How accurate is CBCT in measuring bone density? A comparative CBCT-CT in vitro study
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Updated: May 15, 2026

Cortical Bone Assessment Using Ultrasonic Guided Waves: A Reproducibility Study in a Healthy Population
Published on: January 31, 2025
Michele Cassetta1, Luigi Vito Stefanelli, Andrea Pacifici
1Department of Oral and Maxillofacial Sciences, School of Dentistry, "Sapienza" University of Rome, Rome, Italy.
Purpose:
Recently, cone beam computed tomography (CBCT) has become widely used for oral and maxillofacial imaging. Twenty dry mandibles were CBCT and conventional multislice CT scanned to evaluate if there is a statistically significant difference between the bone density values they produce, defined as gray density values, and to determine any correlation between them.
Materials And Methods:
Using software and a radiographic template, the CT and CBCT scan images were overlapped, and two data sets were created, each one giving the respective gray values (voxel value [VV] or Hounsfield unit [HU]) of the same area with the same spatial coordinates. For the statistical analysis, t-test, Pearson's correlation, and Pearson's r were used.
Results:
The differences between the CBCT (VV) and CT (HU) gray density values were statistically significant (p ≤ .05), whereas the Pearson's correlation coefficients and Pearson's r-values demonstrated a statistically significant linear correlation between VV and HU gray density values.
Conclusion:
The lower radiation dose and reduced costs of CBCT make this a useful substitute for CT; however, this study has shown that, in order to more accurately define the bone density with CBCT, a conversion ratio needs to be applied to the VV.

