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Reliability and Accuracy of Assessing TAD - Tooth Root Contact using CBCT

Srinivasan, Soorya
http://rave.ohiolink.edu/etdc/view?acc_num=osu1553782462280014

Abstract Details

2019, Master of Science, Ohio State University, Dentistry.
Objective: Use of Temporary Anchorage Devices (TADs) for skeletal anchorage has found profound applications in the field of Orthodontics. Small field-of-view Cone Beam Computed Tomography (CBCT) imaging has been used clinically to evaluate TAD placement regarding its proximity to adjacent tooth roots. The objective of this study was to investigate the reliability and accuracy of CBCT based assessment of TAD –tooth root proximity depending on the presence of metal brackets, choice of software programs and color enhancement techniques. Methods: Mandibles collected from 18 fresh pig cadavers were used. In each half mandible, a TAD (Vector 1.4 x 8 mm) was placed at the buccal intermolar alveolar bone. With all soft tissue kept intact, each mandible underwent CBCT scans (Planmeca Promax 3D machine, (90kVp, 12.5mA, and 400um voxel size) before and after placing TADs, as well as after placing metal brackets on involved molars. Alveolar bone specimens containing the TADs were then separated from adjacent bone, TAD carefully removed and exposed to micro-CT scans, (Skyscan 1172, 100kV, 100uA, 27um voxel size). Subsequently, two independent raters, blinded of image identity, diagnosed whether the TAD was in contact with adjacent roots and measured the shortest TAD – root distance using ImageJ for microCT, and Dolphin and Anatomage (with and without color enhancement) softwares for CBCT images. Intra-rater, inter-rater reliability, and the agreement between CBCT and microCT (gold standard) diagnoses were assessed by Cohen’s kappa tests. Intra-rater, Inter-rater reliability of TAD – root distance were assessed with ICC. One way repeated measures ANOVA was used to assess variances between raters, imaging software programs, presence/absence of metal brackets, CBCT and micro- CT measurements. Results: Interrater reliability for categorical diagnosis of TAD – root contact was perfect for microCT images (kappa=1), followed by CBCT diagnosis made in Anatomage (kappa=0.85) and Dolphin (kappa=0.536). The presence of brackets increased CBCT diagnostic reliability made in Anatomage (kappa: 0.85 to 0.93) but decreased it in Dolphin (kappa: 0.536 to 0.113) Intrarater reliability of categorical diagnosis showed similar trend. Overall, kappa was strong for analysis with Anatomage and weak for those analysis done using Dolphin. Analysis made with Dolphin in the presence of brackets and using color enhancement of Anatomage had minimal to no reliability. The diagnostic accuracy of CBCT images compared to micro CT showed no agreement irrespective of the raters, presence of metal brackets or imaging software used. Quantitative measurements made using Anatomage software were more reliable between and within raters, but Dolphin measurements matched micro CT measurements more closely. Measurements made in Anatomage overestimated the TAD – root distance, thus indicating a greater penetration of TADs into the root with its use. Conclusions: Despite reasonable or even good intra and inter-rater reliability, the categorical diagnoses of TAD-root proximity made from clinically used CBCT imaging (0.4 mm voxel size) are inaccurate, with a tendency for more false positive diagnoses. Quantitative measurements of TAD – root contact may be overestimated with use of Anatomage
Zongyang Sun (Advisor)
Anita Gohel (Committee Member)
Do - Gyoon Kim (Committee Member)
Toru Deguchi (Committee Member)
91 p.
Dentistry
CBCT, TADs, diagnostic reliability, diagnostic accuracy, alveolar bone

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Citations

  • Srinivasan, S. (2019). Reliability and Accuracy of Assessing TAD - Tooth Root Contact using CBCT [Master's thesis, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu1553782462280014

    APA Style (7th edition)

  • Srinivasan, Soorya. Reliability and Accuracy of Assessing TAD - Tooth Root Contact using CBCT. 2019. Ohio State University, Master's thesis. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu1553782462280014.

    MLA Style (8th edition)

  • Srinivasan, Soorya. "Reliability and Accuracy of Assessing TAD - Tooth Root Contact using CBCT." Master's thesis, Ohio State University, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=osu1553782462280014

    Chicago Manual of Style (17th edition)

osu1553782462280014
518
© 2019, some rights reserved.Creative Commons License Reliability and Accuracy of Assessing TAD - Tooth Root Contact using CBCT by Soorya Srinivasan is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License. Based on a work at etd.ohiolink.edu.
This open access ETD is published by The Ohio State University and OhioLINK.