{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T10:50:08Z","timestamp":1761130208487,"version":"build-2065373602"},"reference-count":35,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T00:00:00Z","timestamp":1735862400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dentistry Journal"],"abstract":"<jats:p>Objectives: Buccal cortical bone dimensions are crucial in dental radiology, as they impact orthodontic treatment outcomes. Changes in alveolar bone dimensions can result in malocclusion and require interdisciplinary approaches for correction. The accurate quantification of buccal bone dimensions is crucial for appropriate treatment planning and avoiding medico-legal issues. This study aimed to compare buccal bone height measurements between three-dimensional (3D) digital imaging and communications in medicine (DICOM) data and portable document format (PDF) cone beam computer topography reports for mandibular frontal teeth, testing the hypothesis of no difference in values between the two modalities. Methods: Each of the five observers performed a total of 720 height measurements (360 by DICOM and 360 by PDF), yielding a total of 3600 measurements overall. Results: Compared with the DICOM format, using PDF files was associated with a significantly greater rate of inability to carry out the measurements (8.8% vs. 3%, respectively, p &lt; 0.001, chi-square). The average buccal bone height measured in the DICOM was 11.51 mm, which was significantly greater than the 10.35 mm measured in the PDF (p &lt; 0.001). The mean height measured by the DICOM was consistently greater than that measured by the PDF, with highly significant differences in the findings of four of the examiners (p &lt; 0.001). Conclusions: Viewing modality significantly affected the height of the buccal bone in the frontal mandibular area. Compared with the generated PDF reports, the 3D DICOM viewer performed better than the printed PDF and enabled more measurements in the target area.<\/jats:p>","DOI":"10.3390\/dj13010022","type":"journal-article","created":{"date-parts":[[2025,1,3]],"date-time":"2025-01-03T05:02:02Z","timestamp":1735880522000},"page":"22","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Can Viewing Modality Affect Frontal Mandibular Bone Height Measurement? A Comparison Between 3D Digital Imaging and Communications in Medicine Viewer and Printed Portable Document Format Cone Beam Computer Tomography Reports"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2038-3681","authenticated-orcid":false,"given":"Michael","family":"Solomonov","sequence":"first","affiliation":[{"name":"Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"},{"name":"\u201cBina\u201d Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4167-9553","authenticated-orcid":false,"given":"Yoav","family":"Shapinko","sequence":"additional","affiliation":[{"name":"Departments of Orthodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ella","family":"Lalum","sequence":"additional","affiliation":[{"name":"Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"},{"name":"\u201cBina\u201d Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6798-3900","authenticated-orcid":false,"given":"Joe","family":"Ben Itzhak","sequence":"additional","affiliation":[{"name":"Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"},{"name":"\u201cBina\u201d Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sapir","family":"Argaman","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces (IDF), Ramat Gan 52625, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matan","family":"Schottig","sequence":"additional","affiliation":[{"name":"Departments of Orthodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amit","family":"Halpern","sequence":"additional","affiliation":[{"name":"Medical Corps, Israel Defense Forces (IDF), Ramat Gan 52625, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nirit","family":"Yavnai","sequence":"additional","affiliation":[{"name":"Department of Community Dentistry, Faculty of Dental Medicine, Hebrew University, Hadassah Ein Kerem Campus, Jerusalem 91120, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9152-0885","authenticated-orcid":false,"given":"Idan","family":"Stiklaru","sequence":"additional","affiliation":[{"name":"Departments of Endodontics, Israel Defense Forces (IDF), Medical Corps, Tel Hashomer Medical Center, Ramat Gan 52621, Israel"},{"name":"\u201cBina\u201d Program, Faculty of Dental Medicine, Hebrew University of Jerusalem, Jerusalem 12271, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,3]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"470","DOI":"10.1038\/s41415-019-0164-3","article-title":"Governance concerns in CBCT interpretation and reporting","volume":"226","author":"Mahmood","year":"2019","journal-title":"Br. Dent. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"502","DOI":"10.1111\/iej.12267","article-title":"European Society of Endodontology position statement: The use of CBCT in endodontics","volume":"47","author":"Patel","year":"2014","journal-title":"Int. Endod. J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1016\/j.ijom.2009.02.028","article-title":"Cone-beam computerized tomography (CBCT) imaging of the oral and maxillofacial region: A systematic review of the literature","volume":"38","author":"Casselman","year":"2009","journal-title":"Int. J. Oral. Maxillofac. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1007\/s10278-011-9377-y","article-title":"Exploring CBCT-Based DICOM Files. A Systematic Review on the Properties of Images Used to Evaluate Maxillofacial Bone Grafts","volume":"24","author":"Marcantonio","year":"2011","journal-title":"J. Digit. Imaging"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e37","DOI":"10.1016\/j.tripleo.2010.05.008","article-title":"The effects of slice thickness and interslice interval on reconstructed cone beam computed tomographic images","volume":"110","author":"Chadwick","year":"2010","journal-title":"Oral. Surg. Oral. Med. Oral. Pathol. Oral. Radiol. Endod."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"S130","DOI":"10.1016\/j.ajodo.2010.01.015","article-title":"Considerations in the use of cone-beam computed tomography for buccal bone measurements","volume":"137","author":"Molen","year":"2010","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"140","DOI":"10.1111\/prd.12194","article-title":"Effect of orthodontic treatment on the periodontal tissues","volume":"74","author":"Antoun","year":"2017","journal-title":"Periodontology"},{"key":"ref_8","first-page":"46","article-title":"Mucogingival considerations in orthodontic treatment","volume":"2","year":"1996","journal-title":"InSeminars Orthod."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"6-e1","DOI":"10.1016\/j.ajodo.2006.01.015","article-title":"Periodontal status of mandibular central incisors after orthodontic proclination in adults","volume":"130","author":"Yared","year":"2006","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.ajodo.2009.04.016","article-title":"Working with DICOM craniofacial images","volume":"136","author":"Grauer","year":"2009","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Jacobs, R., Salmon, B., Codari, M., Hassan, B., and Bornstein, M.M. (2018). Cone beam computed tomography in implant dentistry: Recommendations for clinical use. BMC Oral. Health, 18.","DOI":"10.1186\/s12903-018-0523-5"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"353","DOI":"10.1016\/j.ajodo.2012.10.019","article-title":"Factors affecting the accuracy of buccal alveolar bone height measurements from cone-beam computed tomography images","volume":"143","author":"Wood","year":"2013","journal-title":"Am. J. Orthod. Dentofac. Orthop."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1016\/j.crad.2020.04.006","article-title":"Cone-beam computed tomography and its applications in dental and maxillofacial radiology","volume":"75","author":"Schulze","year":"2020","journal-title":"Clin. Radiol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1038\/sj\/dmfr\/4600448","article-title":"Development of a compact computed tomographic apparatus for dental use","volume":"28","author":"Arai","year":"1999","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1148\/radiol.13130225","article-title":"Dedicated cone-beam CT system for extremity imaging","volume":"270","author":"Carrino","year":"2014","journal-title":"Radiology"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1016\/j.anorl.2010.10.008","article-title":"Cone-beam imaging: Applications in ENT","volume":"128","author":"Hodez","year":"2011","journal-title":"Eur. Ann. Otorhinolaryngol. Head Neck Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1007\/s00270-005-0287-6","article-title":"Cone-beam CT with flat-panel-detector digital angiography system: Early experience in abdominal interventional procedures","volume":"29","author":"Hirota","year":"2006","journal-title":"Cardiovasc. Interv. Radiol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"E11","DOI":"10.3171\/2016.9.FOCUS16356","article-title":"Stereotactic radiosurgery for intradural spine tumors using cone-beam CT image guidance","volume":"42","author":"Monserrate","year":"2017","journal-title":"Neurosurg. Focus."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.ejrad.2010.11.028","article-title":"Effective dose range for dental cone beam computed tomography scanners","volume":"81","author":"Pauwels","year":"2012","journal-title":"Eur. J. Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1558","DOI":"10.1007\/s003300050586","article-title":"A new volumetric CT machine for dental imaging based on the cone-beam technique: Preliminary results","volume":"8","author":"Mozzo","year":"1998","journal-title":"Eur. Radiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"792","DOI":"10.1111\/iej.13916","article-title":"ESE position statement on root resorption","volume":"56","author":"Patel","year":"2023","journal-title":"Int. Endod. J."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1111\/iej.12824","article-title":"External cervical resorption: A three-dimensional classification","volume":"51","author":"Patel","year":"2018","journal-title":"Int. Endod. J."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1675","DOI":"10.1111\/iej.13187","article-title":"European Society of Endodontology position statement: Use of cone beam computed tomography in Endodontics: European Society of Endodontology (ESE) developed by","volume":"52","author":"Patel","year":"2019","journal-title":"Int. Endod. J."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"914","DOI":"10.1016\/j.joen.2021.02.015","article-title":"Diagnosis and management of traumatic dental injuries using intraoral radiography and cone-beam computed tomography: An in vivo investigation","volume":"47","author":"Patel","year":"2021","journal-title":"J. Endod."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/S8756-3282(99)00009-5","article-title":"Histomorphometric study of bone reactions during orthodontic tooth movement in rats","volume":"24","author":"Verna","year":"1999","journal-title":"Bone"},{"key":"ref_26","first-page":"283","article-title":"The biology of fracture healing. An overview for clinicians. Part I","volume":"248","author":"Frost","year":"1989","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1111\/j.1600-0757.2011.00421.x","article-title":"Development of prognostic indicators using classification and regression trees for survival","volume":"58","author":"Nunn","year":"2012","journal-title":"Periodontology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1259\/dmfr\/12615645","article-title":"The current status of cone beam computed tomography imaging in orthodontics","volume":"40","author":"Kapila","year":"2011","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"20140282","DOI":"10.1259\/dmfr.20140282","article-title":"CBCT in orthodontics: Assessment of treatment outcomes and indications for its use","volume":"44","author":"Kapila","year":"2015","journal-title":"Dentomaxillofacial Radiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2096","DOI":"10.1038\/s41467-022-29637-2","article-title":"A fully automatic AI system for tooth and alveolar bone segmentation from cone-beam CT images","volume":"13","author":"Cui","year":"2022","journal-title":"Nat. Commun."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1449","DOI":"10.14219\/jada.archive.2004.0056","article-title":"The standard of care in dentistry: Where did it come from? How has it evolved?","volume":"135","author":"Graskemper","year":"2004","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/0096-6347(47)90209-3","article-title":"Case analysis and treatment planning based upon the relationship of the tooth material to its supporting bone","volume":"33","author":"Howes","year":"1947","journal-title":"Am. J. Orthod. Oral. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1590\/2177-6709.25.6.079-116.sar","article-title":"Orthodontic treatment of periodontal patients: Challenges and solutions, from planning to retention","volume":"25","author":"Feu","year":"2021","journal-title":"Dent. Press. J. Orthod."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"151589","DOI":"10.1016\/j.aanat.2020.151589","article-title":"Structural features of the anterior region of the mandible","volume":"233","author":"Paulsen","year":"2021","journal-title":"Ann. Anat.-Anat. Anz."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"151512","DOI":"10.1016\/j.aanat.2020.151512","article-title":"Anatomical and radiological features of the bone organization of the anterior part of the mandible","volume":"231","author":"Paulsen","year":"2020","journal-title":"Ann. Anat.-Anat. Anz."}],"container-title":["Dentistry Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/1\/22\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:22:19Z","timestamp":1759918939000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2304-6767\/13\/1\/22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,3]]},"references-count":35,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1]]}},"alternative-id":["dj13010022"],"URL":"https:\/\/doi.org\/10.3390\/dj13010022","relation":{},"ISSN":["2304-6767"],"issn-type":[{"type":"electronic","value":"2304-6767"}],"subject":[],"published":{"date-parts":[[2025,1,3]]}}}