Original Article

Accuracy of Linear Measurements Using Cone Beam Computed Tomography in Comparison with Clinical Measurements


Objectives: This study sought to evaluate the accuracy and errors of linear measurements of mesiodistal dimensions of Kennedy Class III edentulous space using cone beam computed tomography (CBCT) in comparison with clinical measurements.
Materials and Methods: Nineteen Kennedy Class III dental arches were evaluated. An impression was made of each dental arch and poured with dental stone. The distance was measured on dental cast using a digital Vernier caliper with an accuracy of 0.1mm and on CBCT scans. Finally, the linear mesiodistal measurements were compared and the accuracy of CBCT technique was evaluated by calculating absolute value of errors, intra-class correlation coefficient and simple linear regression model.
Results: In comparison with the cast method, estimation of size on CBCT scans had an error of -8.46% (underestimation) to 5.21% (overestimation). In 26.5% of the cases, an accepted error of ±1% was found. The absolute value of errors was found to be in the range of 0.21-8.46mm with an average value of 2.86 ±2.30mm.
Conclusions: Although the measurements revealed statistically significant differences, this does not indicate a lower accuracy for the CBCT technique. In fact, CBCT can provide some information as a paraclinical tool and the clinician can combine these data with clinical data and achieve greater accuracy. Undoubtedly, calibration of data collected by clinical and paraclinical techniques and the clinician’s expertise in use of CBCT software programs can increase the accuracy of implant placement.


- Sato S, Arai Y, Shinoda K, Ito K. Clinical application of a new cone-beam computerizedtomography system to assess multiple twodimensional images for the preoperative treatment planning of maxillary implants: case reports. Quintessence Int. 2004 Jul-Aug;35(7):525-8.

- Schropp L, Stavropoulos A, GotfredsenE, Wenzel A. Comparison of panoramic and conventional cross-sectional tomography for preoperative selection of implant size. Clin Oral Implants Res. 2011 Apr;22 (4):424-9.

- Hardy TC, Suri L, Stark P. Influence of patient head positioning on measured axial tooth inclination in panoramic radiography. J Orthod. 2009 Jun;36 (2):103-10.

- Liang H, Frederiksen NL. Focal trough and patient positioning. Dentomaxillofac Radiol. 2004 Mar;33 (2):128-9.

- Nishikawa K, Suehiro A, Sekine H, Kousuge Y, Wakoh M, Sano T. Is linear distance measured by panoramic radiography reliable? Oral Radiol. 2010 Jun;26(1):16-9.

- Kobayashi K, Shimoda S, Nakagawa Y, Yamamoto A. Accuracy in measurement of distance using limited cone-beam computerized tomography. Int J Oral Maxillofac Implants. 2004 Mar-Apr;19(2):228-31.

- Visconti MA, Verner FS, Assis NM, Devito KL. Influence of maxillomandibular positioning in cone beam computed tomography for implant planning. Int J Oral Maxillofac Surg. 2013 Jul;42(7):880-6.

- Ritman EL, Kinsey JH, Robb RA, Harris LD, Gilbert BK. Physics and technical considerations in the design of the DSR: a high temporal resolution volume scanner. AJR Am J Roentgenol. 1980 Feb;134(2):369-74.

- Robb RA, Sinak LJ, Hoffman EA, Kinsey JH, Harris LD, Ritman EL. Dynamic volume imaging of moving organs. J Med Syst. 1982 Dec;6(6):539-54.

-Mah J, Hatcher D. Three-dimensional craniofacial imaging. Am J Orthod Dentofacial Orthop. 2004 Sep;126(3):308-9.

- Akdeniz BG, Oksan T, Kovanlikaya I, GençI. Evaluation of bone height and bone density by computed tomography and anoramic radiography for implant recipient sites. J Oral Implantol. 2000 Apr;26(2):114-9.

- Frei C, Buser D, Dula K. Study on the necessity for cross-section imaging of the posterior mandible for treatment planning of standard cases in implant dentistry. Clin Oral Implants Res. 2004 Aug;15(4): 490-7.

- Cushen SE, Turkyilmaz I. Impact of operator experience on the accuracy of implant placement with stereolithographic surgical templates: an in vitro study. J Prosthet Dent. 2013 Apr;109(4):248-54.

- Jabero M, Sarment DP. Advanced surgical guidance technology: a review. Implant Dent. 2006 Jun;15(2):135-42.

- Loubele M, Bogaerts R, Van Dijck E, Pauwels R, Vanheusden S, Suetens P, et al. Comparison between effective radiation dose of CBCT and MSCT scanners for dentomaxillofacial applications. Eur J Radiol. 2009 Sep;71(3):461-8.

- Patel S, Dawood A, Ford TP, Whaites E. The potential applications of cone beam computed tomography in the management of endodontic problems. Int Endod J. 2007 Oct;40(10):818-30.

- Kamburoğlu K, Murat S, Yüksel SP, Cebeci AR, Paksoy CS. Occlusal caries detection by using a cone-beam CT with different voxel resolutions and a digital intraoral sensor. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2010 May;109(5):e63-9.

- Pauwels R, Beinsberger J, Collaert B, Theodorakou C, Rogers J, Walker A, et al. Effective dose range for dental cone beam computed tomography scanners. Eur J Radiol. 2012 Feb;81(2): 267-71.

- Dawood A, Brown J, Sauret-Jackson V, Purkayastha S. Optimization of cone beam CT exposure for pre-surgical evaluation of the implant site. Dentomaxillofac Radiol. 2012 Jan;41(1):70-4.

- Lascala CA, Panella J, Marques MM. Analysis of the accuracy of linear measurements obtained by cone beam computed tomography (CBCT-New Tom). Dentomaxillofac Radiol. 2004 Sep;33(5):291-4.

- Ludlow JB, Laster WS, See M, Bailey LJ, Hershey HG. Accuracy of measurements of mandibular anatomy in cone beam computed tomography images. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Apr;103(4):534-42.

- Pinsky HM, Dyda S, Pinsky RW, Misch KA, Sarment DP. Accuracy of three-dimensional measurements using cone-beam CT. Dentomaxillofac Radiol. 2006 Nov;35(6):410-6.

- van Vlijmen OJ, Bergé SJ, Bronkhorst EM, Swennen GR, Katsaros C, Kuijpers-Jagtman AM. A comparison of frontal radiographs obtained from cone beam CT scans and conventional frontal radiographs of human skulls. Int J Oral Maxillofac Surg. 2009 Jul;38(7):773-8.

- Wittwer G, Adeyemo WL, Beinemann J, Juergens P. Evaluation of risk of injury to the inferior alveolar nerve with classical sagittal split osteotomy technique and proposed alternative surgical techniques using computer-assisted surgery. Int J Oral Maxillofac Surg. 2012 Jan;41(1): 79-86.

- Misch CE. Contemporary Implant Dentistry. Implant Dent. 1999 Jan;8(1):90.

- Decurcio DA, Bueno MR, de Alencar AH, Porto OC, Azevedo BC, Estrela C. Effect of root canal filling materials on dimensions of cone-beam computed tomography images. J Appl Oral Sci. 2012 Mar-Apr;20(2):260-7.

IssueVol 13, No 5 (2016) QRcode
SectionOriginal Article
Cone-Beam Computed Tomography Dental Arch Dimensional Measurement Accuracy

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
Rokn AR, Hashemi K, Akbari S, Kharazifard MJ, Barikani H, Panjnoosh M. Accuracy of Linear Measurements Using Cone Beam Computed Tomography in Comparison with Clinical Measurements. Front Dent. 2016;13(5):333-339.

Most read articles by the same author(s)