title: Bone quality evaluation at dental implant site using multislice CT, micro-CT, and cone beam CT.
abstract: OBJECTIVE
  The first purpose of this study was to analyze the correlation between bone volume fraction (BV/TV) and calibrated radiographic bone density Hounsfield units (HU) in human jaws, derived from micro-CT and multislice computed tomography (MSCT), respectively. The second aim was to assess the accuracy of cone beam computed tomography (CBCT) in evaluating trabecular bone density and microstructure using MSCT and micro-CT, respectively, as reference gold standards.
  
  
  METHODS
  Twenty partially edentulous human mandibular cadavers were scanned by three types of CT modalities: MSCT (Philips, Best, the Netherlands), CBCT (3D Accuitomo 170, J Morita, Kyoto, Japan), and micro-CT (SkyScan 1173, Kontich, Belgium). Image analysis was performed using Amira (v4.1, Visage Imaging Inc., Carlsbad, CA, USA), 3Diagnosis (v5.3.1, 3diemme, Cantu, Italy), Geomagic (studio(®) 2012, Morrisville, NC, USA), and CTAn (v1.11, SkyScan). MSCT, CBCT, and micro-CT scans of each mandible were matched to select the exact region of interest (ROI). MSCT HU, micro-CT BV/TV, and CBCT gray value and bone volume fraction of each ROI were derived. Statistical analysis was performed to assess the correlations between corresponding measurement parameters.
  
  
  RESULTS
  Strong correlations were observed between CBCT and MSCT density (r = 0.89) and between CBCT and micro-CT BV/TV measurements (r = 0.82). Excellent correlation was observed between MSCT HU and micro-CT BV/TV (r = 0.91). However, significant differences were found between all comparisons pairs (P < 0.001) except for mean measurement between CBCT BV/TV and micro-CT BV/TV (P = 0.147).
  
  
  CONCLUSIONS
  An excellent correlation exists between bone volume fraction and bone density as assessed on micro-CT and MSCT, respectively. This suggests that bone density measurements could be used to estimate bone microstructural parameters. A strong correlation also was found between CBCT gray values and BV/TV and their gold standards, suggesting the potential of this modality in bone quality assessment at implant site.
authors: Section of Oral Radiology, Department of General and Specialized Dentistry, Academic Center for Dentistry Amsterdam (ACTA), Amsterdam, The Netherlands.
authors: Azin
authors: A
authors: Parsa
authors: Norliza
authors: N
authors: Ibrahim
authors: Bassam
authors: B
authors: Hassan
authors: Paul
authors: P
authors: van der Stelt
authors: Daniel
authors: D
authors: Wismeijer
mesh_terms: D000465:Algorithms; D015519:Bone Density; D002102:Cadaver; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000000981:diagnostic imaging*; D008334:Mandible / Q000000981:diagnostic imaging*; D061330:Multidetector Computed Tomography / Q000379:methods*; D011857:Radiographic Image Interpretation, Computer-Assisted; D015203:Reproducibility of Results; D055114:X-Ray Microtomography / Q000379:methods*
keywords: bone density; bone volume fraction; cone beam computed tomography; dental implants; micro-computed tomography; multislice computed tomography