CLINICAL VALIDATION OF CONE-BEAM COMPUTED TOMOGRAPHY IMAGING FOR OBJECTIVE ASSESSMENT OF JAW BONE QUALITY AND QUANTITY

Radiological bone evaluation has been considered an essential element during oral and maxillofacial pre-surgical planning and follow-up. Clinical evaluation of bone quality is to a large extent still based on linear measurements and subjective visual interpretation of two-dimensional (2D) images of bone structure, which are not reproducible and lead to interpretation errors . With the development of high-resolution three-dimensional (3D) imaging modalities, new methods for analysing the bone structure in 3D have made it possible to evaluate the bone quality in a quantitative and objective way. In the last decade, improvements in the Cone-Beam CT (CBCT) technology yielded much higher spatial resolutions in the maxillofacial area ranging from 75 µm to 400 µm, illustrating the possibility of CBCT to accurately depict and render cortical and trabecular bone structures in the jaws. Reliable and standardized methods to assess bone quality should, therefore, be considered as a supplement means in pre-surgical planning and follow-up to provide a better estimation of the surgical treatment outcome. The primary goal of this thesis was to investigate the accuracy and reliability of CBCT for the assessment of jaw bone structures. More specifically, developing objective 3D methods to plan and follow up maxillofacial treatments. For cortical and trabecular bone assessment, CBCT showed to be accurate and reliable clinical tool in both dentate and edentulous alveolar bone. Computer-aided and 3D quantification methods can offer objectivity in treatment planning and following up.