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Volume 28 , Issue 2
March/April 2013

Pages 536–542

Comparison of the Accuracy of Cone Beam Computed Tomography and Medical Computed Tomography: Implications for Clinical Diagnostics with Guided Surgery

Marcus Abboud, DMD, PhD1/José Luis Calvo Guirado, DDS, PhD, MS2/ Gary Orentlicher, DMD3/Gerhard Wahl, DMD, PhD4

PMID: 23527357
DOI: 10.11607/jomi.2403

Purpose: This study compared the accuracy of cone beam computed tomography (CBCT) and medicalgrade CT in the context of evaluating the diagnostic value and accuracy of fiducial marker localization for reference marker–based guided surgery systems. Materials and Methods: Cadaver mandibles with attached radiopaque gutta-percha markers, as well as glass balls and composite cylinders of known dimensions, were measured manually with a highly accurate digital caliper. The objects were then scanned using a medical-grade CT scanner (Philips Brilliance 64) and five different CBCT scanners (Sirona Galileos, Morita 3D Accuitomo 80, Vatech PaX-Reve3D, 3M Imtech Iluma, and Planmeca ProMax 3D). The data were then imported into commercially available software, and measurements were made of the scanned markers and objects. CT and CBCT measurements were compared to each other and to the caliper measurements. Results: The difference between the CBCT measurements and the caliper measurements was larger than the difference between the CT measurements and the caliper measurements. Measurements of the cadaver mandible and the geometric reference markers were highly accurate with CT. The average absolute errors of the human mandible measurements were 0.03 mm for CT and 0.23 mm for CBCT. The measurement errors of the geometric objects based on CT ranged between 0.00 and 0.12 mm, compared to an error range between 0.00 and 2.17 mm with the CBCT scanners. Conclusions: CT provided the most accurate images in this study, closely followed by one CBCT of the five tested. Although there were differences in the distance measurements of the hard tissue of the human mandible between CT and CBCT, these differences may not be of clinical significance for most diagnostic purposes. The fiducial marker localization error caused by some CBCT scanners may be a problem for guided surgery systems. Int J Oral Maxillofac Implants 2013; 28:536–542. doi: 10.11607/jomi.2403

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