Mistretta Fabio, Magnini Andrea, Cinci Lorenzo, Zanobini Patrizio, Pisano Maria, Barcali Eleonora, Bocchi Leonardo, Nardi Cosimo
Department of Experimental and Clinical Medicine, University of Florence, 50134, Florence, Italy.
Department of Experimental and Clinical Biomedical Sciences, University of Florence, Largo Brambilla 3, 50134, Florence, Italy.
Radiol Med. 2025 Jul 16. doi: 10.1007/s11547-025-02052-5.
Bone quality is currently considered a set of intrinsic characteristics of the bone, among which macro- and microarchitecture of the trabecular bone tissue stands out. The investigation of bone quality is crucial in maxillofacial area and especially in dental implant planning. Nevertheless, there is currently no consensus about what bone quality really represents. The aim of this study was to investigate the role of CBCT in assessing bone quality of mandibular and maxillary bones.
This systematic review included fourteen articles selected via PubMed, Embase, and Web of Science databases, with the following features: samples of maxillary or mandibular bones from living individuals or corpses; CBCT as diagnostic investigation tool; a reference standard in assessing bone quality. Ten studies using µCT as reference standard were included in the meta-analysis.
CBCT voxel size was from 80 to 400 µm. Only half of the studies evaluated a considerable number of morphometric parameters as described by the Society for Bone and Mineral Research. Meta-analysis was only possible for the 3D Accuitomo 170 CBCT scanner with a voxel size of 80 µm. Trabecular separation (Tb.Sp) and Degree of Anisotropy (DA) microstructural parameters showed moderate to low heterogeneity among studies without significative differences between CBCT and μCT.
High-resolution CBCT with a voxel size down to 80 μm should be considered a suitable tool for the assessment of bone microarchitecture. Tb.Sp and DA showed similar values between CBCT and μCT and they could thus be considered as reliable tools for the assessment of bone quality with CBCT. Nevertheless, the high heterogeneity in several bone microstructural parameters and the lack of standardization both in imaging protocols and in image analysis software made CBCT not adequate to be currently deemed the gold standard technique for the assessment of jawbones quality.
目前认为骨质量是骨骼的一组内在特征，其中小梁骨组织的宏观和微观结构尤为突出。骨质量的研究在颌面区域至关重要，尤其是在牙种植规划中。然而，目前对于骨质量究竟代表什么尚无共识。本研究的目的是探讨锥形束计算机断层扫描（CBCT）在评估下颌骨和上颌骨骨质量中的作用。
本系统评价纳入了通过PubMed、Embase和Web of Science数据库筛选出的14篇文章，其具有以下特点：来自活体或尸体的上颌骨或下颌骨样本；将CBCT作为诊断研究工具；有评估骨质量的参考标准。荟萃分析纳入了10项以微计算机断层扫描（µCT）作为参考标准的研究。
CBCT体素大小为80至400微米。只有一半的研究评估了骨与矿物质研究协会所描述的相当数量的形态计量学参数。仅对体素大小为80微米的3D Accuitomo 170 CBCT扫描仪进行了荟萃分析。小梁间距（Tb.Sp）和各向异性程度（DA）微观结构参数在各研究之间显示出中度至低度异质性，CBCT与µCT之间无显著差异。
体素大小低至80微米的高分辨率CBCT应被视为评估骨微观结构的合适工具。Tb.Sp和DA在CBCT与µCT之间显示出相似的值，因此它们可被视为用CBCT评估骨质量的可靠工具。然而，几个骨微观结构参数的高度异质性以及成像方案和图像分析软件中缺乏标准化，使得CBCT目前不足以被视为评估颌骨质量的金标准技术。
