ArticleDento maxillo facial radiology2026
Novel marker-based cone-beam CT registration for enhanced accuracy in dental implant planning.
Article in Dento maxillo facial radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesAccurate image registration is essential for successful digital dental implant planning. Surface-based registration, commonly used in clinical software, is sensitive to cone-beam CT (CBCT) artifacts and relies on manual landmark selection, potentially reducing accuracy. Marker-based registration offers improved precision but is underused due to its technical complexity and time demands. The purpose of this ex-vivo study was to evaluate the accuracy of a novel marker-based registration method using limited-view CBCT reconstructions derived from 2 orthogonal projection images and to compare it with a conventional surface-based registration method.
methodsAn ex-vivo model consisting of a maxillary arch with removable 3D-printed teeth and a radiographic guide containing radiographic markers was used to simulate 5 metal artifact conditions. Full-view CBCT scans were acquired for each condition. For the conventional method, 3 examiners independently performed dual-scan registrations using user-defined surface landmarks on full CBCT reconstructions. For the proposed method, examiners selected orthogonal projection images where markers were clearly visible and limited-view reconstructions were generated to identify marker centroids. Registration error was measured as the point-to-point distance between corresponding surface reference points, standardized to a common frame of reference. Inter-rater reliability was also assessed.
resultsBoth methods maintained consistent performance across all artifact conditions. The proposed method demonstrated greater accuracy, with lower point-to-point registration errors and less spatial variation. Inter-rater reliability was excellent for the proposed method and good for the conventional approach.
conclusionThe proposed marker-based registration method using orthogonal projection images and limited-view CBCT reconstructions showed higher accuracy than conventional surface-based registration under controlled ex-vivo conditions. Although the workflow currently requires additional examiner input, it may improve precision in dual-scan protocols for implant planning. Future clinical studies and software developments are required to support clinical implementation.
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