In Vitro Evaluation of Accuracy of CBCT-Derived Volumes in Maxillary Defects: Effects of kVp, Device, and Software

Murat S. Kamburoğlu K. Vazquez D. Nart L.J. Azcona V. Benitez L.E. Awawdeh M. Aboelmaaty W.
May 2025 Multidisciplinary Digital Publishing Institute (MDPI)

Diagnostics
2025 #15 Issue 10

Objectives: This study aimed to evaluate the accuracy of CBCT-based volumetric measurements of maxillary defects and to investigate the effects of different CBCT devices, kVp settings, and segmentation software on measurement accuracy. Methods: CBCT images from eight patients with maxillary defects were used to generate 3D-printed models for volumetric assessment. Two CBCT systems (Largev Smart and Planmeca Promax) were evaluated at three different kVp settings. Volume calculations were conducted using ITK-SNAP version 4.2.2 and 3D Doctor version 4.0 software, while micro-CT served as the gold standard (GS) for comparison. Statistical analysis included a three-way ANOVA to assess the effect of CBCT parameters and software on volumetric accuracy. Additionally, post-hoc Tukey HSD analysis was performed to identify specific differences between kVp groups, and Pearson correlation analysis was used to evaluate consistency with the GS. Significance level was set at p < 0.05. Results: Higher kVp settings significantly improved volumetric accuracy, with 100 kVp yielding the smallest deviations (−3.77%) from the GS. Tukey HSD analysis revealed significant differences between 60–80 kVp (p = 0.008), 60–100 kVp (p < 0.001), and 80–100 kVp (p = 0.041), confirming the influence of kVp on accuracy. No significant differences were observed between CBCT devices or software programs (p > 0.05). A strong positive correlation (r = 0.96) between CBCT-derived and micro-CT volumes confirmed CBCT’s reliability for volumetric assessments (p < 0.001). Conclusions: CBCT provides accurate volumetric measurements of maxillary defects, particularly at higher kVp settings. These findings support its clinical application for preoperative planning and postoperative evaluation, offering a cost-effective alternative to micro-CT.

computer-assisted , cone-beam computed tomography , image processing , volume measurement , X-ray microtomography

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Department of Prosthodontics, Faculty of Dentistry, Ankara University, Ankara, 06560, Turkey
Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, 06560, Turkey
Department of Diagnostic Imaging, Faculty of Dentistry, University of Buenos Aires, Buenos Aires, C1122AAH, Argentina
Department of Surgery and Pediatric Dentistry, Faculty of Stomatology, Khoja Akhmet Yassawi International Kazakh Turkish University, Turkestan, 161200, Kazakhstan
Preventive Dental Science Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 11481, Saudi Arabia
King Abdullah International Medical Research Center, Ministry of National Guard—Health Affairs, Riyadh, 11481, Saudi Arabia
Maxillofacial Surgery and Diagnostic Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences (KSAU-HS), Riyadh, 11481, Saudi Arabia
Oral Radiology and Diagnostic Sciences Department, Faculty of Dentistry, Mansoura University, Mansoura City, 35516, Egypt

Department of Prosthodontics
Department of Dentomaxillofacial Radiology
Department of Diagnostic Imaging
Department of Surgery and Pediatric Dentistry
Preventive Dental Science Department
King Abdullah International Medical Research Center
Maxillofacial Surgery and Diagnostic Sciences Department
Oral Radiology and Diagnostic Sciences Department

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