CBCT in Dental Research: Is Complexity Necessary? An Exploratory Proof-of-Concept Study

Abstract

This exploratory proof-of-concept study aimed to develop and preliminarily evaluate a 3D-printed holder designed for reuse in cone beam computed tomography (CBCT) in dental research, particularly for comparative studies requiring pre- and post-intervention tooth assessment. The holder was designed using computer-aided design software and fabricated from polylactic acid using 3D printing. A conventional alginate-based holder was used for comparison. The comparison therefore concerned two complete positioning systems with different geometries and modes of adaptation to the CBCT headrest. The two positioning devices were independently placed by two operators with different levels of experience, and all CBCT scans were acquired by the same operator. The procedure was repeated after a 5-day interval. Root canal morphology was assessed using volumetric and surface measurements, as well as voxel counts. The independently segmented canal models were qualitatively displayed together in their native coordinate space to visualize positional consistency between acquisitions. Paired analyses showed substantially lower positional deviations with the 3D-printed holder than with the conventional holder in all four acquisition comparisons (Holm-adjusted p < 0.001). Mean deviations ranged from 0.126 to 0.172 mm for the 3D-printed holder and from 3.626 to 8.318 mm for the conventional holder. Morphometric parameters derived from 3D analysis remained identical across all acquisitions, regardless of operator, time point, or positioning method. Qualitative 3D analysis showed near-complete overlap for the 3D-printed holder and clear spatial discrepancies for the conventional holder. Under the evaluated conditions, the 3D-printed holder exhibited less positional variability than the conventional alginate-based holder.