between both protocol measurements. Kappa analyses yielded a good interobserver agreement. In this proof-of-concept study, CBCT imaging using the lower-dose, modified arc, and 180° acquisition protocol shows comparable results to the conventional 360° protocol for preoperative implant assessment.

Figure 1.
Figure 1.

Diagram illustrating differences between 360° and 180° rotation protocols.


Figure 2.
Figure 2.

Schematic representation of the methodology.


Figure 3.
Figure 3.

Figure demonstrating an example of measurements taken at each site to determine linear accuracy between the 2 protocols.


Figure 4.
Figure 4.

Cross-sectional images depicting inferior alveolar nerve canal and floor of the maxillary sinus in both the protocols.


Figures 5A and 5B.
Figures 5A and 5B.

Graphical representation of linear agreement between the 2 protocols. (R = 0.99).


Figure 6.
Figure 6.

Graphical representation of linear regression between the 2 protocols as measured by an oral radiologist and oral surgeon (R = 0.99).


Contributor Notes

Corresponding author, e-mail: tadinada@uchc.edu
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