Evaluation of the CBCT imaging accuracy in the volumetric assessment of unilateral alveolar cleft

Abstract

Introduction: Appropriate radiographic evaluation is a fundamental step for determining the topography of the defect before the surgical intervention for alveolar bone grafting. Evaluation of cleft volume by CBCT has been done in dry skull samples in previous studies and it was recommended as an effective tool in the volumetric evaluation of the bone defect prior to the surgery. The purpose of this study was to evaluate the accuracy of preoperative clinical use of CBCT² imaging in determining the alveolar cleft volume.

Material and methods: We performed a clinical study. 20 patients with unilateral alveolar cleft underwent preoperative radiographic evaluation using CBCT scan. Volumetric measurement was performed by an oral and maxillofacial radiologist using 0.5, 1, and 2 mm slices and an oral and maxillofacial surgeon using 2 mm slices. After the closure of the nasal floor and palatal mucosa, the alveolar defect was clinically measured with putty impression material. Descriptive and bivariate statistics were computed and the p-value was set at 0.05.

Results: This study showed that there is a statistically significant difference between CBCT-estimated and clinical volumes of the alveolar cleft (paired T-test, p-value < 0.05).

Conclusion: Considering the significant difference between clinical and CBCT-estimated volumes of the alveolar cleft, CBCT imaging is not considered an accurate tool for pre-operative volumetric assessment of the alveolar cleft.

Keywords: Alveolar bone grafting; Alveolar cleft volume; CBCT imaging; Volume estimation.