Accuracy of linear measurements obtained from stitched cone beam computed tomography images versus direct skull measurements

Background: To assess whether the linear measurements obtained from stitched cone beam computed tomography (CBCT) images were as accurate as the direct skull measurements. Methods: Nine dry human skulls were marked with gutta-percha at reference points to obtain Twenty-two linear measurements on each skull. Ten measurements in the cranio-caudal plane, two measurements in the antero-posterior plane, and ten measurements in the medio-lateral plane. CBCT linear measurements obtained using stitching software were measured and compared with direct skull measurements. Results: The absolute Dahlberg error between direct linear measurements and linear measurements on stitched CBCT images ranged from (0.07 mm to 0.41 mm). The relative Dahlberg error ranged from (0.2% to 1.8%). Moreover, Intra-class Correlation Coefficient (ICC) ranged from (0.97 to 1.0) indicating excellent agreement. Conclusion: Stitched CBCT linear measurements were highly comparable to the direct skull measurements using a digital caliper.