Comparison between Two Computer Simulation Systems for Volumetric Analysis of Alveolar Bone Grafts Using Cone Beam Computed Tomography

Abstract

In the current study, the accuracy and reliability of two commercially available imaging software programs named as Planmeca Romexis viewer 3.5.1R (Planmeca Oy, Helsinki, Finland) and Mimics15.0 (Materialise Interactive Medical Image Control System, Leuven, Belgium) were compared in segmentation and calculation of ABG volume postoperatively using CBCT with referral to the clinical volume of bone graft as the GS. Thirty patients of both sexes with cleft lip and primary palate and/or cleft palate (CL+/-P) who received secondary alveolar cleft grafting at the Oral and Maxillofacial Surgery Department, Faculty of Dentistry, Ain Shams University were enrolled in this study. To assess bone graft volume, CBCT data were analyzed using the two semiautomatic segmentation softwares for each patient and the volumetric results were compared in relation to the clinically calculated bone graft volume by the syringe. Mimics software was found to be twice as accurate as Planmeca Romexis software in ACG volumetric calculations. Although both softwares recorded statistically significant underestimation and over estimation of ACG volume as compared to the GS, Mimics volumetric error (-0.3cm3) could be considered clinically insignificant. Radiologists and clinician should take into consideration the percentage of Mimics minification (-17.5%) in their volumetric measurements of ABG which is more acceptable than Planmeca Romexis percentage error (38%). Regarding the inter/intraobserver analysis of measures taken from both software programs it was found that, no statistically significant difference either between the first and second readings of the first observer or between the two observers. So, ACG volume determination using Mimics software program combined with CBCT is a reproducible and practical method for assessing the secondary ABG in patients with UCLP and BCLP.