Detection of crestal radiolucencies around dental implants: an in vitro experimental study.
The aim of this study was to compare the diagnostic potentials and practical advantages of different imaging modalities in detecting bone defects around dental implants.
MATERIALS AND METHODS:
Crestal bone defects with sequentially larger diameters were randomly prepared around 100 implants that were inserted in bovine bone blocks. Conventional periapical radiography (PR), direct digital radiography (DDR), panoramic radiography (PANO), cone-beam computed tomography (CBCT), and multislice computed tomography (MSCT) were performed for all specimens. The diagnostic accuracies of the devices, confidence of the answers, subjective image quality, defect visibility in planar orientations, and duration of diagnosis were analyzed based on the interpretations of 7 calibrated observers.
The agreement levels of intra- and interobserver scores were rated good. PR, DDR, and CBCT were mostly more accurate than PANO and MSCT (P < .05). Confidence levels were positively correlated with the defect size (ρ = 0.20, P < .01), and that of DDR was the highest (P < .05). The subjective image quality of PR and DDR was higher than that of CBCT, PANO, and MSCT (P < .05 for all comparisons). Axial-coronal-sagittal visibilities of the defects were higher for CBCT compared with MSCT (P < .05). The diagnostic time was shorter for DDR (P < .05) and longer for the tomographic systems (P < .05) than for the other devices.
DDR may provide a faster and more confident diagnostic option that is as accurate as PR in detecting peri-implant radiolucencies. CBCT has a comparable potential to these intraoral systems but with slower decision making and lower image quality, whereas PANO and MSCT become more reliable when bone defects have a diameter that is at least 1.5 mm larger than that of the implant
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ABSTRACT: Objective: To investigate the reliability and accuracy of CBCT images obtained at different FOVs in detecting and quantifying simulated buccal marginal alveolar peri-implant defects. Methods: Simulated buccal defects were prepared in 69 implants inserted into cadaver mandibles. Cone beam computed tomographic (CBCT) images at 3 different fields of view were acquired: 40 x 40 mm; 60 x 60 mm, and; 100 x 100 mm. The presence or absence of defects was assessed on 3 sets of images using a 5-point scale by three observers. Observers also measured the depth, width and volume of defects on CBCT images which were compared to physical measurements. Kappa was calculated to assess intra- and inter-observer agreement. Six-way repeated ANOVA was used to evaluate treatment effects on the diagnosis. Pairwise comparisons of median true positive (TP) and true negative (TN) rates were calculated by the Chi-square test. Pearson correlation coefficient was used to determine the relationship between measurements. Significance level was set as p<0.05. Results: All observers had excellent intra-observer agreement. Defect status (p<0.001) and defect size (p<0.001) factors were statistically significant. Pairwise interactions were found between defect status and defect size (p=0.001). No differences between median TP or TN values were found between CBCT FOVs (p>0.05). Significant correlations were found between physical measurements and CBCT measurements (p<0.001). Conclusion: All CBCT images performed similarly for the detection of simulated buccal marginal alveolar peri-implant defects. Depth, width and volume measurements of the defects from various CBCT images correlated highly with physical measurements.Dentomaxillofacial Radiology 03/2014; DOI:10.1259/dmfr.20130332 · 1.27 Impact Factor
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ABSTRACT: OBJECTIVE: To assess the accuracy of cone-beam computed tomography (CBCT) in periimplant fenestration and dehiscence detection, and to determine the effects of 2 voxel sizes and scan modes. STUDY DESIGN: One hundred titanium implants were placed in bovine ribs in which periimplant fenestration and dehiscence were simulated. CBCT images were acquired with the use of 3 protocols of the i-CAT NG unit: A) 0.2 mm voxel size half-scan (180°); B) 0.2 mm voxel size full-scan (360°); and C) 0.12 mm voxel size full scan (360°). Receiver operating characteristic curves and diagnostic values were obtained. The Az values were compared with the use of analysis of variance. RESULTS: The Az value for dehiscence in protocol A was significantly lower than those of B or C (P < .01). They did not statistically differ for fenestration (P > .05). CONCLUSIONS: Protocol B yielded the highest values. The voxel sizes did not affect fenestration and dehiscence detection, and for dehiscence full-scan performed better than half-scan.01/2013; 115(1):121-127. DOI:10.1016/j.oooo.2012.10.003