In Vitro Evaluation of Accuracy of CBCT-Derived Volumes in Maxillary Defects: Effects of kVp, Device, and Software.

This study aimed to evaluate the accuracy of CBCT-based volumetric measurements of maxillary defects and to investigate the effects of different CBCT devices, kVp settings, and segmentation software on measurement accuracy. CBCT images from eight patients with maxillary defects were used to generate 3D-printed models for volumetric assessment. Two CBCT systems (Largev Smart and Planmeca Promax) were evaluated at three different kVp settings. Volume calculations were conducted using ITK-SNAP version 4.2.2 and 3D Doctor version 4.0 software, while micro-CT served as the gold standard (GS) for comparison. Statistical analysis included a three-way ANOVA to assess the effect of CBCT parameters and software on volumetric accuracy. Additionally, post-hoc Tukey HSD analysis was performed to identify specific differences between kVp groups, and Pearson correlation analysis was used to evaluate consistency with the GS. Significance level was set at < 0.05. Higher kVp settings significantly improved volumetric accuracy, with 100 kVp yielding the smallest deviations (-3.77%) from the GS. Tukey HSD analysis revealed significant differences between 60-80 kVp ( = 0.008), 60-100 kVp ( < 0.001), and 80-100 kVp ( = 0.041), confirming the influence of kVp on accuracy. No significant differences were observed between CBCT devices or software programs ( > 0.05). A strong positive correlation (r = 0.96) between CBCT-derived and micro-CT volumes confirmed CBCT's reliability for volumetric assessments ( < 0.001). CBCT provides accurate volumetric measurements of maxillary defects, particularly at higher kVp settings. These findings support its clinical application for preoperative planning and postoperative evaluation, offering a cost-effective alternative to micro-CT.