Evidence map›Paper›PMID 39448399›Full record

ArticleJournal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie2026

Tooth segmentation by low-dose CBCT for orthodontic treatment planning : Explorative ex vivo validation.

Maurice Ruetters, Holger Gehrig, Sinclair Awounvo, Ti-Sun Kim, Sara Doll, Korallia Alexandrou, Anna Felten, Christopher Lux, Sinan Sen

Abstract readValidation Study
In one paragraph

Article in Journal of orofacial orthopedics = Fortschritte der Kieferorthopadie : Organ/official journal Deutsche Gesellschaft fur Kieferorthopadie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Maurice RuettersHeidelberg University, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany. Maurice.ruetters@med.uni-heidelberg.de.ORCID http://orcid.org/0000-0001-9945-7286
Holger GehrigHeidelberg University, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Sinclair AwounvoUniversity Hospital Heidelberg, Institute of Medical Biometry, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Ti-Sun KimHeidelberg University, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Sara DollDepartment of Anatomy and Cell Biology, Heidelberg University, Im Neuenheimer Feld 307, 69120, Heidelberg, Germany.
Korallia AlexandrouDepartment of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Anna FeltenHeidelberg University, Department of Operative Dentistry, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Christopher LuxDepartment of Orthodontics, University Hospital Heidelberg, Im Neuenheimer Feld 400, 69120, Heidelberg, Germany.
Sinan SenDepartment of Orthodontics, University Hospital Schleswig Holstein, Arnold-Heller-Straße 3, 24105, Kiel, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThree-dimensional imaging has become an increasingly important component of orthodontics. Associated with this, however, is a higher radiation exposure for patients. New cone-beam computed tomography (CBCT) devices have been developed that can provide low-dose CBCT (LD-CBCT). We hypothesized that LD-CBCT is as precise and reproducible as standard high-dose CBCT (HD-CBCT) in segmenting roots and crowns as well as measuring tooth length.

methodsHD-CBCT and LD-CBCT scans were taken of four human cadaveric heads. Thirty single-rooted teeth were segmented twice by one investigator. The length of each tooth was also measured. Lin's concordance correlation coefficient (CCC) was calculated to assess the agreement of HD-CBCT and LD-CBCT measurements and the intraclass correlation coefficient (ICC) was calculated to assess intrarater reliability. Analyses were supported by Bland-Altman plots.

resultsVolume measurements obtained using HD-CBCT were significantly higher than those obtained using LD-CBCT (p < 0.001). CCC was 0.975 (95% confidence interval [CI] = 0.956-0.986) indicating excellent agreement between the two modalities. Intrarater reliability between the two sets of LD-CBCT and HD-CBCT volume measurements was excellent (ICC = 0.998, 95%CI = 0.995-0.999 [HD-CBCT], ICC = 0.997, 95%CI = 0.992-0.998 [LD-CBCT]). CCC for tooth length measurements was 0.991 (95% CI = 0.983-0.995), indicating excellent agreement between HD-CBCT and LD-CBCT. Intrarater reliabilities between the two sets of tooth length measurements were also excellent for both methods (ICC = 0.998, 95%CI = 0.995-0.999 [HD-CBCT], ICC = 0.997, 95%CI = 0.992-0.998 [LD-CBCT]).

conclusionsWithin the limitations of this experimental setting, LD-CBCT is as valid as HD-CBCT for measuring tooth length. Regarding the volume differences, in vivo studies are required to determine their clinical relevance.

Indexed as

Cone-Beam Computed TomographyImaging, Three-DimensionalOdontometryPatient Care PlanningToothCadaverHumansIn Vitro TechniquesRadiation DosageReproducibility of ResultsSensitivity and SpecificityLow-dose cone-beam computed tomographyRadiation exposureThree-dimensional imagingTooth lengthTooth volume

Identifiers

PMID39448399
PMCPMC12808202

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.