Aim: Cone-beam computed tomography (CBCT) is becoming a common adjunct in orthodontic diagnosis and treatment, however several questions remain about the impact of surrounding anatomical structures and varying scan settings on the ability to delineate buccal bone and overall diagnostic quality of images produced. The aim of this study was to determine if adjacent structures with similar radiodensity and variable scan settings (field of view and voxel size) significantly impact the ability to accurately identify the tooth socket facial lamina dura, facial bone surface, facial bone margin, as well as the facial bone thickness measurement. Materials & Methods: CBCT scans (NewTom 5G) were performed on 2 fresh cadaver heads at 2 different time points, before (T1) and after (T2) tooth extraction, using 4 different scan settings that produced images in the decreasing order of clarity: 12x8 cm2 FOV at 100 μm voxel size (Group 1), 12x8 cm2 FOV at 150 μm voxel size (Group 2), 18x16 cm2 FOV at 150 μm voxel size (Group 3), and 18x16 cm2 FOV at 300μm voxel size (Group 4). The CBCT volumes were superimposed (Invivo 5.2) in pairs, before and after extraction, among the different scan settings (groups). Mid-sagittal images of the teeth were created and eleven total points along the external cortical border and facial lamina dura surface of each socket were identified. Absolute discrepancies between each pair were recorded and comparisons made using Wilcoxon Signed Rank Tests and Friedman’s Two-Way ANOVA (α = 0.05). Results: Although there were statistically significant differences (p < 0.05) in group and time-point discrepancies in 15 of 52 comparisons evaluated, the measured differences were low and likely clinically negligible. Conclusions: This study, with its own limitations, shows that the ability to accurately outline buccal bone, irrespective of the presence of the tooth structure, is not clinically significantly affected by the variation in FOV and voxel size of the CBCT images.

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 Y. K.

Degree Name

Master of Science (MS)

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 Eruption; Mandible

Subject - Local

Orthodontic Diagnosis and Treatment; Buccal Bone; Facial Lamina Dura; Facial Bone Surface; Facial Bone Margin



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