Aim: The accuracy in identifying anatomical landmarks on CBCT images can be affected by the presence of surrounding anatomical structures with similar radiodensity. The purpose of this study was to evaluate the effect of the presence of tooth structure on the accuracy in identifying the lamina dura surface, facial bone surface, facial and lingual bone margins, socket apex, as well as in facial bone thickness measurement. Materials & Methods: Three fresh cadaver heads were scanned using a NewTom 5G CBCT at 0.100 mm voxel size at three time-points: before extraction (T1), after extraction and reinsertion (T2), and after tooth removal (T3). Only single rooted teeth were extracted in a minimally traumatic fashion. The volumes were superimposed (Invivo 5.2) in pairs (T1-T2, T1-T3, T2-T3) and mid-sagittal images of each socket were produced. The lamina dura and facial bone surfaces were plotted at 3, 5, 7, 9, and 11 mm apical to the CEJ. In addition, the facial and lingual bone margins, and the socket apex were plotted. The point coordinates were recorded and the facial bone thickness calculated. The discrepancies of all parameters between time-points were compared using Wilcoxon Signed Rank test (α = 0.05). Results: Although there were statistically significant differences (p < 0.05) in time-point discrepancy in 5 of 21 parameters evaluated, the measured discrepancies were low and likely clinically inconsequential. Conclusions: At 0.100 mm voxel size, the ability to accurately identify socket lamina dura, and measure the facial bone thickness on CBCT images does not seem to be clinically affected by the presence of tooth structure, nor by the minimally traumatic extraction procedure.

LLU Discipline

Orthodontics and Dentofacial Orthopedics


Orthodontics and Dentofacial Orthopedics


School of Dentistry

First Advisor

Rungcharassaeng, Kitichai

Second Advisor

Caruso, Joseph M.

Third Advisor

Kan, Joseph

Degree Name

Master of Science in Orthodontics and Dentofacial Orthopedics (MSODO)

Degree Level


Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

Radiography - Dental - Digital; Cone-Beam Computed Tomography; Imaging - Three-Dimensional; Tooth Socket; Tooth Migration; Alveolar Process; Mandible

Subject - Local

CBCT; Radiodensity; Tooth Structure; Lamina Dura Surface; Facial Bone Surface; Facial and Lingual Bone Margins; Socket Apex



Page Count


Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives