International Journal of Dental Sciences and Research
ISSN (Print): 2333-1135 ISSN (Online): 2333-1259 Website: Editor-in-chief: Marcos Roberto Tovani Palone
Open Access
Journal Browser
International Journal of Dental Sciences and Research. 2018, 6(6), 159-162
DOI: 10.12691/ijdsr-6-6-4
Open AccessArticle

A Robust Model to Test the Accuracy of Cone Beam Computed Tomography Linear Measurements

Mohamed Ahmed Alkhodary1, 2, , Abd Elaleem Hassan Elsantawy3 and Abeer Mohamed Ettesh3

1Department of Prosthetic Dental Sciences, College of Dentistry, Qassim University, Al Mulidaa, Kingdom of Saudi Arabia

2Department of Prosthodontics, Faculty of Dentistry, Alexandria University, Alexandria, Egypt

3Department of Oral and Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Qassim University, Al Mulidaa, Kingdom of Saudi Arabia

Pub. Date: December 06, 2018

Cite this paper:
Mohamed Ahmed Alkhodary, Abd Elaleem Hassan Elsantawy and Abeer Mohamed Ettesh. A Robust Model to Test the Accuracy of Cone Beam Computed Tomography Linear Measurements. International Journal of Dental Sciences and Research. 2018; 6(6):159-162. doi: 10.12691/ijdsr-6-6-4


In planning for placement of dental implants in edentulous mandibles, the accuracy of the linear measurements of the cone beam computed tomography (CBCT) has been questioned. This study used a digital caliper as the gold standard to which linear measurements taken from CBCT were compared. Customized aluminum screws, 2.8 mm in diameter and 11-12 mm in length, were used as dental implant analogues in the canine, premolar, and molar regions in completely edentulous synthetic polyurethane mandibles. A 2 mm aluminum wire was used as the mandibular canal. A total of 240 readings by the digital caliper and the CBCT were recorded for the screws length and diameter, mandibular canal wire diameter, and the distance from the apices of the screws to the superior border of the mandibular canal wire. The statistical analysis was performed using the paired sample T test, with a p value of .05 considered statistically significant. Statistically significant differences between the digital caliper readings and those of the CBCT were recorded in the canine, premolar and molar regions where all the over-and under-estimations did not exceed half a millimeter. The statistically significant discrepancies found in the linear measurements of the CBCT were less than 1 mm, and therefore did not exclude the CBCT from being a beneficial tool in the planning for dental implant placement. However, it is important to note that the results of this study and cannot be generalized to all CBCT machines as they are not created equal by different manufacturers.

cone beam computed tomography linear measurements completely edentulous mandibles

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit


Figure of 3


[1]  Moshiri, M., Scarfe, W.C., Hilgers, M.L., Scheetz, J.P., Silveira, A.M., and Farmanf, A.G. “Accuracy of linear measurements from imaging plate and lateral cephalometric images derived from cone-beam computed tomography”, American Journal of Orthodontics and Dentofacial Orthopedics, 132. 550-560. 2007.
[2]  Da Silva, M.B.G., Gois, B.C., Sant’Anna, E.F. “Evaluation of the reliability of measurements in cephalograms generated from cone beam computed tomography”, Dental Press J Orthod, 18. 53-60. 2013.
[3]  Salem, W.S., Dahaba, M.M., Khalifa, S. “Precision of Measurements from Computed Tomography (CT), Cone Beam Computed Tomography (CBCT) and their Reformatted Images in Pre-Operative Implant Assessment: Int J Surg Res Pract, 1. 004. 2014.
[4]  Daniel Deluiz, et al. “Validation of a method using cone beam computed tomography for measuring bone block grafts for the alveolar ridge augmentation” Musculoskelet Regen, 2. 1312. 2016.
[5]  Purtaji, B., Panjnoush, M., Shamshiri, A., Purtaji, M. “Difference in implant measurements made on cone beam computed tomography scans taken with and without radiographic stent” Int J Med Res Health Sci, 12. 84-91. 2016.
[6]  Gonzalez Cortes, A.R., Monteiro Gomes, A.F.A., Tucunduva, M.A.P., Arita, E.S. “Evaluation of linear tomography and cone beam computed tomography accuracy in measuring ridge bone width for planning implant placement” Braz J Oral Sci, 11. 116-119. 2012.
[7]  Amarnath, G.S., Kumar, U., Hilal M., Muddugangadhar, B.C., Anshuraj, K., Shruthi, C.S. “Comparison of cone beam computed tomography, orthopantomography with direct ridge mapping for pre-surgical planning to place implants in cadaveric mandibles: An ex-vivo study” J Int Oral Health, 1. 38-42. 2015.
[8]  Lascala, C.A., Panella, J., and Marques, M.M. “Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-New Tom)” Dentomaxillofacial Radiology, 33. 291-294. 2004.
[9]  Sisman, Y., Ercan-Sekerci, A., Payveren-Arıkan, M., Sahman, H. “Diagnostic accuracy of cone-beam CT compared with panoramic images in predicting retromolar canal during extraction of impacted mandibular third molars” Med Oral Patol Oral Cir Bucal, 20. 74-81. 2015.
[10]  Shaibah, W.I., Yamany, I.A., and Jastaniah, S.D. “Physical Measurements for the Accuracy of Cone-Beam CT in Dental Radiography” Open Journal of Medical Imaging, 4. 57-64. 2014.
[11]  Abu Osman, N.A., Ibrahim, S., Wan Abas, W.A.B., Abd Rahman, H.S., Ting, H.N. “Validation of Cone Beam CT Scan for Measurement of Palatal Depth in Study Casts” Biomed Proceedings, 21. 758-76. 2008.
[12]  Wikner, J., Hanken, H., Eulenburg, C., Heiland, M., Gröbe, A., Assaf, A.T., et al. “Linear accuracy and reliability of volume data sets acquired by two CBCT-devices and an MSCT using virtual models: a comparative in-vitro study” Acta Odontol Scand, 74. 51-9. 2016.
[13]  Sabban, H., Mahdian, M., Dhingra, A., Lurie, A.G., Tadinada, A. “Evaluation of linear measurements of implant sites based on head orientation during acquisition: an ex vivo study using cone-beam computed tomography” Imaging Sci Dent, 45. 73-80. 2015.
[14]  Thönissen, P., Ermer, M.A., Schmelzeisen, R., Gutwald, R., Metzger, M.C., Bittermann, G. “Sensitivity and specificity of cone beam computed tomography in thin bony structures in maxillofacial surgery-A clinical trial” J Craniomaxillofac Surg, 43. 1284-8. 2015.
[15]  Maroua, A.L., Ajaj, M., Hajeer, M.Y. “The accuracy and reproducibility of linear measurements made on CBCT-derived digital models”, J Contemp Dent Pract, 17. 294-9. 2016.
[16]  Brüllmann, D., Schulze, R.K. “Spatial resolution in CBCT machines for dental/maxillofacial applications-what do we know today?” Dentomaxillofac Radiol, 44. 20140204. 2015.
[17]  Menezes, R.F., Araújo, N.C., Santa Rosa, J.M., Carneiro, V.S., Santos Neto, A.P., Costa, V., et al. “Detection of vertical root fractures in endodontically treated teeth in the absence and in the presence of metal post by cone-beam computed tomography” BMC Oral Health, 16. 48. 2016.
[18]  Khoury, H.J., Andrade, M.E., Araujo, M.W., Brasileiro, I.V., Kramer, R., Huda, A. “Dosimetric study of mandible examinations performed with three cone-beam computed tomography scanners”, Radiat Prot Dosimetry, 165. 162-5. 2015.
[19]  Lukat, T.D., Perschbacher, S.E., Pharoah, M.J., Lam, E.W. “The effects of voxel size on cone beam computed tomography imag-es of the temporomandibular joints” Oral Surg Oral Med Oral Pathol Oral Radiol, 119. 229-37. 2015.
[20]  Shokri, A., Khajeh, S. “In vitro comparison of the effect of different slice thicknesses on the accuracy of linear measure-ments on cone beam computed tomography images in implant sites” J Craniofac Surg, 26. 157-60. 2015.
[21]  Ganguly, R., Ramesh, A., Pagni, S. “The accuracy of linear measurements of maxillary and mandibular edentulous sites in cone-beam computed tomography images with different fields of view and voxel sizes under simulated clinical conditions” Imaging Sci Dent, 46. 93-101. 2016.
[22]  Ludlow, J.B., Laster, W.S., See, M., Bailey, L.T.J., Hershey, H.G. “Accuracy of measurements of mandibular anatomy in cone beam computed tomography images”, Oral Surg Oral Med Oral Pathol Oral Radiol Endod, 103(4). 534-42. 2007.
[23]  Tarazona-Álvarez, P., Romero-Millán, J., Peñarrocha-Oltra, D., Fuster-Torres, M.Á., Tarazona, B., Peñarrocha-Diago, M. “Comparative study of mandibular linear measurements obtained by cone beam computed tomography and digital calipers”, J Clin Exp Dent. 6(3). E 271-4. 2014.
[24]  Tang, Z., Liu, X., and Chen, K. “Comparison of digital panoramic radiography versus cone beam computerized tomography for measuring alveolar bone”, Head & Face Medicine, 13. 2. 2017.
[25]  Stratemann, S.A., Huang, J.C., Maki, K., Miller, A.J., Hatcher, D.C. “Comparison of cone beam computed tomography imaging with physical measures”, Dentomaxillofac Radiol, 37. 80-93. 2008.
[26]  Lagravère, M.O., Carey, J., Toogood, R.W., Major, P.W. “Three-dimensional accuracy of measurements made with software on cone-beam computed tomography images”, Am J Orthod Dentofacial Orthop, 134. 112-6. 2008.
[27]  Brown, A.A., Scarfe, W.C., Scheetz, J.P/, Silveira, A.M., Farman, A.G. “Linear accuracy of cone beam CT derived 3D images” Angle Orthod, 79. 150-7. 2009.
[28]  Scarface WC, Farman AG, Sukovic P. Clinical applications of cone-beam computed tomography imaging with physical measures. Dentomaxillofac Radiol. 2008; 37: 80-93.
[29]  Da Silva, N.C., Barriviera, M., Junqueira, J.L.C., Panzarella, F.K., Ricardo Raitz, R. “Intraobserver and interobserver reproducibility in linear measurements on axial images obtained by cone-beam computed tomography”, Imaging Science in Dentistry, 47. 11-5. 2017.
[30]  Antar, E., Khalifa, M., Hosny, S. “Determination of the Accuracy of Linear and Volumetric Measurements on Cone Beam Computed Tomography Images (In-vitro study)” EDJ. 57. 2917-2925. 2011.
[31]  Damstra, J., Fourie, Z., Huddleston Slater, J.J., Ren, Y. “Accuracy of linear measurements from cone-beam computed tomography-derived surface models of different voxel sizes”, Am J Orthod Dentofacial Orthop, 137: 1-7. 2010.
[32]  Baumgaertel, S., Martin, J., Palomo, L., Hans, M.G. “Reliability and accuracy of cone-beam computed tomography dental measurements”, Am J Orthod Dentofacial Orthop, 136. 19-28. 2009.
[33]  Glover, G.H., Pelc, N.J. “Nonlinear partial volume artefacts in x-ray computed tomography”, Med Phys, 7. 238-48. 1980.
[34]  Ganguly, R., Ruprecht, A., Vincent, S., Hellstein, J., Timmons, S., Qian, F. “Accuracy of linear measurement in the Galileos cone beam computed tomography under simulated clinical condi-tions”, Dentomaxillofac Radiol, 40. 299-305. 2011.
[35]  Torres, M.G., Campos, P.S., Segundo, N.P., Navarro, M., Crusoé-Re-bello, I. “Accuracy of linear measurements in cone beam com-puted tomography with different voxel sizes”, Implant Dent, 21. 150-5. 2012.
[36]  Abboud, M., Calvo Guirado, J.L., Orentlicher, G., Wahl, G. “Comparison of the Accuracy of Cone Beam Computed Tomography and Medical Computed Tomography: Implications for Clinical Diagnostics with Guided Surgery”, J Oral Maxillofac Implants, 28. 536-542. 2013.