Assessment of the Capability of Bone Density Contrast Dissociation in Cone Beam Computed Tomography Compared to Digital Periapical Radiography by Using a Phantom

ssessment of bone density changes plays an important role in diagnosis, treatment, and follow-up procedures. The feasibility of cone-beam computed tomography (CBCT) for assessment of bone density changes is still con-troversial.

The aim of this study was to investigate the capability of bone density contrast dissociation of CBCT compared to digital periapical radiography.

In this in vitro, experimental study, we designed radi-ographic phantom for bone density simulation. The phantom was a polytetrafluoro-ethylene rectangular cube with five-chambers. Five micro-tubes (2 mL) containing different concentrations of dipotassium phosphate (K2HPO4) were placed within these chambers. Different concentrations of K2HPO4 were scanned by CBCT; the mean voxel value of each micro-tube was measured and compared with the concen-tration of K2HPO4 that represented bone density.

CBCT results showed that there were no significant correlations between 300 mg/mL and lower concentrations of K2HPO4 and CBCT voxel values (P≤0.52) but there was a significant correlation between concentrations of K2HPO4 higher than 300 mg/mL and CBCT voxel values (p< 0.001).

CBCT is a reliable method for the assessment of bone density changes in the high range of bone density but it is not reliable for such assessment in the lower range of bone density. Digital periapical imaging method may not be applied for the assessment of bone density, whereas in higher densities, the employment of CBCT seems to be feasible.