Sensitivity and Accuracy of Cone Beam Computed Tomography in Diagnosing Osseous Defects at the Mandibular Condyle

Objectives: To assess the ability of using cone-beam computed tomography (CBCT) to diagnose small osseous defects at the mandibular condyle, this study investigated: 1) the impact of defect size and CBCT scan resolutions on the accuracy of qualitative and quantitative diagnoses of condylar defects and, 2) the ability to determine a suspected defect to be true/false based on CBCT measurements. Methods: Cylindrical holes simulating condylar defects of varied levels of diameter (=2mm; 2-3mm; >3mm) and depth (=2mm; >2mm) were created at 22 fresh pig mandibular condyles, with defect number/size per condyle/quadrant randomly determined. With soft tissues repositioned, CBCT scans (0.4mm, 0.2mm voxel-size) of the pig heads were obtained. Reconstructed CBCT data were analyzed independently by two calibrated, blinded raters using Dolphin-3D to diagnose osseous defects qualitatively (defect identification/localization) and quantitatively (geometric measurements of diameter/depth), which were compared to physical diagnoses obtained from polyvinyl siloxane impressions. Statistical tests were conducted for the research objectives. Results: Overall, qualitative defect identification/localization demonstrated moderate inter-rater reliability, excellent specificity and sensitivity, except for extremely small defects (both diameter and depth <2mm) viewed from 0.4mm scans, which had a significantly lower sensitivity (67.3%). Quantitative diagnoses (geometric measurements) demonstrated good inter-rater reliability, only submillimeter inaccuracy regardless of the variation of defect sizes or scan resolutions. The overall ability to determine true/false of a suspected defect based on its CBCT geometric measurements was fair to good depending on scan resolutions. For a suspected defect with less than 2mm (diameter), 1.2mm (depth) or 3.7mm3 (volume) CBCT measurements, a positive diagnosis had less than 80% specificity. Conclusion: When using 0.4mm voxel-size CBCT scans, extremely small (1-2mm) condylar osseous defects are difficult to detect; accepting a suspected defect with only 1-2 mm linear CBCT measurements as a true defect has over 20% chance of making a false-positive error.

Name thesis:degree_name

Master of Science

Level thesis:degree_level

masters

Discipline thesis:degree_discipline

Dentistry

Grantor dc:publisher

The Ohio State University

Year dc:date

2013

Author dc:creator

• Patel, Alpesh

Contributors dc:contributor

• Sun, Zongyang

• Dentistry
• Radiology
• CBCT
• mandibular condyle
• porcine
• diagnosis

Statement dc:rights

• unrestricted
• This thesis or dissertation is protected by copyright: all rights reserved. It may not be copied or redistributed beyond the terms of applicable copyright laws.

Language dc:language

English

Repository record dc:identifier

http://rave.ohiolink.edu/etdc/view?acc_num=osu1363606389

OAI identifier oai:identifier

oai:etd.ohiolink.edu:osu1363606389