Head positioning in a cone beam computed tomography unit and the effect on accuracy of the three-dimensional surface mode

Head position during cone beam computed tomography (CBCT) examination can easily deviate from the ideal, which may affect the accuracy of the segmented three-dimensional (3D) model. The aim of this study was to determine the effect of head positioning on the accuracy of the 3D model. A human dry skull was positioned at predetermined orientations in a CBCT scanner and scanned in multiple orientations and voxel sizes. The resulting 3D surface models were superimposed over those derived from the reproducible centered positioned skull with 0 degrees inclination. Color mapping and analysis of the differences expressed by the root mean square error (RMSE) were performed. The RMSE for each orientation using the 0.3 mm voxel ranged from 0.31 to 0.87 mm for the whole maxillofacial region, from 0.44 to 0.91 mm in the maxilla, and from 0.31 to 0.72 mm in the mandible. For the 0.4 mm voxel, the RMSE ranged from 0.47 to 0.86 mm for the whole maxillofacial region, from 0.60 to 0.96 mm in the maxilla, and from 0.56 to 0.86 mm in the mandible. The maxilla showed a slightly higher deviation than the mandible in both voxel groups. It can be concluded that the head position affects the accuracy of the segmented 3D model, but the inaccuracy does not exceed clinically relevant levels.