Surgical and Radiologic Anatomy

, Volume 35, Issue 6, pp 495–502 | Cite as

Cone-beam computed tomography and microtomography for alveolar bone measurements

  • Nathália Ferrare
  • André Ferreira Leite
  • Hugo César Pinto Marques Caracas
  • Ricardo Bentes de Azevedo
  • Nilce Santos de Melo
  • Paulo Tadeu de Souza Figueiredo
Original Article



To compare cone-beam computed tomography (CBCT) and microtomography (micro-CT) for alveolar bone measurements.


Forty teeth and alveolar bone blocks of five pigs were scanned on a micro-CT with a 9.05 μm pixel size, and on a CBCT device at 0.125 mm voxel size. One height and four thickness measurements were performed twice in standardized slices by two radiologists to verify reliability. Agreement between imaging methods was assessed by correlation coefficients, Bland–Altman plots, and the difference was tested by a Wilcoxon signed-rank test.


Regarding intra- and interobserver agreements, all bone measurements presented excellent precision values for micro-CT, but interobserver agreement for CBCT presented good to moderate values. Bone height differed about 0.3 mm, but no statistically significant differences were found for the bone thickness measurements.


CBCT underestimated bone height. No statistically significant differences were found for bone thickness. Regions of thin bone tissue may not be visualized on CBCT images. There are risks of underestimating bone measurements with CBCT and assuming bone loss that does not exist clinically. Although the difference of the bone height measurement was small, the clinical relevance must be analyzed on how to interpret CBCT


Cone-beam computed tomography X-ray microtomography (micro-CT) Reproducibility of results Alveolar bone 


Conflict of interest



  1. 1.
    Al-Ekrish AA, Ekram M (2011) A comparative study of the accuracy and reliability of multidetector computed tomography and cone beam computed tomography in the assessment of dental implant site dimensions. Dentomaxillofac Radiol 40:67–75. doi: 10.1259/dmfr/27546065 PubMedCrossRefGoogle Scholar
  2. 2.
    Ballrick JW, Palomo JM, Ruch E, Amberman BD, Hans MG (2008) Image distortion and spatial resolution of a commercially available cone-beam computed tomography machine. Am J Orthod Dentofacial Orthop 134:573–582. doi: 10.1016/j.ajodo.2007.11.025 PubMedCrossRefGoogle Scholar
  3. 3.
    Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1:307–310. doi: 10.1016/S0140-6736(86)90837-8 PubMedCrossRefGoogle Scholar
  4. 4.
    de Oliveira Júnior MR, Saud AL, Fonseca DR, De-Ary-Pires B, Pires-Neto MA, de Ary-Pires R (2011) Morphometrical analysis of the human mandibular canal: a CT investigation. Surg Radiol Anat 33:345–352. doi: 10.1007/s00276-010-0708-3 PubMedCrossRefGoogle Scholar
  5. 5.
    Hassan B, Souza PC, Jacobs R, Berti SA, van der Stelt P (2010) Influence of scanning and reconstruction parameters on quality of three-dimensional surface models of the dental arches from cone beam computed tomography. Clin Oral Investig 14:303–310. doi: 10.1007/s00784-009-0291-3 PubMedCrossRefGoogle Scholar
  6. 6.
    Howe RB (2009) First molar radicular bone near the maxillary sinus: a comparison of CBCT analysis and gross anatomic dissection for small bony measurement. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 108:264–269. doi: 10.1016/j.tripleo.2008.12.021 PubMedCrossRefGoogle Scholar
  7. 7.
    Krouwer JS (2008) Why Bland–Altman plots should use X, not (Y + X)/2 when X is a reference method. Stat Med 27:778–780. doi: 10.1002/sim.3086 PubMedCrossRefGoogle Scholar
  8. 8.
    Lettry S, Seedhom BB, Berry E, Cuppone M (2003) Quality assessment of the cortical bone of the human mandible. Bone 32:35–44. doi: 10.1016/S8756-3282(02)00921-3 PubMedCrossRefGoogle Scholar
  9. 9.
    Liang X, Jacobs R, Hassan B, Li L, Pauwels R, Corpas L, Souza PC, Martens W, Shahbazian M, Alonso A, Lambrichts I (2010) A comparative evaluation of cone beam computed tomography (cbct) and multi-slice Ct (Msct) Part I. on subjective image quality. Eur J Radiol 75:265–269. doi: 10.1016/j.ejrad.2009.03.042 PubMedCrossRefGoogle Scholar
  10. 10.
    McElderry JD, Kole MR, Morris MD (2011) Repeated freeze-thawing of bone tissue affects Raman bone quality measurements. J Biomed Opt 16:071407. doi: 10.1117/1.3574525 PubMedCrossRefGoogle Scholar
  11. 11.
    Misch KA, Yi ES, Sarment DP (2006) Accuracy of cone beam computed tomography for periodontal defect measurements. J Periodontol 77:1261–1266. doi: 10.1902/jop.2006.050367 PubMedCrossRefGoogle Scholar
  12. 12.
    Mizutani R, Suzuki Y (2012) X-ray microtomography in biology. Micron 43:104–115. doi: 10.1016/j.micron.2011.10.002 PubMedCrossRefGoogle Scholar
  13. 13.
    Mol A, Balasundaram A (2008) In vitro cone beam computed tomography imaging of periodontal bone. Dentomaxillofac Radiol 37:319–324. doi: 10.1259/dmfr/26475758 PubMedCrossRefGoogle Scholar
  14. 14.
    Molen AD (2010) Considerations in the use of cone-beam computed tomography for buccal bone measurements. Am J Orthod Dentofacial Orthop 137:130–135. doi: 10.1016/j.ajodo.2010.01.015 CrossRefGoogle Scholar
  15. 15.
    Momin MA, Matsumoto K, Ejima K, Asaumi R, Kawai T, Arai Y, Honda K, Yosue T (2012) Correlation of mandibular impacted tooth and bone morphology determined by cone beam computed topography on a premise oh third molar operation. Surg Radiol Anat. doi: 10.1007/s00276-012-1031-y PubMedGoogle Scholar
  16. 16.
    Oth O, Louryan S, van Sint Jan S, Rooze M, Glineur R (2012) Impact of the mandibular divergence on the position of the inferior alveolar nerve and mylohyoid nerve: a computed tomography atudy and its relevance to bilateral sagittal aplit osteotomy. Surg Radiol Anat. doi: 10.1007/s00276-012-1010-3 PubMedGoogle Scholar
  17. 17.
    Panzarella FK, Junqueira JLC, Oliveira LB, de Araújo NS, Costa C (2011) Accuracy assessment of the axial images obtained from cone beam computed tomography. Dentomaxillofac Radiol 40:369–378. doi: 10.1259/dmfr/88722046 PubMedCrossRefGoogle Scholar
  18. 18.
    Particelli F, Mecozzi L, Beraudi A, Montesi M, Baruffaldi F, Viceconti M (2012) A comparison between micro-CT and histology for the evaluation of cortical bone: effect of polymethylmethacrylate embedding on structural parameters. J Microsc 245:302–310. doi: 10.1111/j.1365-2818.2011.03573.x PubMedCrossRefGoogle Scholar
  19. 19.
    Patcas R, Müller L, Ullrich O, Peltomäki T (2012) Accuracy of cone-beam computed tomography at different resolutions assessed on the bony covering of the mandibular anterior teeth. Am J Orthod Dentofacial Orthop 141:41–50. doi: 10.1016/j.ajodo.2011.06.034 PubMedCrossRefGoogle Scholar
  20. 20.
    Razavi T, Palmer RM, Davies J, Wilson R, Palmer PJ (2010) Accuracy of measuring the cortical bone thickness adjacent to dental implants using cone beam computed tomography. Clin Oral Implants Res 21:718–725. doi: 10.1111/j.1600-0501.2009.01905.x PubMedCrossRefGoogle Scholar
  21. 21.
    Scarfe WC, Farman AG (2008) What is cone-beam CT and how does it work? Dent Clin North Am 52:707–730. doi: 10.1016/j.cden.2008.05.005 PubMedCrossRefGoogle Scholar
  22. 22.
    Sequeira SM, Whiting BR, Shimony JS, Vo KD, Hullar TE (2011) Accuracy of computed tomography detection of superior canal dehiscence. Otol Neurotol 32:1500–1505. doi: 10.1097/MAO.0b013e318238280c PubMedCrossRefGoogle Scholar
  23. 23.
    Stratemann AS, Huang JC, Maki K, Miller AJ, Hatcher DC (2008) Comparison of cone beam computed tomography imaging with physical measures. Dentomaxillofac Radiol 37:1–14. doi: 10.1259/dmfr/31349994 CrossRefGoogle Scholar
  24. 24.
    Sun Z, Smith T, Kortam S, Kim DG, Tee BC, Fields H (2011) Effect of bone thickness on alveolar bone-height measurements from cone-beam computed tomography images. Am J Orthod Dentofacial Orthop 139:117–127. doi: 10.1016/j.ajodo.2010.08.016 CrossRefGoogle Scholar
  25. 25.
    Swain MV, Xue J (2009) State of the art of Micro-CT applications in dental research. Int J Oral Sci 1:177–188. doi: 10.4248/IJOS09031 PubMedCrossRefGoogle Scholar
  26. 26.
    Thomsen JS, Laib A, Koller B, Prohaskas S, Mosekilde LI, Gowin W (2005) Sterelogical measures of trabecular bone structure: comparison of 3D micro computed tomography with 2D histological sections in human proximal tibial one biopsies. J Microsc 218:171–179. doi: 10.111/j.1365-2818.2005.01469.x PubMedCrossRefGoogle Scholar
  27. 27.
    Timock AM, Cook V, McDonald T, Leo MC, Crowe J, Benninger BL, Covell DA Jr (2011) Accuracy and reliability of buccal bone height and thickness measurements from cone-beam computed tomography imaging. Am J Orthod Dentofacial Orthop 140:734–744. doi: 10.1016/j.ajodo.2011.06.021 PubMedCrossRefGoogle Scholar
  28. 28.
    Vandenberghe B, Luchsinger S, Hostens J, Dhoore E, Jacobs R; The SEDENTEXCT Project Consortium (2012) The influence of exposure parameters on jawbone model accuracy using cone beam computed tomography and multi-slice computed tomography. Dentomaxillofac Radiol 41:466-474. doi:  10.1259/dmfr/81272805 Google Scholar
  29. 29.
    Veyre-Goulet S, Fortin T, Thierry A (2008) Accuracy of linear measurement provided by cone beam computed tomography to assess bone quantity in the posterior maxilla: a human cadaver study. Clin Implant Dent Relat Res 10:226–230. doi: 10.1111/j.1708-8208.2008.00083.x PubMedGoogle Scholar
  30. 30.
    Wang S, Liu Y, Fang D, Shi S (2007) The miniature pig: a useful large animal model for dental and orofacial research. Oral Dis 13:530–537. doi: 10.1111/j.1601-0825.2006.01337.x PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag France 2013

Authors and Affiliations

  • Nathália Ferrare
    • 1
  • André Ferreira Leite
    • 2
  • Hugo César Pinto Marques Caracas
    • 3
  • Ricardo Bentes de Azevedo
    • 4
  • Nilce Santos de Melo
    • 5
  • Paulo Tadeu de Souza Figueiredo
    • 2
  1. 1.Department of Dentistry, Faculty of Health ScienceUniversity of BrasíliaBrasília, DFBrazil
  2. 2.Oral Radiology, Department of Dentistry, Faculty of Health ScienceUniversity of BrasíliaBrasília, DFBrazil
  3. 3.Private PracticeBrasília, DFBrazil
  4. 4.Department of Genetics and Morphology, Institute of Biological ScienceUniversity of BrasíliaBrasília, DFBrazil
  5. 5.Oral Pathology, Department of Dentistry, Faculty of Health ScienceUniversity of BrasíliaBrasília, DFBrazil

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