Preliminary study: evaluating the reliability of CBCT images for tongue space measurements in the field of orthodontics

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Oral Radiology


Introduction: Accurately measuring tongue space is challenging, but this information can be useful to many dental specialties. This study was intended to estimate the reliability of using cone-beam computed tomography (CBCT) to measure tongue space, which includes tongue volume and the oral cavity air capacity. Methods: For this preliminary study, CBCT images from ten participants (five females and five males, mean age of 29.8 ± 3.3 years) were available for evaluation. Each participant was radiographed two times (T0 and T1). The average time between T0 and T1 was 15.8 ± 3.7 days. CBCT scans were standardized to reduce variability. Three-dimensional landmarks were established to identify tongue space and 3D image analysis software (SimPlant® 17 Pro; Materialise Dental, Leuven, Belgium) was used to measure the volume circumscribed by the landmarks. Two investigators independently calculated airway, tongue dimensions, and total tongue space for CBCT image T0 twice (day 1 and day 14), and T1 once. Intraclass correlation coefficients (ICCs) were used to estimate intra-rater and inter-rater reliability. Bland–Altman charts were constructed to demonstrate agreement within and between raters. Results: The intra-rater and inter-rater ICCs of the CBCT measurements at T0 were excellent (> 0.90). Measurements for T0 vs. T1 show good (0.75–0.90) intra-rater and excellent (> 0.90) inter-rater reliability. Bland–Altman charts show that 90–95% of the total measurements fall within the 95% limits of agreement for both intra- and inter-rater pairs Conclusions: The results of this preliminary study suggest that the landmarks chosen to measure the overall tongue space are reproducible and can be measured clearly using CBCT.

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